Permit .
• a CITY OF TIGARD
MECHANICAL PERMIT
a �. - COMMUNITY DEVELOPMENT Permit #: MEC2013 -00103
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/19/2013
Parcel: 25101 DD00101
Jurisdiction: Tigard
Site address: 6975 SW SANDBURG ST
Project: Verizon Wireless Subdivision: TECH CENTER BUSINESS PARK Lot: C
Project Description: Installation of generator and gas line
Contractor: TURNURE TELECOM LLC Owner: WESTON INVESTMENT CO LLC
2683 151ST PLACE NE 2154 NE BROADWAY, STE 200
REDMOND, WA 98052 PORTLAND, OR 97232
PHONE: 425 - 822 -6860 PHONE:
FAX:
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FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/19/2013 $176.51
Class of Work: ALT Type of Const: Plan Review 02/19/2013 $44.13
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 02/19/2013 $21.18
Stories: Info Process /Archiving - Sm $0.50 (up to 02/19/2013 $1.00
11x17)
Project Valuation: $4,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
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Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP: -
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: • .
Heat Pump:
Appliances •
Vent Fans: Vent Systems: Total $242.82
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503:232.1987 or 1.800.332.2344.
c .,97...„1, Issued By: Y ■ 1 _ . Permittee Signature: ��
Call 503.639.4175 by 7:00 a.m. for the next available inspec n at .
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Applicat m -` 0 VCD Recet / FOR OFFICE USE ONLY •
q 13125 SW Hall Blvd., Tigard,OR 9722 •
City of Tigard a � Da ly / ! Permit No u�e_l 3 „ O a 0 Z '
iq (C
II
C Phone: 503.718.2439 Fax: 503.598.1960FEB 1 9 2013 Date B ie
Nh f ll I� O ther Permit: M H�AOI3� ODOO �
T I G A R D Inspection Line: 503.639.4175 Date Ready y: Jun s ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TI�IGARDr Notified/Method: "t1 C Supplemental Information
BUILDING D '13 Li COMMERCIAL FEE* SCHEDULE - USE'CHECKLIST
TYPE OF WORK
Mechanical permit fees' are based on the value of the work
❑ New construction NI Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all Z
El Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. r0
Value: $ I/ 000. e-?
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - and 2- family dwelling Cg Commercial /industrial ❑ Accessory building For special information use checklist. (�
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total �
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 1
Job site address: c g ? s 5 + (requires site plan showing placement) 46.75 a
Furnace 100,000 BTU (ducts/vents) 46.75 0
City/State/ZIP: 9 i4 2� , 9 7 a a 3 Furnace 100,000+ BTU ( ducts/vents) 54.91 (n
Suite/bldg. /apt. no.: Project name: Vitt, 7_e , R!! I E SS Heat pump 'J
(Li (requires site plan showing placement) 61.06 CA
Cross street/directions to job site: Duct work 23.32
/ Hydronic hot water system 23.32
t d
EA 54 S • ! o r T .A f. S 57 M LD 0(g fA2 >' <rnl7 Residential boiler (radiator or
/ / hydronic) 23.32
Unit heaters (fuel -type, not electric), e.
in -wall, in -duct, suspended, etc. 46.75 1C
Flue /vent for any of above 23.32 M
'77 Subdivision: s A E. Lot no.:
Other 23.32 a
Tax map /parcel no.: e V 5 / O I 'D - 00 / 0 I Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert 33.39
n./ 5 h4 l 1 A Awl 13".. 1 C ".1 E./z./k AP-4 94 s 1 Ai L Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Ei PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: I,3Es4-o,4 14 0,ekt nl CO L.L_ Environmental exhaust and ventilation:
Address: ?(.5--ii Range hood/other kitchen
/..� E i>R-o A 4� 4/ equipment 33.39
City /State /ZIP: F?0 R. 4- , ' 2 q 7 . w-?_ Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ®' CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: (41:; A2e,.x:. -I--s . ENgi�f£f 2 5 pc. Fuel pipin
Contact name: 77 ye , r3t�..12 / <E / $14.15 for first four; $4.03 for each additional
Furnace, Address: to q 76- .5W �j / 4 Not ,b ,,,,fa? s 1 - G as heat e um
/ pump
City /State /ZIP: 4 d , 02 9 aza 3 Wall/suspended/unit heater
Phone: (5 ) Fax:: ( ) Water heater
3 l � � (O 7 �/, 1 Fireplace
Email: .bi /c� �lpC.Ala' 4' fS• co AA-
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: '/ ,v 2I.f 4,?E 7 f /E co 04 L. L
Other:
Address: 024, g 3 /S/ 5f / /J. E . MECHANICAL PERMIT FEES*
City /State /ZIP: 7f oAl QI t t,t) A 9f P_S --- Subtotal
Phone: Fax: Minimum permit fee ($90.00)
('/ 5) g .. 6 S� o ( ) Plan review (25% of permit fee)
CCB lie.: .tt ) ( 5 1 ? 9 e State surcharge (12% of permit fee)
A.4...-------.., TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete.
Print name: - C O ZY K2 Date: Z ,/� 0 / ' Fee methodology set by Tri- County Building Industry Service Board
1:\Building\Permits\MEC- Permi tApp,doc 09/09/10 440 -4617T (II1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
'Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$ 10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including •
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including ti�
$100,000.00.
• ;f
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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1:\Building\Permits\MEC- PermitApp.doc 09/09/10
2
i ll i g
Building Division
Development Code Provision Review
T i c A R ° Commercial Projects with Approved Land Use
Building Permit No.: At g C_.. 9-0(3 — oo (
Land Use Casefile No.: )`'t )1D c90( Z ?
Routed Plans: ( Submittal Date: / 1 3
Submittal Date:
Submittal Date:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies
to the Building Division. Only checked ( ✓) items are approved. Items not approved and those listed in the
notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed
above each section.
STAFF: please only mark those items on the left side that are approved.
Planning Review (contact at 503 - 718 - 24 or 14,6_1 @tigard - or.gov)
Lid' Land Use Approval
EV _/
Building Plans Match Approved Plan: Yes lid' No ❑
❑ Maximum Building Height NI A-
f "Conditions Met
❑ Street Trees
❑ Protected Trees
Notes: rY mD2A1 3'0000°1 D(ppMfad
Original Plan: Approved DI Not Approved ❑ Date: 241111
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
❑ Actual Slope:
❑ PFI Permit #
❑ Conditions Met
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ . te:
Revision 2: Approved • Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert()tigard- or.gov)
❑ Planning Okay to Issue Permit ❑ '..orist Okay to Issue Permit
❑ Engineering Okay to Issue Permit
Notes:
Original Plan: Date Sent to Appli nt:
Revision 1: Date Sent to A cant
Revision 2: Date Sent to pplicant
Okay to Issue Permit: 'Yes ❑ . No ❑
Date Routed to Building:
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Page 2 of 2
° Building Division
Over- The - Counter (OTC) Mechanical Permit
TIGARD
Check List
Project Description: (5 oj M 0 3-vU f 0
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: COVti Oregon Specialty Code:
Number of Stories:
FUEL FURNACES
Type: Furnace < 100K BTU Furnaces >= 100K BTU
Gas Pressure: Roof Top Unit (RTU) Tons
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler (BTUs) Vent Fans Gas Line 1O)
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work Gas Fireplace
Fire /Smoke Dampers Other Mechanical Units — Describe:
Total Project Valuation: $ Aporr) FEES DUE
$ 17 (,, • j ( Mechanical Permit Fee
$ 44-, (? Plan Review
$ , [E) 12% State Surcharge
$ Info Proc /Arch, Lg (over 11x17 $2.00)
$ ( ,CCD Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Misc. Admin Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff:
Date /Time: $ 2k�,e ,TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OUR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC- MEC.docx 01/13/2011
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