Permit CITY OP TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00166
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/26/2013
Parcel: 1 S135DC00200
Jurisdiction: TIGARD
Site address: 11845 SW GREENBURG RD 100
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: Installation of (1) forced air furnace and a/c unit with venting. Per Planning, placement of a/c unit must be
screened from view from public right -of -way.
Contractor: GENERAL CONSTRUCTION SERVICES Owner: TWO G'S REAL ESTATE LLC
18395 WOOD THRUSH ST 18395 WOOD THRUSH ST
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503 - 684 -0550 PHONE: 503 -684 -0550
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/26/2013 $145.81
Class of Work: ALT Type of Const: Plan Review 03/26/2013 $36.45
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/26/2013 $17.50
Stories:
Project Valuation: $3,000.00
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 1 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $199.76
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 = rules ado. - = . the Oregon
Utility Notif - - - - liter. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0090. • • may o.: a cot of the rules
or dire questions to OU b . 'ng 503.232.1987 or 1.800.332.2344.
i
Issue. By: / / // , / Permittee Signature: /
Call 503.639.4175 by 7:00 a.m. for the next available insp. lion date.
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.
Mechanical Permit A lication FOR OFFICE USE ONI..Y
E IVED R ceivyd A ge , l a c e "e0/ / 66
City of Tigard DeateB / Permit No /7 a(
• ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' C : Phone: 503.718.2439 Fax: 503.598.1960MA 6 2013 D ateBy: Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITYOI?TIGARD Notified/Method: Supplemental Information
TYPE OF IaJdING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction v isit Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ b Q"------' -
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling 'Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: `\C� � Q. �tl , �•� - `IDCI / (requires site plan showing placement) 46.75
� ll n -� Furnace 100,000 BTU (ducts/vents) I 46.75
City/State /ZIP \�
1 E»'+ , w` Q(7 ?Z- Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: \ - 02 Project name: "1-03t,_. Sp C d' p/rc ->< Heat pump
C r - (requires site plan showing placement) 61.06
Cross street/directions to i
b o site: �
J , c'Ze.O.\� v`,� C ''''C:40 Duct work 1 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above I 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
� Gas fireplace/insert 33.39
�- �� C ALL (\ A L tl
Y m1 \,, CG AS Flue vent for water heater or gas
LW e.-`42- s '$'•3\ A - fireplace 23.32
`~-- Log lighter (gas) 23.32
Wood/pellet stove 33.39
lD Q 0k4» J,.,+D L L4J1 Lk) (i Wood fireplace /insert 23.32
PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
/' 1^ Other: 23.32
NamE- TIAA /> `' 7 `7�Q'A- �-ii \ e LLB— Environmental exhaust and ventilation:
Address: S'NAf va '�Y V,S - `Nc , S Range hood/other kitchen
equipment 33.39
City/State/ZIP: l_s>,V., (C, Co O ) 0 - ° C?o : 3 , Clothes dryer exhaust 33.39
gy -(, , ��- a Fax: d b SS 063
Single-duct compartments, rtments (bathrooms, utility rooms)
Phone: (
( � �2 toilet compartments, utility roo 23.32
`.® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Other: 23.32
���5 � Fuel piping:
Contact name: cX \. $14.15 for first four; $4.03 for each additional
Address: \q„: f 00 \ e. ) Furnace, etc.
Gas heat pump
City /State /ZIP: \ 0;;Issw,,e2o0 AC_ 1'703_5 Wall /suspended/unit heater
Phone:63 )7y1, q 07 Fax: :,5113 j22o _,f3 Water heater
Fireplace
E -mail: ''\`V � �G c t r;Tyl_r ‘ k...\10 ‘ C c i(\( N Range
CONTRACTOR Barbecue
Business name:
C Clothes dryer (gas)
\ % Other:
Address: Ylf000 , }N LAS \-\ S \ MECHANICAL PERMIT FEES*
City /State /ZIP Q es 4 z ( l .") c..) -_.s subtotal
Phone: ) ' l a 9 4 3 bpi Fax:.6131-24:17-0 �5� Minimum (25% fee permit fee)
Plan review (25 /o of permit fee)
CCB lic.: \cgL State surcharge (12% of permit fee)
/ TOTAL PERMIT FEE 177 •7(0
This permit application expires if a permit is not obtained within 180
Authorized sign. ;.4:
. e: �� days after it has been accepted as complete.
Print name: I y O��_ Date: — z1 0 -' ' • Fee methodology set by Tri County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 03/07/12 440-4617T (I1 /07JCOM/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
$i 00,000.00. -
$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.
I -
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