Permit CITY OF TIGARD MECHANICAL PERMIT
II
a . COMMUNITY DEVELOPMENT Permit: MEC2013 -00163
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04 /08/2013
TIGARD 9 Parcel: 1 S 134AA02100
Jurisdiction: Tigard
Site address: 10300 SW NIMBUS AVE P -A
Project: FMC Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 3
Project Description: HVAC modifications for new tenant.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: FRESENIUS MEDICAL CARE, NA
19300 SW 118TH AVE 5251 DTC PARKWAY
TUALATIN, OR 97062 GREENWOD VILLAGE, CO 80111
PHONE: 503 -691 -9699 PHONE: 303 - 712 -1814
FAX: 503 -691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/08/2013 $1,610.22
Class of Work: ALT Type of Const: IIIB Plan Review 04/08/2013 $402.56
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 04 /08/2013 $193.23
Stories: 1 Info Process /Archiving - Lg $2.00 (over 04/08/2013 $10.00
11x17)
Project Valuation: $59,900.00 Info Process /Archiving - Sm $0.50 (up to 04/08/2013 $5.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 - 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:
Heat Pump:
Appliances
Vent Fans: 2 Vent Systems: Total $2.221.01
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: 7
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
issuan if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Util• Notification Ceri _ . Thos- rules are set forth in OAR 952 -001 -0010 through OAR 952 -001 -0090. You may btain a copy of the rules
or irect questions to OUN• b allin. : 3.232.1987 or 1.800.332.2344.
( )
Iss ed By: k I /: Permittee Signature: X
Call 503.639.4175 by 7:00 a.m. for the next available inspection 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 Applicati ` FOR OFFICE USE ONLY
City of Tigard E ��D Received _ ,9.5' / Permit No.: H X ro /4
III • 13125 SW Hall Blvd., Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
MAR 2 5 2013 Date/By: 4— 13 anerPertnit: PJu pAolS - oa 00 9
I I ( . `1t I Inspection Line: 503.639.4175 Date Ready/By: *! Juns: 0 See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: / 3 �i Supplemental Information
TYPE OF WORK COMMERCIAL DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overheac rofit.
Value: $ ` - - 5/ rq
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMEN1 / STEMS 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. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
/ ..w ) _ r � Air conditioning
Job site address: lit/ �/`!' /t (requires site plan showing placement) 46.75
City /State /ZIP: -72.--i r01-016 Furnace 100,000 BTU (ducts/vents) 46.75
C/' _ Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: p,. A I Projec name: r_m Heat pump
v (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
��a/,� „ 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: I Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater .2337
g1/4 C _ ' / p Gas fire.lace/insert 33.39
6 7_,6111) (/ �l L ��/ Flue vent for water heater or gas ,-
fire rlace 23. 2
‘f-f . - Log lighter (gas) � 32
�l,(/t Wood/pellet stove 33.39
e'x' Ae,c.4 S -- Wood fireplace /insert 23.32
❑ PROPERTY OWNER 1 ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: 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
Business name: oh, A 2........
Other: 23.32
// �[ Fuel piping:
Contact name: . /�,(I /7/145L, $14.15 for first four; S4.03 for each additional
Address: (� � Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( 7 ) t [ % 7!b a Fax: : ( ) Water heater
"� �i Fire .lace
E -mail: / �/ � -e l I Range
(/' CONTRA(iTOR Barbecue
Business name: O II A Clothes dryer (gas)
mo d' Other:
Address: �/) /�� /, MECHANICAL PERMIT FEES*
City /State /ZIP: L/ ' r7 � t � 4 12 07 ',// 3 Subtotal
Phone: (�j f� / p Minimum permit fee ($90.00)
hone:
V�� 9 s / Fax: ( ) Plan review (25% of permit fee)
CCB lie.: / "7 2f -/J , f w � State surcharge (12% of permit fee)
t // !� 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: 1_,.e i v/ i //j . Date: 3 � .5 ' Fee methodology set by Tri- County Building Industry Service Board
I: \ Building \Permits\MEC-- PeermitApp.doe 03/07/12 ( 17T(I1 OM/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
$100,000.00.
$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:\ Building \Pertnits\MEC- PermitApp.doc 03/07/12 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10300 SW NIMBUS AVE P-A, TIGARD, OR,
97223
Commercial - Mechanical
615 Mechanical rough-in
04/09/2013 00:00
MEC2013-00163
PART
Duct work only
Violation Summary:
Inspector Contractor