Permit CITY OF TIGARD MECHANICAL PERMIT
:114
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00185
T t GA R.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/22/2013
Parcel: 1 S135DC00200
Jurisdiction: TIGARD
Site address: 11845 SW GREENBURG RD 120
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: Gas furnace and duct work for TI. This HVAC services suite 120 & 110.
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:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/22/2013 $130.46
Class of Work: ALT Type of Const: VB Plan Review 04/22/2013 $32.62
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 04/22/2013 $15.66
Stories:
Project Valuation: $2,500.00
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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $178.74
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 : • -s a • all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if • 's not •rted within 18c days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you • follow he r. es adopted by e Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -! • -0090. :y obtain a c• • of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. �
1
Issued By: k )<` / Permittee Si • - atu
u Call 503.639.4175 by 7:00 a.m. for the next a •bl- 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 Applicatio E
RED rtlli
O. FI(I l SF ON I 'i
City Ti and Re ceived Permit No.
IN 111 131 SW Hall Blvd., Tigard,OR 97223 APR 0 3 2013 Date/By: Z i ` i ilj- , � e2p /3 / / � Plan II Phone: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: e• *,, Pr �
D �, ,� � ' � � Other Perm' �0/3 �D 7
TIGARD Inspection Line: 503.639 OF TIGARD Date Ready
Internet: www.tigard- or.gov CITY \
DI V ISK) Notified/Method. Jur H Se P g e 2 for
Bt91LD�1G v t<,Jf` Supplemental Information
TYPE OF WORK 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, overhead, and profit.
Value: $ 2_46w- °V - - -
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling- TCommercial /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
Job site address: \ U ■l ‘k (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City/State/ZIP:-T i ' .( / b� 'f'? ^ Z� Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Q ... ., CQ �, r _ Duct work 23.32
� -r' 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 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
S Gas fireplace/insert 33.39
�'C `�'�. <`-'� - \c V`� 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
.I PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: 1 - u c_, 7 ,a�L g� \ Environmental exhaust and ventilation:
Address: \ iVef ;,N\t \),_S \N, S
� A ?� ' Range hood/other kitchen
equipment 33.39
City /State /ZIP: L/).`t._ v..Ai t.?__ is 0 ) 0 ::),„ C7 17 p`3 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
�Q APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: C..... Other: 23.32
. ��� — f � �r ` � Fuel piping:
Contact name: \ $14.15 for first four;
$4.03 for each additional
Address: \Q(?� -- 'yvt ) \-.�Y S \\ c..,--c Furnace, etc.
/}� >� Gas heat pump
City /State /ZIP: `_._Q+ L CJ w t?-0 J v on 0 '3 Wall /suspended/unit heater
Phone: (d3)� ■.y-j,..e l Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name:
L Clothes dryer (gas)
\ �
Other:
Address: q 3 q (, \j } ,, S \-\- MECHANICAL PERMIT FEES*
City /State /ZIP: 1& R � ev p e) Subtotal
Phone: (� j )g' _ 431 Fax: ( ) Minimum permit fee ($90.00)
1 Plan review (25% of permit fee)
CCB lic.: \ L'.6 \ ....e , nO\ \ State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ���" C> U .-. .- J > Date: •I) /3) v * Fee methodology set by Tri- County Building Industry Service Board
I:\ B \ \
uilding PermitsMEC- PennitApp.doe 03/07/12 440 -4617T (11 /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 $20721 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\Permits\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
11845 SW GREENBURG RD 120, TIGARD, OR,
97223
Commercial - Mechanical
625 Duct work
05/29/2013 00:00
MEC2013-00185
PASS
Violation Summary:
Inspector Contractor
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
11845 SW GREENBURG RD 120, TIGARD, OR,
97223
Commercial - Mechanical
610 Gas Line
05/29/2013 00:00
MEC2013-00185
PASS
60# for 30 minutes
Violation Summary:
Inspector Contractor
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
11845 SW GREENBURG RD 120, TIGARD, OR,
97223
Commercial - Mechanical
610 Gas Line
05/29/2013 00:00
MEC2013-00185
PASS
60# for 30 minutes
Violation Summary:
Inspector Contractor