Permit CITY OF TIGARD MECHANICAL PERMIT
IN 2, COMMUNITY DEVELOPMENT Permit ft: MEC2013 -00329
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/01/2013
Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15353 SW SEQUOIA PKWY
Project: LA Fitness Subdivision: PACIFIC CORPORATE CENTER Lot: 3
Project Description: Install Lenox unit with curb adapter.
Contractor: WOLFER'S, INC Owner: PACIFIC REALTY ASSOCIATES LP
290 YOUNG ST ATTN: N PIVEN
WOODBURN, OR 97071 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 981 -4511 PHONE:
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/01/2013 $316.80
Class of Work: ALT Type of Const: IIIB Plan Review 07/01/2013 $79.20
Occupancy Grp: A - Occupancy Load: 12% State Surcharge - Mechanical 07/01/2013 $38.02
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 07/01/2013 $4.50
11x17)
Project Valuation: $8,858.00 Misc Administration Fee 07/01/2013 $5.00
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 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 $443.52
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.
Issued By: By: 4,0 Permittee Signature: brAi /9-pp L / ("41-7710
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 Application RECEVE FOR OFFIC E use ONLY
'T'' ece i ve d
City of Tigard DateBy: 6 /3 , . — Pennir No - _,, r, 3-_ .
' 13125 SW Hall Blvd., Tigard, OR 97223 JUN 1 3 2013 plan Revue•
Iii
0 . , Phone: 503.718.2439 Fax: 503.598.19 Date/By / �1 /� Other Permit:
T I G ARD Inspection Line: 503.639.4175 CITY 1 OF TIGAR I Date Ready / : y: T Juris: ® See Page 2 for
Internet: www.tigard or.gov otified /Method: / 76— Supplemental Information
BUILDING DIUISI 0
'GO
MMERCIAL' €EEE "'1SCHEDUL'E ,- USE+.CLLECKL;IST
Mechanical permit fees* are based on the value of the work
❑ New construction igi, Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, _ rofi .
Val∎
' . , AGATEGORYtOFICONSTRUCTION �-
:::: . - IRESIDENTIAL''EQUIPMENT irSYSTEMSSFEFS!,!..
❑ 1- and 2- family dwelling Ai Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
INFORMATION .AND; "LOCATION .i.
Heating, /cooling:
JOB °SITE.'
. ,i ; ; : Air conditioning
(requires site plan showing placement) 46.75
Job site address: 153 s .S t,.� S U G
3 � K- � Li
Fumace 100.000 BTU (ducts/vents) 46.75
City /State /ZIP: PO e 4, 1 s ,.,,, ti a Q . - g - 7 'u-ii Fumace 100.000+ BTU (ducts/vents) 54.91
Project name: t Heat pump
Suite/bldg./apt. no.: J - - _ . . (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 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
Lot no.: Flue/vent for any of above 23.32
Subdivision: Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCR1PTION' OF WORK - Water heater
2332
Gas fireplace /insert
33.39
-.416.4.(4,1( ' O j ris L- , o X P (�,�,IL� L) rt„ i -J- Flue vent for water heater or gas
fireplace 23.32
►N ‘‘ f-ln. G U fir) a. -p i.-t/ Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑;
Chimney /liner /flue /vent 23.32
rPRUPER {I3Y ;OWNER ;1 :'flENAN , Other: 23.32
Name: L q. �; 4„ y‘,12.4 ( Environmental exhaust and ventilation: ,
P Range hood /other kitchen
Address: Ia';S3 � rity Q ; r k„ wl equipment 33.3
City /State/ZIP: 90 d a y - 7aa y Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( log 9 T Fax: ( ) toilet compartments, utility rooms) 23.32
VI � _ ;ATP.IMOANT : ";t❑ CONIiA'CTJP,ERSON , i Attic /crawlspace fans 23.32 1
, Other: 23 (�
Business name: 1/11 • 1 -0 iS tyi k ( � � Fuel piping: I "
I Contact name: V `. tom ,5,, e �� a I ea r !� _ CR- IA— ✓- ? r/' �� $14.15 for first four; $4.03 for each additional
Address:
r , U Y' Furnace, etc.
Gas heat pump
City /State/ZIP: \A YAW 11 i 0 67 a -1 I Wall /suspended /unit heater
Phone: (isoa q g) 1 I Fax :: (,j q I a Rn I Water heater
Fireplace
E-mail: ) IcQ C W 0 l .- Cam' J ► E _-1-1.1-9 �� (ijl�Yl Range
CONTRAC TO- R : - Barbecue
Business name: 1 I t ALr Q g 1 Clothes dryer (gas)
/1 C Other:
ll J
Address: 7 ' " "" ` " "` : 'M);CHANICAL ":fERMLT:IiE � "
City /State/ZIP: K 0 b u ' 1� AV 01 In I Subtotal
L Minimum perndt fee ($90.00) r
Phone: (I3O3) �� I - '4 ✓ I I Fax: (i5)) gel - DgO 1 Plan review (25% of permit fee) ll�/
CCB lic.: „'' I ci I ( State surcharge (12% of permit fee) n
TOTAL PERMIT FEE
Anlhnrizert si rmalure �'
v-7 � V i � mow — , - � - /0 " r W This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.