Permit y CITY OF TIGARD MECHANICAL PERMIT
g COMMUNITY DEVELOPMENT Permit #: MEC2013 -00426
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/29/2013
Parcel: 2S113AA01000
Jurisdiction: Tigard
Site address: 16570 SW 72ND AVE B9
Project: Stay'N Power Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS C,C
Project Description: HVAC modification for TI, install (1) new restroom exhaust
Contractor: WILLAMETTE HVAC LLC Owner: PACIFIC REALTY ASSOCIATES
3075 SW 234TH AVE. #206 ATTN: N PIVEN
HILLSBORO, OR 97123 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 259 -3200 PHONE: 503 - 624 -6300
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/29/2013 $102.83
Class of Work: ALT Type of Const: Plan Review 07/29/2013 $25.71
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 07/29/2013 $12.34
Stories:
Project Valuation: $1,600.00
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:
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: 1 Vent Systems: Total $140.88
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
issuan , or if work is • spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Uf - Notification Center. os • - s are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain copy of the rules
r direct questions to OUNC b =fling 57 • 2.1987 or 1.800.332.2344.
Issued By: ` Permittee Signature: y gY-64,A
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 FOR OFFICE USE ONLY
City of Tigard RECEIVED Date/By: 7 ..21 / 3( Permit No.: H 2 /5 . Co
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review n 2
— eel Date /By: Other Permit: Pa�i 7 i! 6,3
TI G A RD Ins Line: 503.639.4175 J U l_ 2013 �
Date Read /B Ju ris
Ready /By: Vi See Page 2 for
Internet: www.tigard- or.gov Notified /Method: Supplemental Information
CITY OFTIGARD
TYPE OFKAMINGDIVISIO 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: $ $1,600.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 16570 SW 72nd Ave (requires site plan showing placement) 46.75
City /State / "LIP: Tigard OR Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Stay'N Power Heat pump
(requires site plan showing placement) 61.06
Cross streeUdirections 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
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
Gas fireplace /insert 33.39
Install or re- locate registers to accommodate new office layout. Install one Flue vent for water heater or gas
restroom exhaust. fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ 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
Phone: ( Fax: ( ) Single -duct exhaust (bathrooms,
) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: same as below Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E-mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Willamette HVAC, LLC Clothes dryer (gas)
Other:
Address: 3075 SW 234 Ave Suite 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro, OR 97123 Subtotal Ma.- �L
Minimum permit fee ($90.00)
Phone: (503) 259.3200 Fax: (503) 848.2597
Plan review (25% of permit fee)
CCB lie.: 56951 State surcharge (12% of permit fee) `a.
TOTAL PERMIT FEE gyp. $
Authorized signature: / This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: michael malstrom Date: 7/26/13 * Fee methodology set by Tri- County Building Industry Service Board
I \Building \ Permits \MEC - Permit App.doc 03/07/12 440 -4617T (I 1/02 /COM/WEB)