Permit CITY OF TIGARD MECHANICAL PERMIT
8 COMMUNITY DEVELOPMENT Permit#: MEC2013-00483
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2013
Parcel: 2S101AD00800
Jurisdiction: Tigard
• Site address: 12550 SW 68TH AVE
Project: Heintzberger/Payne Subdivision: WEST PORTLAND HEIGHTS Lot: 26
Project Description: Installing NC split system for server room on exterior pad.
Contractor: AIR COMFORT INC Owner: BHKZ LLC
16055 SW 74TH AVE SUITE B 12600 SW 68TH PKWY
TIGARD,OR 97224 PORTLAND,OR 97223
PHONE: 503-260-7806 PHONE: 503-546-4151
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/20/2013 $130.46
Class of Work: ALT Type of Const: Plan Review 08/20/2013 $32.62
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/20/2013 $15.66
Stories: Info Process/Archiving-Sm$0.50(up to 08/20/2013 $2.50
11x17)
Project Valuation: $2,500.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm: 1
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $181.24
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 o.tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800
Issued By Permittee Signature: All �s
_ i / f�. '. /p°
Call 503.• 9.4175 by 7:00 a.m.for the next available inspectio �
This permit card shall be kept in a conspicuous place on the job site until completion o 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 .� r� Received Permit No.:
III ° 13125 SW Hal Blvd.,Tigard,OR 9 =,w ®no'�7 Plaan Revrew � / ,3 C I -4J L ,C
Phone: 503.718.2439 Fax: 503.598. it i A� Date/By: Other Permit: Bed), J ^OO i*
T I G A R D Inspection Line: 503.639.4175 P�V �l� S�Q Dale ReadyBy: lulls: Hi See Page 2 for
Internet: www.tigard-or.gov 0� ��, Notified/Method: Supplemental Information
TYPE OF WORK�1S)\ COMMERCIAL FEE*.SCHEDULE — USE CHECKLIST
$ Mechanical permit fees*are based on the value of the work
❑New construction '®aFddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition <❑Other: mechanical materials,equipment,labor,overhead,and profit.
— Value:$ . �1V •
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 El Other: Description Qty. Ea. Total
JOB SITE INFORMATION.AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 1 s-1-0 c 1;,L) 6't4 A t/_ , Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -I"-_, -_I Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: /q
(7 l Heat pump 61.06
��•N-i_'L V PGiyA/r___ Duct work 23.32
Cross street/directions to job site: Hydronic hot water system '23.32
` Residential boiler(radiator or
6 H. ,.. hydronic) 23.32
• Unit heaters(fuel-type,not electric),
. in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
::-. .1 S' CL c02-06711— p_Jebp/ A7 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: 4t (VAL_ Range hood/other.kitchen
Address: equipment 33.39
's.�U (''t.� eP Ikt t).-.2 t Clothes dryer exhaust 33.39
City/State/ZIP: !� Single-duct exhaust(bathrooms,
T� '�I toilet compartments,utility rooms) 23.32
Phone:( (b3) Fax:( ) Attic/crawlspace fans 23.32 _
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: �w r/
Fuel piping:
1 C - l/ $14.15 for first four;$4.03 for each additional
Contact name: j, - • (2110P9U Furnace,etc.
Address: /'/ Gas heat pump
l i t �' . 1-l) -7k/ it iv-{ CA,l tl E Wall/suspended/unit heater
City/State/ZIP: iti- 1 Ati.,-) r Q 111---_, Water heater
Phone:( ) Fax: :( ) Fireplace
Range _
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: , v C.00-1 'Q Coo-1 Other:
V_ ( ���� g MECHANICAL PERMIT FEES*
Address: 1 G %\-- S' w •--t II P1 ,p t, ('•�■1. G (, Subtotal
City/State/ZIP: 7r In q� U V�Y' l Minimum permit fee($90.00)
�J Plan review(25%of permit fee)
Phone:( ) Fax:( ) (12%State surcharge(12/0 of permit fee)
CCB lie.: rte' g- 3 �� j 4, '/,, TOTAL PERMIT FEE 151 2i1
1 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: r Date: R/2v/Z0 f
1:\ uilding Permits\MEC_PermitApp_040 I I3.doc 440-461 Tr(I 1/02/CoM/WEEB
B \
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.
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