Permit CITY OF TIGARD MECHANICAL PERMIT
$11 .
COMMUNITY DEVELOPMENT Permit#: MEC2013-00510
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2013
Parcel: 1 S 134BC00300
Jurisdiction: Tigard
Site address: 12272 SW SCHOLLS FERRY RD
Project: Greenway Pub Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Push/pull grease fan.
Contractor: HVAC INC Owner: FW OR-GREENWAY TOWN CENTER LLC
5188 SE INTERNATIONAL WAY PO BOX 790830
MILWAUKIE, OR 97222 SAN ANTONIO,TX 78279
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/10/2013 $130.46
Class of Work: ALT Type of Const: Plan Review 09/10/2013 $32.62
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 09/10/2013 $15.66
Stories: Info Process/Archiving-Lg$2.00(over 09/10/2013 $2.00
11x17)
Project Valuation: $2,500.00
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: Vent Systems: Total $180.74
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Grease Fan
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the - les adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You y• obtain a copy of the rules
or direct questions to UNC b calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: L)/
Call 503.639.4175 by 7:00 a.m.for the next available inspection •<te
This permit card shall be kept in a conspicuous place on the job site until comple'•n of the project.
Approved plans are required on the job site at the time of each Inspection.
Mechanical Permit Application FOR OFFICE USE ONLY.
City of Tigard RECEIVED Date/By: `AO, 1. - Permit N�yte�0/3-OOS/D
1111111 13125 SW Hall Blvd.,Tigard,OR 97223 ���JJJ���///
0 Plan Review �
Phone: 503.718.2439 Fax: 503.598.1960 Darby 4 i v Other Permit
TI Gn It D Inspection Line: 503.639.4175 S E P 1 0 2013 Date Ready/By: iwi
Internet: www.ti ardor. ov Supplemental See Page 2 for
g g Notified/Method: / Supplemental Information
(CITYOFTII�GARD f
TYPE OF W1pRWLDINCJ Dl v'ISIO``t _. COMMERCIAL FEE*:SCHEDULE - USE CHECKLIST .
Mechanical permit fees*are based on the value of the work
❑New construction ,Addit ion/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhh{��ead,and profit.
Value:$ �-S00
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 I Qty. I Ea. l Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
y�� �/� (� - Air conditioning
Job site address: 4�/12r- W S OAO t t S `/� • " ( Il d. (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1f aArf Crl-3--).:3
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: (Ytc(Yt,em GwAvo Heat pump
(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
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
n �,p,,gAGas fireplace/insert 33.39
P iANI 1 �r -V ftlAn 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
. ❑ PROPERTY OWNER I ❑ 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: Single-duct exhaust(bathrooms,
( ) Fax:( ) toilet compartments,utility rooms) 23.32
❑ APPLICANT . . ❑ CONTACT PERSON . Attic/crawlspace fans 23.32 _
�4V_A r � u Other: 23.32
Business name: 1/ `/ Fuel piping:
n \ P p g:
Contact name:- '` i 91,P 1,. ) $14.15 for first four;$4.03 for each additional
Address:- D ��JGGG ���"""I/�n�, }/�/� �/� r Furnace,etc.
�r Jnl�'�' v 1 "v Gas heat pump
City/State/ZIP: ‘t IA)d V lrl ----i-0 WalUsuspended/unit heater
Phone:( 1 k4b 3- t4/� / Fax::(S143)�.b�- Water heater
E-mail: 1 0 (� 0 .,U a�a vvC Aii e , ,,,„,,,,
Fireplace
w Range
CONTRACTOR Barbecue
Business name: ,rki Pt C L L, Clothes dryer(gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee($90.00)
Plan review(25%of permit fee)
CCB lic.: • W1 On State surcharge(12%of permit fee)
t 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: 6L1 Date: a I-5 ' Fee methodology set by Tri-County Building Industry Service Board
1:\Building\Permits\MEC-PermiiApp.doc 03/07/12 440-4617T(III.j/`02/COM/WEB)
. .
III q Building Division
Over-The-Counter (OTC) Mechanical Permit
T I G A R D Check List
Project Description: T1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: "2.— Type of Construction:
*Type of Use: Oregon Specialty Code: 20 in
Number of Stories:
FUEL FURNACES
_Type: Furnace< 100K BTU Furnaces>= 100K BTU
Gas Pressure: Roof Top Unit(RTU) Tons
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft � _
Fire Wrap & t Pf .\ s, i
APPLIANCES
Boiler(BTUs) Vent Fans Gas Line
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets •
Woodstove Duct Work Gas Fireplace _ _,
Fire/Smoke Dampers Other Mechanical Units—Describe:
Total Project Valuation: $ 2-15-01:3,00 FEES DUE
$ (, 44 Mechanical Permit Fee
$ "Z2, . 2., Plan Review
$ �j, or 12%State Surcharge
$ , _? CO Info Proc/Arch,Lg(over 11x17 $2.00)
$ Info Proc/Arch,Sm(up to 11x17 $0.50)
$ Misc.Admin Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff:
Date/Time: $ (. ,74 TOTAL FEES DUE /f 0 , 7 V v
*OPTIONS:
TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
'CLASS OF WORK ACS=accessory;ADD=addition;ALT=alteration;FND=foundation;DEM=demo;
FND= foundation;FPS=fire protection system;NEW=new;OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies);
REP=repair.
l:\Building\Forms\OTC-MEC.docx 01/13/2011