Permit q CITY OF TIGARD MECHANICAL PERMIT
2' COMMUNITY DEVELOPMENT Permit#: MEC2013-00605
. TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2013
Parcel: 25 102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST 110
Project: NW Framing . Subdivision: BURNHAM TRACT Lot: 1
Project Description: New duct work and t-bar grilles. (1)restroom exhaust fan and venting to outside.
Contractor: MILLENNIUM HVAC INC Owner: DOLAN&CO LLC
2723 NE 159TH CIRCLE BY FLORENCE T DOLAN
RIDGEFIELD,WA 98642 4523 NE DAVIS ST
PORTLAND,OR 97213
PHONE: 971-235-3699 PHONE:
FAX: 360-546-0512
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/14/2013 $121.25
Class of Work: ALT Type of Const: Plan Review 10/14/2013 $30.31
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/14/2013 $14.55
Stories:
Project Valuation: $2,200.00
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 $166.11
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No 4 ion e - . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir questions to OUN .y .: g 503.232.1987 or 1.800.332.2344.
w
Iss ed By: / Permittee Signature: ��� I
Call 503.639.4175 by 7:00 a.m.for the next available inspecti� ate. .f /�'�
This permit card shall be kept in a conspicuous place on the job site until c; pletio f the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received S
Date/By:ive ' l0 /y �,�� PermitNo.: �'eto/3--aD O
° 13125 SW Hall Blvd.,Tigard,OR 9�2 ECE1\/ED Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: 6,,`I13_00/.
Fl G n It v Inspection Line: 503.639.4175 . OCT 1 4 Z013 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE'OF nt G DI V lS1O�F
`.t COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ .'Z.).Z O D "O
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwellingmmercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heatinp/cooling:
Air conditioning 46.75
Job site address: /253.-0 f,e /14q,pit Si7 Furnace 100,000 BTU(ducts/vents) _ 46.75
. City/State/ZIP: )`''P d Og 172-23 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:' 7 0 Project name: N it„,9
/ ?,--e:2 In r'11 1 Duct work 23.32
Cross street/directions to job site: 'J 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
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
�i1 7'w// -f fe7C, p�uL r•�4 Ce�,�rd -64,- fireplace 23.32
J / Log lighter(gas) 23.32
jf l t e S . . .r1-`54`t if D n r•e5'4�Y�N'a t-2`4`ty s� Wood/pellet stove 33.39
,i. rt , ,r r' jJ ei-t -1 1-c ',It-f 15l'de a Wood fireplace/insert 23.32
J
Chimney/liner/flue/vent 23.32
• ❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawispace fans 23.32
,'APPLICANT ❑ CONTACT PERSON Other: 23.32 _
Fuel piping:
Business name: A,/74-'4 n t' 4 VAC
Ai 071 �/1 C . $14.15 for first four;$4.03 for each additional
Contact name: -y-- t� Furnace,etc.
J i"�YiJ /3 �/- f �..eYt/ Gas heat pump
Address: 2. 7 2-.3 /�L1 /5-7 C `rUE�
/ Wall/suspended/unit heater
City/State/ZIP: 2 r�5 E..-.'r 1 E is WA- `lg 4 I/2 - Water heater
r Fireplace
Phone:(g-7/) 2 3 5-- 34,R 9 Fax: (3k)) ,SYE- 0-S/Z
�
+ Range .
E-mail: rn h Vgt e Cap t /r/1 e 'f .. C e •rrl Barbecue - _
CO NTRACTOR. . Clothes dryer(gas)
Business name: .
Other:
C •.MECHANICALPERMIT,FEES*
Address: • ,> /12-e-/ aS q dV e 2
Subtotal /g/. .;,Pc-
City/State/ZIP:
Minimum permit fee($90.00)
Phone:( ) Fax:( /o
Plan review(25%of permit fee) g, . j/
jState surcharge(12ofpermitfee) /1./.5-5-
CCB lie.: /5 7.Q f 33(i 7j I I D TOTAL PERMIT FEE 14,6.//
This permit application expires if a permit is not obtained within 180 r days after it has been accepted as complete.
Authorized signature: / � • Fee methodology set by Tri-County Building Industry Service Board
Print name: �e..,, ��-.-t-E.13 6.•,,_, Date: foil,cf��
I:\Building\Permits�C_PermitApp_040I13.doc 440-4 (I I/2/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 $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.
I:\Building\Permits\MEC_PennitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12550 SW MAIN ST 110, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
2013-12-19 (null)
MEC2013-00605
PASS - No C of O
Violation Summary:
Inspector Contractor