Permit INCITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2014-00260
T(GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/29/2014
Parcel: 2S 103DD00800
Jurisdiction: Tigard
Site address: 13815 SW PACIFIC HWY 40
Project: Hoppy Growler LLC Subdivision: MELROSE Lot: 7-8
Project Description: Exhaust fan for Bathroom addition.
Contractor: DW SIVERS CONSTRUCTION Owner: D W SIVERS CO
4730 SW MACADAM AVE#101 4730 SW MACADAM AVE#101
PORTLAND, OR 97239 PORTLAND, OR 97239
PHONE: 503-223-2680 PHONE:
FAX: 503-223-2750
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/29/2014 $69.06
Class of Work: ALT Type of Const: Plan Review 05/29/2014 $17.27
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 05/29/2014 $8.29
Stories:
Project Valuation: $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 $94.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Exhaust fan
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1%00.337 734--,
Issued By: Permittee Signature:
Call 503.639. by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard tiNtil Received e
MI I
• 13125 SW Hall Blvd.,Tigard,OR 9 � SDP
v..// Plan Review
Phone: 503.718.2439 Fax: 503.598.
Date/By: Other Permit.G • c it'(--Y,r�I(
TIGARD Inspection Line: 503.639.4175 A Date Ready/By: !aria: See Page 2 for
Internet: www.tigard-or.gov MAC 2 9 7 \ Notified/Method: Supplemental Information
TYPE OF WO I c COMMERCIAL FEE*SCHEDULE - USE CHECKLIST
t I Or ` ISIt" Mechanical permit fees;are based on the value of the work
❑New construction �.Addition/alteratggly(reyty�' performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: +DVI1�17� mechanical materials,equipment,labor,ovv head,and profit.
Value:$Q,O--- 500
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling g Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
_ ll/A� Air conditioning 46.75
Job site address: 1 3 s/. 3&,�J (a C i (t L 1.4, ��c Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: L1do,/ 0 a 772 3 J Furnace 100,000+BTU(ducts/vents) 54.91
e Heat pump 61.06
Suite/bldg./ t.no.: I Project name:l Morel - ' Duct work 23.32
Cross street/directions to job site:
V 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 _l 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
/J r L Flue vent for water heater or gas
!'t t � 3 �Irv,rtir TGx✓t !ti 3(/PhvplJmn 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 ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: B. ij, S 1,„, 4) • Range hood/other kitchen
equipment 33.39
Address: /1.73 0 Si/0 Alt ictig iv, AV{ Clothes dryer exhaust 33.39
City/State/ZIP: �pr,t-lal-a 0,2 7773 Single-duct exhaust(bathrooms,
_ / toilet compartments,utility rooms) 23.32 71.
Phone:(S e3 )27 3 )6'V Fax:( ) Attic/crawlspace fans 23.32
'APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping: _
Business name: n, �J , Si v4� 6 J $14.15 for first four;$4.03 for each additional
Contact name: via(A 61.Ile )4 . Furnace,etc.
/ Gas heat pump
Address: /1-7 30 500 Ma C a rC u,4, 4- Wall/suspended/unit heater
City/State/ZIP: Mi.i-ki_-t'ri( v 2 972 3 / Water heater
Phone:(Yid )22,5 Z,,,o,O Fax::( ) Fireplace
Range
E-mail: /a 1^ (9 Si t✓e, (U _ Barbecue ,
CONTRACTOR Clothes dryer(gas)
Business name: j/ a 55 Ve44 (O Other:
A MECHANICAL PERMIT FEES*
Address: 1'73 0 Sw Alt Ca da—e- '4 Subtotal GI.ag_
Minimum permit fee($90.00)
City/State/ZIP: Po�l1-4,...a, p -7'/Z3 y
(5'c1!) ZZ 3 2 6 O Fax:( ) (12%Plan review(25%of permit fee) 17,2?
Phone:
State surcharge(12 of permit fee) iri 62 I
CCB lie.: /tJ 1- I( 6 % io 7 Pi TOTAL PERMIT FEE /11.,( This permit application expires if a permit is not obtai within 180
days after it has been accepted as complete.
Authorized signature: "�� • Fee methodology set by Tri-County Building Industry Service Board
Print name: a� G', ��/t Date: cj Lv—1-7-At-
—
I:\Building1Permits\MEC_PermitApp_040113.doc 440-46177(I I/o2/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.
1:\Building\Permits\MEC_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13815 SW PACIFIC HWY 40, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
May 30, 2014 at 9:28:10 AM
MEC2014-00260
Chip Barnett
Violation Summary:
Inspector Contractor