Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2014-00356
T IC;A Ft O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07!14/2014
Parcel: 2S102AA00490
Jurisdiction: Tigard
Site address: 12085 SW HALL BLVD 130
Project: Arellanos Market Subdivision: TIGARD HIGHWAY TRACTS Lot: 13
Project Description: Relocate(3)grilles
Contractor: S& R CRIDER INC Owner: HALL STREET CROSSING LLC
9131 SE TAGGART BY MR&MRS ROGER W TOM
PORTLAND, OR 97266 8067 SW RIGERT COURT
BEAVERTON, OR 97007
PHONE: 503-516-7793 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/14/2014 $69.06
Class of Work: ALT Type of Const: Plan Review 07/14/2014 $17.27
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 07/14/2014 $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 $94.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Cen - . Those . -s are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o direct questions to OUNC b' , ing 50 . 2.1987 or 1.800.332.2344.
sued By: , 1,4L A&g4 / r Permittee Signature: cc
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE I SE.Om.)
City of Tigard RECEIVEP D 747MlM Permit No.:r/f ( _ 5
11111 . • 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Dl t Review
Date/By: Other Permit:
t GA It I Inspection Line: 503.639.4175 JUL 1 4 2014 Date Ready/By: Juris 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
aTY OFTI(:ARD
TYPE Ol iratWNF niVl.�lON COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
�J l l`I t It Mechanical permit fees*are based on the value of the work
New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materiajequipment,labor,overhead,and profit.
Value:$ c U 0
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 ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating cooling:
Air conditioning 46.75
Job site address: 1 7 Q �i S S w 1 C II 3 Iv c) 5+,,f�.13c, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: �/j (�r 9 3 Z Z 3 Furnace 100,000+BTU(ducts/vents) 54.91
T1 �'G r Heat pump __ _ 61.06
Suite/bldg./apt.no.: ' ; 0 I Project name: I-1 ftu I i G n Q s Bo r Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
Nw f 9 1 in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I 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
fireplace 23.32
Log lighter(gas) 23.32
R e I U c G i c 3 CV c-ae Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I TENANT Other: 23.32
('� (p� Environmental exhaust and ventilation:
Name: ri re IIGn 0 s 13 r Range hood/other kitchen
/ equipment 33.39
Address: 12 0 8 5 S(A! /-4 G 1 I R I V U S1 4'L 130 Clothes dryer exhaust 33.39
9 Single-duct exhaust(bathrooms,
City/State/ZIP:
�+ G 4 v O !3Z 23 toilet compartments,utility rooms) 23.32
Phone:( '71 ) Fax:( ) Attic/crawlspace fans 23.32
9 ys - 6P. ZS
APPLICANT ❑ CONTACT PERSON Other: 23.32
1 Fuel piping:
Business name:
- f e I C/'►C1 5 Y 514.15 for first four;54.03 for each additional
Contact name: O Inc r' r`l f e j I G I�U Furnace,etc.
Address: 12085 S W ��4 I 1 Q I U , F- 13 C Gas heat pump
P U C Wall/suspended/unit heater
City/State/ZIP: 7r1'4:6 r. Cr Ci 7 Z.2 3 Water heater
Phone:(g 7,) 6 LI s-(,8 z s Fax::( ) Fireplace
�' Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
( fl A e J� t./ Q CQtotQ hod_ Other:
Business name: f _r r MECHANICAL PERMIT FEES"
Address: 9/3/ e —1 f1 a k2.r Subtotal _ 6 7.e47
City/State/ZIP: P-i-L1-) Q 2 9 7•2-6,4 Minimum permit fee($90.00)
Plan review(25%of permit fee) /7 A-7
Phone:(CI 71 ) 6 ti 5_-6 Q ZS Fax:( ) State surcharge(12%of permit fee) '
CCB lic.: Z Q 0 Q 0 1 5/D- 1,c TOTAL PERMIT FEE 9q. _
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: gyytty 04]2/4„.... * Fee methodology set by Tri-County Building Industry Service Board
Print name: ()m G f A'ell ei h v Date: 3_ 14 _ 1(4
1:\Building\PermiuUlEC_PermitApp_040113.doc 440-46171'(I1/02/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.
L\Building\Permits\MEC_PermitApp_040113.doc 2