Permit INU
OF TIGARD MECHANICAL PERMIT
tt. COMMUNITY DEVELOPMENT Permit#: MEC2014-00627
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2014
Parcel: 1 S 1358000300
Jurisdiction: TIGARD
Site address: 9735 SW SHADY LN 308
Project: Westside Endodonitics Subdivision: ASHBROOK FARM Lot: 5
Project Description: Installing(2)80 CFM exhaust fans:(1)fan in breakroom 308,and(1)fan for lab 307.
Contractor: WILLAMETTE HVAC LLC Owner: MCFADDEN,ARTHUR L
3075 SW 234TH AVE.#206 BY SKLARZ, ERIC
HILLSBORO,OR 97123 621 SW MORRISON ST, STE 800
PORTLAND, OR 97205
PHONE: 503-259-3200 PHONE:
FAX: 503-848-2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/18/2014 $78.27
Class of Work: ALT Type of Const: Plan Review 11/18/2014 $19.57
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/18/2014 $9.39
Stories:
Project Valuation: $800.00
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 $107.23
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Exhaust fans
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 d•_ ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in • - •Hr,01-0010 through OAR 952-001-04a Y may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
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 USE ONLY
City of Tigard Received // t,- / ,h Permit No.:
11111 13125 SW Hall Blvd.,Tigard,OR 97223
S Plan Review All'
Phone: 503.718.2439 Fax: 503.598.1 Date/By: Other Permit:/q '(3)Li ,
DECEIVE DateR : vv
I 1 +t:a Inspection Line: 503.639.4175 Date ReadyBy: Bl See Page 2 for ieM__Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORN 18 2014 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ® Add ition/alttA iP a RD performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: BUILDING echanical materials,equipment,labor,overhead,and profit.
G DNISION Value:$$800.00
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 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address:9735 SW Shady Ln (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:308 Project name:Westside Endodontics 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
Install two 80 CFM exhaust fans.One for the break room 308 and one for the lab Gas fireplace/insert ent r ale 33.39
Flue vent for water heater or gas
room 307. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
El
OWNER ❑ 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
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 23.32
CO APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name:same as below
Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Address: Furnace,etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( )
Fax::( ) Water heater
Fireplace
E-mail:
Range
CONTRACTOR Barbecue
Business name:Willamette HVAC,LLC Clothes dryer(gas)
Other:
Address:3075 SW 234th Ave Suite 206 MECHANICAL PERMIT FEES*
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Minimum permit fee($90.00)
Phone:(503)2593200 Fax:(503)848.2597
Plan review(25%of permit fee)
CCB lic.:56951 State surcharge(12%of permit fee)
TOTAL PERMIT FEE �fo7, ,-
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name:michael malstrom Date: 11/11/14 * Fee methodology set by Tri-County Building Industry Service Board
1:\Building\Permits\MEC-PermitApp.doc 03/07/12 440.4617T(I1/02/COM/WEB) 4204 200
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
9735 SW SHADY LN 308, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00627
George Heimos
Violation Summary:
Inspector Contractor