Permit CITY OF TIGARD MECHANICAL PERMIT
IN a COMMUNITY DEVELOPMENT Permit#: MEC201500193
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/07/2015
Parcel: 1 S 135BC01100
Jurisdiction: Tigard
Site address: 11117 SW GREENBURG RD
Project: Kayu Subdivision: OAKBURG Lot: 27
Project Description: Securing gas lines after structural damage to tenant space. Gas line pressure test.
Contractor: ARROW MECHANICAL Owner: GREENBURG SPACE CENTER LLC
10330 SW TUALATIN RD PO BOX 91305
TUALATIN,OR 97062 PORTLAND, OR 97291
PHONE: 503-692-1565 PHONE:
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/07/2015 $72.13
Class of Work: ALT Type of Const: Plan Review 04/07/2015 $18.03
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 04/07/2015 $8.66
Stories:
Project Valuation: $600.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers 8 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 $98.82
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct• ions • !UN • Aim. 503.232.1987 or 1.800.332.2344.
Issued =y: F ��/ �� �� Permittee Signature: /_
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Date sy: Permit No..
ri g CEIVEp Date/By �i > (- /5 v�,i r3
i •• 13125 SW Hall Blvd,Tigard,OR Plan Review
r ■ Phone: 503.718.2439 Fax: 503.598.1960 Date-/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By- 1�+ See Page 2 for"D D O�Internet: www.tl and-0r. oV Notified/Method. Supplemental Info
rmation
CITY �F : �,
I : r apt {'�1'JE s t ::14Ag I sl 0• l['
Mechanical permit fees'are based on the value of the work
❑New construction 12 Additio alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ •i er: mechanical materials,equipment labor,overhead and profit.
y 'I . Value:$ 00
N -cs �
_ ,_: ,_ .,. - C �.' ` - z- '
' ,�yJ:ep.+f7 .ilfi 1r iF',2401440strZta7-d�- il)R. k V
❑ I-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. 1 Ea. I Total
. .awl .. .111 9! c t N Ada! o_
Heatin8/cooling:
Job site address: ) , ( I .7 _ ," '` (� n/+� Ah d1ti 0,00 (ducts/vents) 46.75
` � IJ Li V R RD 1 Furnace 100,000 BTU ducts/vents 46.75
City/State/ZIP: T(U C " 0_, cy? 3 Furnace 100,000+BTU(ducts/vents) 54.91
f Heat pump 61.06
Suite/bldg./apt.no.: I Project name: K A y U
K 1 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential bailer(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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
w
``---- 4. ' ri, -.F pI ri5x y .� „ v��a Gas fireplace/insert 33.39
.." .?`;` _0 -_._. r,:. ,...:- ,.. 3 -. _._ ..y Flue vent for water,heater or gas
G I,i r3 E P0-£55 40 t 11-&T fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
�Jv r Other: 23.32
��".• __ _ .____...____- Environmental exhaust and ventilation:
Name: K Pr�/V Range hood/other kitchen
equipment 33.39
Address: " 1 ) 7 5 '9 6 f$4 (3,,ctti3 R Clothes dryer exhaust 33.39
G Single-duct exhaust(bathrooms,
City/State/ZIP: Ti 42 Q p l r� z toilet compartments,utility rooms) 23.32
Phone:(5 3 )$57_ 7 a 9c., Fax:(53)..557,... 7.2 Coa Attic/crawlspace fans 23.32
iiieAINT � Other: 23.32
Fuel piping:
Business name: n V.1 tilt kti 4,4 �++kl
514.15 for first four,$4.03 for each additional
Contact name: ME 1_' D I Furnace,etc.
Address: )0310 S�,,,i `1 ,..tk N t 0 16w+e 4 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: TVA Lk' r4 4 an ! 5-,061. Water heater
Phone:$10/ ). 6%7- 6‘6,$) Fax: :(5' o3) d 9/ - /407/' Fireplace
Range
E-mail: Barbecue
- mi l: -sue '�t� y g ftfOl t M Clothes dry er(gas
)i .N �3_. 1 -,.. . r r ...
Business name
RIZ,() 1aJ /"i£C I.� At►J t.CA-tr other
� 1 �r20.�� K #", .
Address: /0/ 3 t:3 S W VDL A�I � A
Subtotal 7e ./
City/State/ZIP: A/ L^T I./� �- 9 7 v C� Minimum permit fee($90.00)
Phone:( �) T., � Fax:( t i ) ,i / Plan review(25%of permit fee) /y.C?3
State surcharge(12%of permit fee) X (C'CCB lic.: 5 TOTAL PERMIT FEE 2,
This permit application expires if a permit is not obtained within BO
days after it has been accepted as complete.
Authorized sign e: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Date: y. 7. /5 )
1:\Building\Pemnts EC_PennitApp_040113.doc 440-.46171'(11/02/COM/WEB)