Permit CITY OF TIGARD MECHANICAL PERMIT
: COMMUNITY DEVELOPMENT Permit#: MEC2015-00445
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2015
Parcel: 2S101AC01300
Jurisdiction: Tigard
Site address: 7105 SW HAMPTON ST
Project: Kaiser Dental Subdivision: BEVELAND NO.2 Lot: 18-19,P
Project Description: Replacing(2)5 ton RTU's and(1)7.5 ton RTU with a 5 ton unit.
Contractor: RELIANT PLUMBING&MECHANICAL Owner: KAISER FOUNDATION HEALTH
11575 SW PACIFIC HWY SUITE 219 PLAN OF THE NORTHWEST#838
TIGARD, OR 97223 ATTN: GENERAL ACCCOUNTING 11TH F
500 NE MULTNOMAH#100
PORTLAND, OR 97232
PHONE: 503-246-1201 PHONE:
FAX: 503-246-1205
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/09/2015 $652.51
Class of Work: ALT Type of Const: VB Plan Review 07/09/2015 $163.13
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 07/09/2015 $78.30
Stories: Info Process/Archiving-Sm$0.50(up to 07/09/2015 $10.00
11x17)
Project Valuation: $22,000.00
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 $903.94
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
7:400.
Cal 503.639.4175 by 7:00 a.m.for the next available inspect� 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 F51.O\l.l
11, City of Tigard ���`� Received ^7 //yy,
g ��n<�a ��,�
Date/By: / /S Permit No.:/"2_G b(5_`Qo gos
•
13125 SW Hall Blvd.,Tigard,OR 97223 �,l Plan Review
2 Phone: 503.718.2439 Fax: 503.598.10as 8 � DateBy: �(� Other Permit:
TI G A R D Inspection Line: 503.639.41754 -\S"'\ Date Ready : Juris ® See Page 2 for
Internet: www.tigard-or.gov 0214, % , Notified/Method: 7/¢/4S Supplemental Information
TYPE OF WORK P '018-* COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction %Addition/alteration/repl e� performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: Mechanical materials,equipment,labor,overhead *fit.
CATEGORY OF CONSTRUCTION Y �' !_� ',�
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: '1 1 OS SNA) k4c.A,pion (jt Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: '.-1-C 0,-8 a2 q 1 O a/3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: V Project name: � pp
ceiStr QG►�C Duct work _ 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
A Residential boiler(radiator or•
�v(� 5 �i t���Pfi hydronic) 23.32
,�1 o�fii�` Unit heaters(fuel-type,not electric),
�D�") � ,Y`k) n/7/ tS 8.) 0 in-wall,in-duct,suspended,etc. 46.75
P.A.j t "„4. - ' Flue/vent for any of above 23.32
Subdivision: 41-S - Other: 23.32
Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert _ 33.39
(7) �,` /� Flue vent for water heater or gas S to n At C u vim} and (j l i.51bh fireplace 23.32
AA;S/1 n J �G I n r� rt. 14 C(A ' Sin Log Wood/pellet(gas) 23.32
P Wood pellet stove 33.39
■ C a8 C44.4. '* Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Mr PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation: 1
Name: K at s (Tt).i,eia,,ah,�(f Range hood/other kitchen
f equipment 33.39
Address: -•*(105 5/,, 1.•••■•0)- S r Clothes dryer exhaust 33.39
City/State/ZIP: -1 5`'a Ok Gi ''3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
W.APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: ^.`- P im(ii,1� n f Wes[ ?j�(� $14.15 for first four;$4.03 for each additional
Contact name: aritU nJ Furnace,etc.
1 ?II
Gas heat pump
Address: //Cj'��� ('(� Qa(A 1(� 3�•!�'( ?I"I
J Wall/suspended/unit heater
City/State/ZIP: -- @ W`1 D{_ at 1 b 3 Water heater
a Fax::(cb',)?Jr- , I?0c- Fireplace
Phone:(�tij)��� I.��' 1_ \ "!tv Range
E-mail: 6Q.h 6 r(,l;AAA- 'IV4C ?ex. (AIM Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:(an(- YU1� t f.tilan(Cit.( -r Yl L Other: *
MECHANICAL PERMIT FEES
Address: (i C 7 Sw Qac si,A, �(y Subtotal
q,� Minimum permit fee($90.00)
City/State/ZIP:'rl Ll ('� 1 3
Plan review(25%of permit fee)
Phone:(5'D') 34 1101 Fax:(5 ) t ''120'5- State surcharge(12%of permit fee)
CCB lic.:101 gL4t4 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
qiff days after it has been accepted as complete.
Authorized signature: r- * Fee methodology set by Tri-County Building Industry Service Board
Print name: /1.,;€112.-
1.4.a,i�O l Mth Date:62(4n/20,A- J c. y t(r�� ,, 1y�
1.\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COMJWEB) 'I� `_/V'�On -f1�vL� " /
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
7105 SW HAMPTON ST, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00445
Chip Barnett
Violation Summary:
Inspector Contractor