Permit CITY OF TIGARD MECHANICAL PERMIT
• ' COMMUNITY DEVELOPMENT Permit#: MEC2015-00533
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2015
Parcel: 1S134BC00401
Jurisdiction: Tigard
Site address: 12442 SW SCHOLLS FERRY RD 100
Project: Providence Medical Group Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Relocation of duct work and air distribution.
Contractor: AMERICAN HEATING INC Owner: PROVIDENCE HEALTH SYSTEM-OREGO
5035 SE 24TH AVE ATTN: REAL ESTATE&CONSTRUCTION
PORTLAND, OR 97202-4765 4400 NE HALSEY BLDG 2 STE 190
PORTLAND, OR 97213
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/05/2015 $339.28
Class of Work: ALT Type of Const: Plan Review 08/05/2015 $84.82
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/05/2015 $40.71
Stories:
Project Valuation: $9,650.00
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 $464.81
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 start-s within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ad•pted by the Oregon
Utility Notific- '•• -nter. Those rules are set forth in OAR 952-001-0010 through OAR 95 'e ::=:. obtain . cos of the rules
or direc estions to O► C by calling 503.232.1987 or 1.800.332.2344.
Issue By: / Permittee Signature: ail
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 projec
Approved plans are required on the job site at the time of each inspection.
i-1
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Mechanical Permit Application 4.9 FOR OFFICE USE ONLY 1,.i
City of Tigard Received Perm IL NO.:
13125 SW Hall Blvd.,Tigard OR 97 G v' ` Q�h Plan Review
/57`5-- 475— ` '�'"��s aLs3 3
Phone: 503.718.2439 Fax 503. 1.. 'J�-
\{, ate/By: Other Pennit:
Inspection Lino: 503.639.4175
j
T I G A R V U r.f1.1`,Ofi to Ready/By: luri fd See Page 2 for
Internet: www.tigard-orgov �\:P, \�) Notified/Method: Supplemental information
Y IVO
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteratiplacement performed.Indicate the value(rounded to the nearest dollar)of all .f
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead and profit. •• 1;
4r��S?�
1 r
Value $
1.•
- RESIAI✓N'I'IAI,EQUm 1fF Ni'T5 ___--_ -. S++, _
❑ 1-and 2-family dwelling lUt CommercialJindustrial ❑Accessory building For special infornuuion use checklist .:
❑Multi-family ❑Master builder ❑Other: Description J Qty. I Ea. I Total
Heating/cnoliog:
-_ Jfl8;fit i(IY�1��'IiOly'�II�I!�.Q019" _ _ ,
Air conditioning 46.75
Job site address: 1d4 L �6W M' .ARQ Furnace 100,000 BTU(ducts/vents) 46.75 •
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
irpre 0 r heat
�o0 t �(0 H . L L4 pump 21.32
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross strect/directions to job site: 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
Other: 23.32
Subdivision: I Lot no.:
i
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
Bii Ciiiiii 14 OF_WORK ---r=te<- -_1 Gas fireplace/insert 33.39 ,
'-._ ••``� ^ '--/�'�''-'— t�t ``� -'�u Flue vent for water heater or gas
fee rten01•1 ()arr1IJvJ4-r Ato Ate �'v?e K'�Je fireplace 23.32
1
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 •
Chimney/liner/flue/vent 23.32 •
- u- -
- Other. 23.32
`, ❑ PAOPF 4 Y t� „1 '.... . . .`°-. -- -
__ .. , --,---;.if=---!..,-,-,,--,..-'1---"!"---7:---2:*: Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 3139
Address' Clothes dryer exhaust 33.39
City/State/LIP: Single-duct exhaust(bathrooms,
toilet Phone:( ) Fax:( ) Att c/cr wlspace fans utility rooms)
23.32
rooms
_-z. - -.'' "-:ass. --z - Other: 23.32 I .
Business name: m � �yi t iT Fuel Ptptng.
L #�rLL 514.15 for first four;54.03 for each additional
Contact name: 4j H Lai Furnace,etc.
Address: S`. :) 4F7 ���� Gas heat pump i
Wall/suspended/unit heater
City/State/ZIP: 4 PLI ° Water heater
Phone:(Wa,..".W._l t o,,. Fax: .2-/ Fireplace
Range
E-mail:
Barbecue•,--Y.... , �-,�- �;s7.-::--- -_-_.--. .,� T} -�/ _z te = ?
Clothes
-,_ _ .._ ter _,.- ..'a =•^ �, --- ----- ,
Business name: Ai. e/ ,,' Other
Minimum permit fee($90.00)
City/State/ZIP: .g a t
Phone:( l WG/ I Fax:( �..� Plan review(25'6 of permit fee)
'"''""'tom '"u� State surcharge(12%of permit fee)
CCB lie.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 151/
days after it has been accepted as complete.
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Authorized signature: �i _a • Fee methodology set by Tri-County Building Industry Service Board ,
IPrint name: VEshiS RCIrlikit Date: 7
LVauildts Petmit AEC PsrmilApp 040113.doc 440-4617r(I1/02/COM/W&B) 1 i
Al
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
12442 SW SCHOLLS FERRY RD 100, TIGARD,
OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00533
Chip Barnett
Violation Summary:
Inspector Contractor