Permit MECHANICAL PERMIT
CITY OF TIGARD
,'� Permit#: MEC2015-00695
- .• COMMUNITY DEVELOPMENT Date Issued: 10/15/2015
TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503 718 2439 parcel: 2S110AA00300
Jurisdiction: Tigard
Site address: 14145 SW 105TH AVE
Project: Pacific Health&Rehab Subdivision. KING CITY TERRACE CONDO Lot: 3-6
Project Description: Replacing(3)existing air conditioner on concrete pads and(3)air handlers
Contractor: A TEAM HEATING Owner CHP TIGARD LLC
5957 MOUNT ANGEL HWY NE BY CORNERSTONE HEALTH CARE
SILVERTON, OR 97381 REAL ESTATE FUND INC
1920 MAIN ST#400
IRVINE, CA 92614
PHONE 503-365-8326 PHONE
FAX 503-365-8333
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/15/2015 $1,358 63
Class of Work: ALT Type of Const: Plan Review 10/15/2015 $339 66
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/15/2015 $163 04
Stories:
Project Valuation: $49,704 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 3
Heat Pump
Appliances
Vent Fans Vent Systems: Total $1,861 33
Hoods Comm Incinerators
Required Items and Reports(Conditions)
Woodstoves Gas Fireplaces:
Clothes Dryers Other Mech Units
Gas Outlets Other Desc Air Handlers
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 r es adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 9.2-101-0090 You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232 1987 or 1.:I1 ••
Issued By: Per ignature: 13.∎ `I '
IJ ...a
Call 503.639.4175 by 7:00 a.m.for the next available inspection .a e.
This permit card shall be kept in a conspicuous place on the job site until comp = ion of the proj ct.
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 Permit No fr
111
- " 13125 SW Hall Blvd,Tigard,OR 97223 Date/By lvlL S/J Or-- /`'1 r�U«(�?ls
Phone: 503.718.2439 Fax: 503 598 1960 Plan Review ( Other Permit
Date/By
TI GARD Inspection Line. 503 639 4175 a�® Date Ready/By lures El See Page 2 for
Internet www.tigard-or goveG ,®' Notified/Method /76 Supplemental Information
ck
TYPE OF WM 1 2015 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/rAr wa performed Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: GO 1 flS10,`i mechanical materials,equipment,labor,overhead,and profit.
yy``'(�` kG D Value $S49,704.00
CATEGORY OF 5`PRUCTION 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 Ea Total
JOB SITE INFORMATION AND LOCATION !leafing/cooling:
Air conditioning 5
Job site address: 14145 SW 105 11'AVE Furnace 100,000 BTU(ducts/vents) ( /-tter35y-
City/State/ZIP: PORTLAND OR 97224 Furnace 100,000+BTU(ducts/vents) 54 91
n Heat pump 61 06
Suite/bldg./apt.no.: Project name: / [,i-� h ft/A. Y Rei-ko. 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),
in-wall,in-duct,suspended,etc 46 75
Flue/vent for any of above 23 32
Subdivision: Lot no.:
Other 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33 39
Replace three air conditioners Flue vent for water heater or gas
fireplace 23 32
I,og lighter(gas) 23.32
Replace 3 air handlers Wood/pellet stove 33 39
Wood fireplace/msert 23 32
Chimney/Inver/flue/vent 23.32
Other 2332
0 PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: Pacific health and rehap Range hood/other kitchen
'' l) equipment 33 39
Address: 14145 sw 105th ave Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: portland or 97224 toilet compartments,utility rooms) 23 32
Phone:(503)639-1144 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT Other 23.32
❑ CONTACT PERSON
Fuel piping:
Business name:A Team 1-leating S14.15 for first four;S4.03 for each additional
Contact name:Chris Rattray Furnace,etc
Gas heat pump
Address:5957 Mount Angel Hwy NE Wall/suspended/unit heater
City/State/ZIP:Silverton OR 97381 Water heater
Fireplace
Phone:(503)365-8326 Fax: :(503)365-8333 Range
E-mail:ateamhvac @yahoo.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other
Business name:A Team Heating MECHANICAL PERMIT FEES*
Address:5957 Mount Angel IIWY NE Subtotal
Minimum permit fee($90 00)
City/Stale/ZIP:Silverton OR 97381 Plan review(25%of permit Ice)
Phone:(503)365-8326 Fax:(503)365-8333 State surcharge(12%of permit fee)
CCB tic.: 188791 TOTAL PERMIT FEE 1/ 8'C/-33
This permit application expires if a permit is not obtained within 180
4 (lays after it has been accepted as complete.
Authorized signature: b I' * Fee methodology set by Tn-County Building Industry Service Board
Print name;; '{y A Date:9/24/15
1\Building\Permits\MEC_PermuApp_040113 doe 440-4617'1(I I/02/COMAVEB)
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.
I.\Building\Pernuts\MEC_PermitApp_040113 doc 2