Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00061
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/26/2016
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: TAP Plastics Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: Duct work and air distribution modifications.
Contractor: OREGON HEATING&AIR CONDITIONING LLC Owner: PACIFIC REALTY ASSOCIATES
19300 SW 118TH AVE ATTN: N PIVEN
TUALATIN, OR 97062 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-691-9699 PHONE:
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/26/2016 $360.41
Class of Work: ALT Type of Const: Plan Review 01/26/2016 $90.10
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/26/2016 $43.25
Stories:
Project Valuation: $10,500.00
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 $493.76
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire ifwork is of started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fo w r e,S—adn tem d by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- obtain a cop f the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: L�e ittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
OR MWOMM
City of Tigard � �v�� vers Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
= Phone: 503.718.2439 Fax: 503.598.1960 c1 C '�01F1 I)at/BY. Other Permit: PA20 IG
Inspection Line: 503.639.4175 1 p`� p U
Internet: www.ti and or. ov J A Date Ready/By: Juris: ® See Page 2 for
g g ��1GNR1 'fied/Method: Supplemental Information
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0-F [t+fL>.3$IEGI *' .. fiIISi
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ O Sots
CilTEGORY OF CON�'1'RUC'[1<4N RESIt?Ell t7AL EQU2PMEIVI tSX$l`EM3 FEES"
❑ I-and 2-family dwelling EffCommercial/industrial ❑Accessory building For special informar on use checklft
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. Total
Heating/cooling:
" Air conditioning 46.75
Job site address: SIU -7).,-,,k f Furnace 100,000 BTU ducts/vents) 46.75
City/State/ZIP: 6� Gj 7 �, Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:�� �(ks�,"($ Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: H dronic hot waters stem 23.32
Residential boiler(radiator or
h dronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for anyof above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
IJ(-tC :! I S ���•dv (9�%`�-`(__i�'-ekI5 fireplace 23.32
Log lighter as 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
Chimney/liner/flue/vent 23.32
Q Il~ "1t ''tliWR- }'l€FIi1 Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawls ace fans 23.32
❑ ICAIVT �'CONTAf't pE }R Other: 23.32
Fuel i in :
Business name: /e fl'q>'-'l $14.15 for first four;$4.03 for each additional
Contact name: c u L�1¢`,�{l r Furnace,etc.
Address: j1�6-C S(.0 l l q4 4,/ Gas heat um
I Wall/sus nded/unit heater
City/State/ZIP: 'Txtti to,4,`rt D X1'70 6?1 Water heater
Phone:(Spy ) $tI cl— 8t 6 Fax::(So� 6 I` SSS6 Fireplace
E-mail: Ran e
Barbecue
CONTRACTOR Clothes dryer
t L �` Other:
Business name:�/r �r`c� n MECHANICAL PERMIT FEES*
Address: 19 3OQ S't.0 1($)-(.. A v2 Subtotal
City/State/ZIP:"r Minimum permit fee($90.00)
G f Plan review(25%of permit fee) 90-10
Phone:&Sp ) l— l6 Fax: State surcharge(12%of permit fee) L- }..X
CCB lie.: 3`7 S`� TOTAL PERMIT FEE I "q-,,-7
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: - * Fee methodology set by Tri-County Building Industry Service Board
Print name.. i'B f r Date: 01
1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617r(11/02/COM/WEB)