Permit I CITY OF TIGARD MECHANICAL PERMIT
q ' COMMUNITY DEVELOPMENT Permit#: MEC2016-00024
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/12/2016
Parcel: 1 S 134AA01900
Jurisdiction: Tigard
Site address: 10115 SW NIMBUS AVE 500
Project: Express Employment Professionals Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Alteration of registers and grilles. Add exhaust fan in restroom and server room. Rework duct work for exhaust
units.
Contractor: WILLAMETTE HVAC LLC Owner: ROBINSON, CONSTANCE A
3075 SW 234TH AVE.#206 BY KILLIAN PACIFIC LLC
HILLSBORO, OR 97123 500 EAST BROADWAY, STE 110
VANCOUVER,WA 98660
PHONE: 503-259-3200 PHONE:
FAX: 503-848-2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/12/2016 $232.50
Class of Work: ALT Type of Const: Plan Review 01/12/2016 $58.13
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/12/2016 $27.90
Stories: Info Process/Archiving-Lg$2.00(over 01/12/2016 $4.00
11x17)
Project Valuation: $5,850.00 Info Process/Archiving-Sm$0.50(up to 01/12/2016 $1.50
11x17)
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: 2 Vent Systems: Total $324.03
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 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
Utilit otification Ce -r. ose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma obtain copy of the rules
o irect questions to OUA' by ailing 503.232.1987 or 1.800.332.2344.
Issued By: ,/`/„, 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 151.Oy11
City of Tigard Received I?g Date/By: / S ? /10 iii&, Permit No.:fiee An/ ,,,,,,e2 A
N . 13125 SW Hall Blvd.,Tigard, . ZQEIVED
Date/By:
Phone: 503.718.2439 Fax: 5 cJ�j an Review Other Permit:4K /6-oo 35-
D
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-ocgov JAN
1 2 2016 Notified/Method: Supplemental Information
I CIT TWA I�IIGAR+�Q�� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
DIVISION 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:$$5,850.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 10115 SW Nimbus Ave (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:500 Project name:Express Employment Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Add or re-locate registers and grilles to accommodate a new office layout. Gas fireplace/insert for water 33.39
Flue vent for water heater or gas
Add restroom fan and server room fan.Re-work duct work for restrooms fireplace 23.32
Log lighter(gas) 23.32
and server room exhaust Wood/pellet stove 33.39
Wood fireplace/insert 23.32
0 PROPERTY OWNER 0 TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) , 23.32
0 APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name:same as below
Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Address: Furnace,etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( )
Fax::( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name:Willamette HVAC,LLC Clothes dryer(gas)
Other:
Address:3075 SE Century Blvd Suite 206 MECHANICAL PERMIT FEES*
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Minimum permit fee($90.00)
Phone:(503)259.3200 Fax:(503)848.2597Plan review(25%of permit fee)
CCB lic.:56951 State surcharge(12%of permit fee)
TOTAL PERMIT FEE ?..3„211.43
oikThis permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name:michael malstrom Date:1/6/16 * Fee methodology set by Tri-County Building Industry Service Board
I\Building\Permits\MEC-PermitApp.doc 03/07/12 440-4617T(I1/02/COM/WEB)
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