Permit r '`
n CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2016 00212
T[GARP 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016
Parcel: 131260000300
Jurisdiction: Tigard
Site address: 9779 WASHINGTON SQUARE RD D11
Project: Champs Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Mechanical for TI:(3)VAV boxes,(2)exhaust fans,and replacing grilles.
Contractor: GREY WOLF HVAC INC. Owner: PPR WASHINGTON SQUARE LLC
7306 NE 37TH AVE PO BOX 847
VANCOUVER,WA 98665 CARLSBAD, CA 92018
PHONE: 360-635-6117 PHONE:
FAX: 360-326-8506
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/28/2016 $1,236.71
Class of Work: ALT Type of Const: Plan Review 03/28/2016 $309.18
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 03/28/2016 $148.41
Stories: Info Process/Archiving-Lg$2.00(over 03/28/2016 $4.00
11x17)
Project Valuation: $45,000.00
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 $1,698.30
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: VAV Boxes
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: leivortv.E___ PtrrInittee Signature: call_ f�\��r
CCC Call 503.639.4175 by 7:00 a.m.for the next available inspection date. J)
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
City of Tigardo-S4 DateBed
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223Ili y 3 ' 1 t0 arr. � ������fkA'�
■ PlanDReview Other Permit: '
Phone: 503.718.2439 Fax: 503.598.1960 ,.T IGA Rl> Inspection Line: 503.639.4175coct
6 Date ReadyBy: loris: Se Pa t for ""Q��
Internet: www.tigard-or.gov • ���0� Notified/Method: Y,A,...6.•
��� Supplemental Information
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/repllaal� I\ ! j , , performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: 'il mechanical materials,equipment,la. overhead,and profit.
Value:$ wo
k t
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description I Qty. I Ea. I Total -
r„.>� i, Heating/cooling:
Air conditioning 46.75
Job site address:-9595rSW Washington Square Rd Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:Dl l 1 Project name:Champs
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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater I 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
3 VAV's,2 EF's,GRD's fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
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/crawlspace fans 23.32
Other: 23.32
Fuel piping:
Business name:Grey Wolf HVAC,Inc.
$14.15 for first four;$4.03 for each additional
Contact name:Darrell Osborne Furnace,etc.
Address:7306 NE 37'h Ave. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98665 Water heater
Phone:(360)635-6117 I Fax::(360)326-8506 Fireplace
Range
E-mail:dosborne@greywolfhvac.com Barbecue
rc
Clothes dryer(gas)
Business name:Grey Wolf HVAC,Inc. Other:
d ,;
Address:7306 NE 371h Ave. Subtotal
City/State/ZIP:Vancouver,WA 98665 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)635-6117 Fax:(360)326-8506 State surcharge(12%of permit fee)
CCB lir.: 165139 TOTAL PERMIT FEE q d (,”JP,�i
' This permit application expires if a permit is not obtai tthin 180
days after it has been accepted as complete.
Authorized signature: /J ilki
.�.rrlaL-al I— * Fee methodology set by Tri-County Building Industry Service Board
Print name:Darrell Osborne 1r Date:031�/Z0i(0
1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I I/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
$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\Permits\MEC_PermitApp_040113.doc 2