Permit (223) n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00497
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/03/2012
Parcel: 2S 115BA02500
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY S2
Project: Spec Space Subdivision: 2004 -015 PARTITION PLAT Lot: 1
Project Description: Install new 6 ton gas pack with drops only. Install approximately 80' gas line
Contractor: WILLAMETTE HVAC LLC Owner: SN PROPERTIES PARTNERSHIP
3075 SW 234TH AVE. #206 1121 SW SALMON ST
HILLSBORO, OR 97123 PORTLAND, OR 97205
PHONE: 503 - 259 -3200 PHONE:
FAX: 503 - 848 -2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/03/2012 $313.99
Class of Work: ALT Type of Const: VB Plan Review 10/03/2012 $78.50
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 10/03/2012 $37.68
Stories: 1 Info Process /Archiving - Lg $2.00 (over 10/03/2012 $4.00
11x17)
Project Valuation: $8,800.00 Info Process /Archiving - Sm $0.50 (up to 10/03/2012 $10.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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 $444.67
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
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 y obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: jeetitAby eittal 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 A licatio / Er FOR OFFICE USE ONLY
City of Tigard .� Plan Date /B Rev iew �i-'t I a ' r,3- Permit No ve - e , „, a .. m i t e /
III
- ° 13125 SW Hall Blvd., Tigard, OR 97223 ���sss l t
: Phone: 503.718.2439 Fax: 503.598.1960 S E P 2 6 2012 Date /By: ,. I U Cher Permit: gap av« -D D 112--
Inspection Line: 503.639.4175
TIGARD y D ate Ready/ o Jul ®S Pa e 2 for
Internet: www.tigard- or.gov � � ; t f � - .-4., t 3��� Notified/Method: f� /� 2— �/ 7 �j Supplemental Information
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Ot[III rIfiklf•rkit�1"�r 3 0 ` -
”' e...r unit' � CO ERCI L FEE* SCHEDULE - USE CHECKLIST
TYPE OF WORK
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: $ $8,800.00
CATEGORY OF CONSTRUCTION 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
1e, aQOJOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 11 SW Pacific HWY (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: Tigard OR d�7� •fiC
Fumace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: NAB 1 Project name: Tigard 'Eosin S4 Yac.u3 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
Gas
Install new 6 ton gas pack with drops only. Install approx 80' gas line. fireplace/insert ate 33.39
Flue veent nt foor r water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ 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
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: same as below Other: 23.32
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: , [ : ' 1 / 1 413 ./PQ Q /1/4 MrAfi VG.C. C,2 / t'L Range
CONTRACTOR Barbecue
Business name: Willamette HVAC, LLC Clothes dryer (gas)
Other:
Address: 3075 SW 234 Ave Suite 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro, OR 97123 Subtotal
Phone: (503) 259.3200 Fax: (503) 848.2597 Minimum permit fee ($90.0
Plan review (25% of permit fee)
)
CCB tic.: 56951 / State surcharge (12% of permit fee)
/ TOTAL PERMIT FEE
`' / This 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: i' lLJ 9 / _ * Fee methodology set by Tri- County Building Industry Service Board
I,\ Building \ Permits \h1EC- PermitApp doe 03/07/12 440-4617T (1 /02 /COM EB)