Permit (233) '4•
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CITY OF TIGARD MECHANICAL PERMIT
IF1 n COMMUNITY DEVELOPMENT Permit #: MEC2012 -00564
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/07/2012
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY S
Project: Gentle Dental Subdivision: 1994 -028 PARTITION PLAT Lot: 2 •
Project Description: Duct work, registers, grills to existing roof top units
Contractor: ARJAE SHEET METAL CO, INC. Owner: SN PROPERTIES PARTNERSHIP
5510 SE MCLOUGHLIN BLVD. 1121 SW SALMON ST
PORTLAND, OR 97202 PORTLAND, OR 97205
PHONE: 503 - 231 -7717 PHONE:
FAX: 503 - 230 -4888
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/07/2012 $525.51
Class of Work: ALT Type of Const: VB Plan Review 10/29/2012 $131.38
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 11/07/2012 $63.06
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Stories: 1 Info Process /Archiving - Lg $2.00 (over 11/07/2012 $10.00
11x17)
Project Valuation: $16,950.00
• Fuel Air Handlers
Fuel Types: 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 $729.95
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Duct work
Duct Work: and registers
Fire /Smoke Dampers:
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notifi . . - - • er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct : estions to OU by calli . 503.232.1987 or 1.800.332.2344.
Issu =d By: /j Permittee Signature: p {
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Call 503.639.4175 by 7:00 a.m. for the next available insp= t' • n date.
— - This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Application FOR OFFICE USE ONLY
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2' City of Tigard � � ��� Date /By Receive : (oI' l a- Permit N� }. 0051 5/_
IIII q 13125 SW Hall Blvd., Tigard, OR 97 �
Phone: 503.718.2439 Fax: 503.598. 6 Plan Dale /By: I r Review ' 1 f ( �I n_ i / /...5( l
Other Permit:
TIGARD Inspection Line: 503.639 OCT-: 2 9 2012 Date Ready /By: �^ ^ tuns: ® See Page 2 for
Internet: www.tigard- or.gov Notified /Method: if. (P / / ��1 /J /-� 11A, Supplemental Information
a - F Iir! '
TYPE OF !� _ Co ME' j L FEE* SCHEDULE - USE CHECKLIST
•.li1 I.: ' 11.1 it. 1$:..
• • - Mechanical permit fees* are based on the value of the work
❑ New construction 21 Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ /6 95
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 I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: i `� (requires site plan showing placement) 46.75
O $ W BALI F l L I-} W of Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: T► GArX.C) . OR. 9/7,1,i- Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: 1 I Project name: GENtt._ 060114 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
T &A ILO lb lW hie- S atu4 Q.E. Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I 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 fireplace/insert 33.39
D WCIZ -1d- (1 2. lislSrc.04 1 G4UL..S TU le-x) S T(6V 6 Flue vent for water heater or gas
fire.lace 23.32
floor- To Q l I1N • •
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER INANT Chimney /liner /flue/vent 23.32
Other: 23.32
Name: G'GNruE o E , irt., : Environmental exhaust and ventilation:
Address: Range hood/other kitchen
�A IINI. C equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICANT I ❑ CONTACT PERSON Attic /crawlspace fans 23.32
�y�� Other: I 1 23.32 I
Business name:
1�IAtE 5 r ...air M _-ri1i..... Fuel piping:
Contact name: 4 11 64 w (SEhnoo N $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
8s - 45 -- s& MCLou6I -}-LlN SIN(• Gas heat pump
City /State /ZIP: M I UN (4 is (e of- 9/ ZZZ Wall/suspended/unit heater
Phone: (03) 23 i 1711 Fax: : 5-03) 23 1/43 9.8 g is Water heater
Fire. lace
E -mail: 3 l yvt & Ap E - CO AA _ Range
CONTRACTOR Barbecue
Business name: SA IwIE Clothes dryer (gas) n
/"ollf 1 7‘40-- /31.3V
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 6"0835 State surcharge (I2 %a 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: J / idfS^ Le7`/ Date: to / / * Fee methodology set by Tri -County Building Industry Service Board
I ?Building \Permits \MEC- PermitApp.doc 03/07/12 440- 4617T(II/02 /COM/WEB)