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Permit (248) PEV!SE9 MECHANICAL PERMIT CITY OF TIGARD . 8 COMMUNITY DEVELOPMENT Permit #: MEC201300093 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/12/2013 Parcel: 2S115AB01900 Jurisdiction: Tigard Site address: 16200 SW PACIFIC HWY A Project: Anytime Fitness Subdivision: 1994 -028 PARTITION PLAT Lot: 2 Project Description: Replace ductwork and exhaust fans 2/12/13 REPRINT to correct ASI information Contractor: BEL SOUTHWEST INC Owner: SN PROPERTIES PARTNERSHIP 5186 E 16TH AVE 1121 SW SALMON ST APACHE JUNCTION, AZ 85119 PORTLAND, OR 97205 PHONE: 480 - 232 -6242 PHONE: FAX: - FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 02/12/2013 $373.11 Class of Work: ALT Type of Const: Plan Review 02/12/2013 $93.28 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 02/12/2013 $44.77 Stories: Project Valuation: $11,000.00 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 $511.16 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 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. /! d /J Issued By: Aki-A—kli - ►n , Permittee Signature: Ojq PPLI e I /Uq 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. CITY OF TIGARD MECHANICAL PERMIT • 1/11 ' COMMUNITY DEVELOPMENT Permit #: MEC201300093 TIGARD 13125 SW Hall Blvd.. Tigard OR 97223 503.718.2439 Date Issued: 02/12/2013 Parcel: 2S115AB01900 Jurisdiction: Tigard Site address: 16200 SW PACIFIC HWY A Project: Anytime Fitness Subdivision: 1994 -028 PARTITION PLAT Lot: 2 Project Description: Replace ductwork and exhaust fans Contractor: BEL SOUTHWEST INC Owner: SN PROPERTIES PARTNERSHIP 5186E 16TH AVE 1121 SW SALMON ST APACHE JUNCTION, AZ 85119 PORTLAND, OR 97205 PHONE: 480 - 232 -6242 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 02/12/2013 $373.11 Class of Work: ALT Type of Const: Plan Review 02/12/2013 $93.28 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 02/12/2013 $44.77 Stories: Project Valuation: $11,000.00 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 $511.16 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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: n duo_ i 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 Applicati0 'RECEIVED Received FOR OFFICE USE ONLY II City of Tigard Date/By: a if -f/ 3 sr- PermitNo.: 012i - ovocr3 ° 13125 SW Hall Blvd., Tigard, OR 97223 0 . Phone: 503.718.2439 Fax: 503.598.1960 FEB 2 2013 Plan Review Date/By: Other Permit: {Z, r p ;013- 091) a TI G n R D Inspection Line: 503.639 Date Ready/By: 1111 El See Page 2 for Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 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: $ ( i doe e t o 0 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling: �/� /, v� 1 / / 4 A f'/ Air conditioning Job site address: l 6 ` 2 t/ t/ s G / / G M K/ $004-4- (requires site plan showing placement) 46.75 Furnace 100,000 BTU (ducts/vents) 46.75 City/State /ZIP: % / �r1 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: 42 ,((4 . F /: t z_f: ss Heat pump (requires site plan showing placement) 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 23.32 / / ' /l / Gas fireplace/insert 33.39 C -! 4- C e i G 7 0 n 7L Px 1l .4- 4 � .4i `$ Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32 Other: 23.32 Name: 5 A / , d,c ,t ,L, e f i " 4- 4 e /„ 54y, Environmental exhaust and ventilation: Address: / / / s w S' _4 /� � © $ t Range hood/other kitchen equipment 33.39 City /State /ZIP: D e 1[ 4 ..-A 0 4 q 7.2o S- Clothes dryer exhaust 33.39 Fax: Single -duct exhaust (bathrooms, Phone: ( ) ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact name: 514.15 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 E -mail: Fireplace Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: C l S D trI !N &S Other: Address: 57� 6 t (G 4-/ A v C- MECHANICAL PERMIT FEES* City/State /ZIP: tf die ✓ v �G i 4, r 2 Subtotal Minimum permit fee ($90.00) Phone: (-0D )2 3,,z _ Ga 4!„z Fax: ( ) Plan review (25% of permit fee) CCB lie.: / 9g t3 L. -5 State surcharge (12% of permit fee) f TOTAL PERMIT FEE ca • 1 to This permit application expires if a permit is not obtained within 180 Authorized signatur . days after it has been accepted as complete. Print name: G / / ( _� 7/X Date: id 3 * Fee methodology set by Tn -County Building Industry Service Board 1:\ Building \Permits\MEcpermitApp.do /0 1712 44 6I7T(I1 /02/COM/WEB) Mechanical Permit Application - City of Tigard .Page 2 Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation: Permit Fee: $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. • 1:\ Building \Permits\MEC- PermitApp.doc 03/07/12 2