Permit (169) CITY OF TIGARD MECHANICAL PERMIT
1' 111 '' COMMUNITY DEVELOPMENT Permit#: MEC2019-00280
Date Issued: 05/20/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 102AA00906
Jurisdiction: Tigard
Site address: 12084 SW MAIN ST
Project: Kimberly Berg's Rebel Fit Subdivision: Lot: 4
Project Description: Adding gas piping for(2)rooftop units.
Contractor: EVOLUTION PLUMBING LLC Owner: BSM REALTY LLC
7715 NE 33RD DR SUITE D BY RITE AID
PORTLAND, OR 97211 PO BOX 3165
HARRISBURG, PA 17105
PHONE: 503-655-3388 PHONE:
FAX: 503-305-8373
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/17/2019 $84.41
Class of Work: ALT Type of Const: VB Plan Review 05/17/2019 $21.10
Occupancy Grp: A-3 Occupancy Load: 12%State Surcharge-Mechanical 05/17/2019 $10.13
Stories: Info Process/Archiving-Sm$0.50(up to 05/17/2019 $1.00
11x17)
Project Valuation: $1,000.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $116.64
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
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.:en 317 2344.
s
Issued By: mittee Signature:
Call 50 .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 bite at the time of each inspection.
Mechanical Permit Applica ow .` , xf FOR OFFICE FSE O\Ll
Cityof Tigard Received Permit No.M
• 131SW Hall Blvd.,Tigard,OR 97223 MAY 01_ ?019 Uate/By: 71.-5\---+
��"���\ ��\��" t�-CG +
Plan Review
1 Phone: 503.718.2439 Fax: 503.598.1960 Other Permk: l>
Date/By: _SACl 1 9 `J 14 : . 13v\C .A...
i F \i 1
1 Inspection Line: 503.639.4175 ( d t § pate /B ; Ea See Page2 for
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/ Supplemental Information
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Mechanical parrot fees'are based on the value of the work
❑New construction N Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other mechanical materials equipment,labor,overhead and profit.
Od
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❑ 1-and 2-family dwelling (Q]Commercial/industrial ❑Accessory building Far spedel information use checklist:
❑Multi-family ❑Master builder 0 Other: Description 1 Qty. 1 Ea. 1 Total
v � ma r or..r.z x r, a.. ,�� .s'�e:�� a�� n ,41,,,,,A-..7;5.. Head,.coOUn::
Air contiitionin: 46.75
Job site address: /t.i1i , "awl Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: "r ✓t-d, De_ (1
/ZZs� Furnace
ce 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: 9_n' C 'TCit
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: l Lot no.: Other 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
]8`s°??IllW l Gas fireplac elinsect 3339
�n/i ( Flue vent for water heater or gas
gun Sas Pi pi r +rit t0 (2,) r lb? tAnt-K• f :.lace 23.32
`J Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
; : - m' .,:. :''' ':'-''''' ''."'""''''''''''c'''.::. . r t ' « ' ls Other: 2332
,_ .''.r , . . s. .1w. .,-:
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
"0111x ., '10C S,.„ .. t 1 >4"O '?� `` ' Other.., 23.32
Business name: �E%,pl -17`umb;n(Jti Fuel '.Sri 1
J $14.15 for first four;$4.03 for each additional
Contact name: .c �l(nea -Fast Furnace,etc.
`11(e N� �'(�^ �vte Awheat.
Address: '
Wallis •-ded/unit heater 111111111111
City/State/ZIP: eThtrtMY wtOIa. cri212 Water heater —_—
Phone:(.5t12) V266.egg. I Fax::( ) Fireplace ■.IIIII
Ranee
E mail.S f I L% 1 ' ND'tuWVC)1n ►1- Barbecue ■.�
,.. ...��F.. . ;T.....r£ ;..:,��,a�5�..,.ti�-�+".-�U~�,`�f �`.�'..�.-«.' 9#.7�,.. .., ,..,::..,��t.,.W��_t�,�„���.�”-� kKI►CS�i er .
C �r.
LVOIt ttitwl 'urnta/j ULC Other
Business name: Efils M r i F t
.
fiv
Address: —72, O ' f , e., ' SubtotalLIARCity/State/ZIP:'b(napykJove— O ' ucMinimum permit fee($90.00)
rev
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Phone:(Q tg . 7. Fax:( )
Plan charge(12%of permit fee)
State surcharge(12°'0 of permit fee) 10.
CCB lie.: j?a'1 TOTAL PERMIT FEE 6 . 1,0/
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: - • .. * Fee methodology set by Tri-County Building Industry Service Board ,
rint
P6uildio name:
irs�MECv rLerm1 App_0o40113.doo V`S l _Date: aero-a6'rr(fi;oz coiRvwsel 1b( v 4�on • #1
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial&MultiFamily Fee Schedule:
_'t- '.'.��a�'T k(x�..�f � -y�� :re V.
$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_PennitApp_040113.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12084 SW MAIN ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2019-00280
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor