Permit CITY OF TIGARD MECHANICAL PERMIT
i. COMMUNITY DEVELOPMENT Permit#: MEC2020-00304
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/23/2020
T Ft;A R 17 9 Parcel: 2S 101 AB03100
Jurisdiction: Tigard
Site address: 12115 SW 70TH AVE 202
Project: Med RX Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Adding supply and returns to each office,ductwork off existing drops,and to exhaust.for TI.
Contractor: WILLAMETTE HVAC LLC Owner: TIGARD TRIANGLE PARTNERS LLC
3075 SW 234TH AVE.#206 BY DEERING MANAGEMENT GROUP
HILLSBORO,OR 97123 4800 SW MACADAM AVE STE 120
PORTLAND, OR 97239
PHONE: 503-259-3200 PHONE:
FAX: 503-848-2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/29/2020 $467.09
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 05/29/2020 $56.05
Occupancy Grp: Occupancy Load: Info Process/Archiving-Lg$2.00(over 05/29/2020 $4.00
11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 05/29/2020 $1.00
Project Valuation: $14,669,00 11x17)
Plan Review 05/29/2020 $116.77
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 $644.91
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 0 by calling 50 232.1987 or 1.8 0.332.2344.
Issued By: --—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 Application "' v.jti- FOR OFFICE USE ONLY
City of Tigard Received
• 13125 SW Hall Blvd.,Tigard,OR 97223 1 2 LQ2� Date/By: LWALIjt,/+t_ ,�_ ,
IdPlan Review
IIIPhone: 503.718.2439 Fax: 503.598.1960 DateBy: �., �,itplii ,
i i< n It 0 Inspection Line: 503.639.4175 q� -3`y ;( i :. Date Read B .tors.
r� 7 O 1 1 n Y y= 61 See Page 2 for
Internet: www.tigardor.gov r-.IN C't' Notified/Method: Supplemental Information
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
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
Value:$$14,669.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 12115 SW 70'h Ave (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) ' 46.75
City/State/ZIP:Tigard OR Furnace 100,000+BTU(duets/vents) 54.91
Suite/bldg./apt.no.:202 Project name:Med FIX 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
Add supply and return to each office.Ductwork off existing drops.Two exhaust Gas fireplace/insert 33.39
Flue vent for water heater or gas
fans. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
0 PROPERTY OWNER 0 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
Phone: Single-duct exhaust(bathrooms,
( ) Fax:( ) toilet compartments,utility rooms) 23.32
® APPLICANT 0 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
14/475/V0MLV14///IaJ.", l /a C Range
CONTRACTOR ,r G°O111 Barbecue
Business name:Willamette HVAC,LLC Clothes dryer(gas)
' Other:
Address:3075 SE Century Blvd Suite 206 MECHANICAL PERMIT FEES*
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Minimum permit fee(S90.00)
Phone:(503)2593200 Fax:(503)848.2597 Plan review(25%of permit fee)
CCB lie.: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 maistrom Date:5/6/2020 * Fee methodology set by Tri-County Building Industry Service Board
I:1Building'Perrnits\MEC-PemmitApp.doe 03/07/12 440-4617T(II/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-PemvtApp.doc 03/07/12 2