Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Pe
COMMUNITY MEC2020-00366
Date Issued: 7/22/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AD02700
Jurisdiction: Tigard
Site address: 12625 SW 69TH AVE
Project: Dr. Hayden Subdivision: WEST PORTLAND HEIGHTS Lot: 1-8, PLL
Project Description: Push/pull a 3-ton split system(on ground).
Contractor: WILLAMETTE HVAC LLC Owner: MCCROSKEY,JOHN B
3075 SW 234TH AVE.#206 1380 MORNING SKY CT
HILLSBORO, OR 97123 LAKE OSWEGO, OR 97034
PHONE: 503-259-3200 PHONE:
FAX: 503-848-2597
FEES
Specifics: Description Date Amount
Type of Use: COM Building Misc Fund(copies/prints) 07/20/2020 $38.00
Class of Work: ALT Type of Const: VB Permit Fee 07/20/2020 $280.27
Occupancy Grp: B Occupancy Load: Plan Review 07/20/2020 $70.07
Stories: 12%State Surcharge-Mechanical 07/20/2020 $33.63
Info Process/Archiving-Sm$0.50(up to 07/20/2020 $50.50
Project Valuation: $7,580.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 1 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: 1
Appliances
Vent Fans: Vent Systems: Total $472.47
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 1.800.332.2344.
Issued By: `/// -7 A /� m�ermittee Signature: -
{ OC Call 503.639.4175 by 7:00 a.m.for the next available inspection date. -1"-- L%I/
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 licatl0 R EC E FOR OFFICE.USE.ONLY
City of Tigard Received .o i5 2-6 0 IIMEINTMAI
114'• 13125 SW Hall Blvd.,Tigard,OR 97223 J U N 1 0 2020 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ifflrillEa Other Pernut:
1 I G A It D Inspection Line: 503.639.4I75 CITY OF TIGARD Date Ready/By: 7uris: ® See Page 2 for
Internet www.tigard-or.gov BUILDING DIVISIO Notified/Method: Supplemental Information
COMMERCIAL"'<'E" §CaiULE — USECHEC
TYPE OF WORK
' Mechanical permit fees*arc based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all i
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$7,580.00
CATEGORY OF CONSTRUCTION , 1111MVIIM.F.9.1VERIE4YERESMII
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder 0 Other: Description Qty. Ea. Total
4' INFORMATION AND Heating/cooling:
:;„ Air conditioning
Job site address: 12625 SW 69th Ave (requires site plan showing placement) 46.75
Furnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP:Tigard OR 97223 Furnace I OQOOp+BTU(ducts/vents) 54.91
Crossbldg/apt.no.: I Project name:Dr.Hayden Heat pump
(requires site plan showing placement) 61.06
Cross street/iirections 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: I Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
, Y`I ESCRIPTION OF WO( Water heater 23.32
Gas fireplace/insert 33.39
Push/pull a 3 ton split system. 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
lig
❑ 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
Other: 23.32
Business name:same as below
Fuel piping:
Contact name: $14.15 for first four;S4.03 for each additional
Address: Furnace,etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( ) Fax: :( ) Water heater
Fireplace
E-mail: Range
IIIIIIIIIIIIIIIIIIIL CONTRACTOR 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($90.00)
Phone:(503)259.3200 Fax:(503)848.2597 Plan review(25%of permit fee)
1 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 malstrom Date:6/10/20 * Fee methodology set by Tri-County Building Industry Service Board
i;\Building\Permits'MEC-PennitApp.doc 03/07/12 440-4617r(I1102/COM/WPB)
Mechanical Permit Application - City of Tigard
Page 2 -Supplemental Information
Commercial & Multi-Famil Fee Schedule:
Total Valuatio 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.
I:1Building\Permits\MEC-PermitApp.doc 03/07/12 2
City of Tigard
III COMMUNITY DEVELOPMENT DEPARTMENT
■
rlcARD Building Permit Review — Commercial - No Land Use
Building Permit #: !Ij EC Zp 20 —06349 to
Site Address: 12(p25 SVN/ (52'h ANg- Suite/Bldg#:
Project Name: Dr, *delft
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: NV( t,V41 C 4 &tVl pr t,n,1 Lon GJn) ld )
Existing Business Activity: I A.
Proposed Business Activity: W I pc
NI Verify site address/suite# exists and active in permit system.
RiverhY_ Terrace Neighborhood ❑ Yes X No
Zoning:Sr U
Permitted Use: ❑ Yes ❑ No ❑ Spec Space
Nil- Confirm no land use required.
tstk Business License:
Exists: 0 Yes ❑ No,applicant was provided a business license application
Notes: PC13110. 41 'Y1-I" — I I k-e�vr I :Ve• ®us-hr nonc. vwt vn .
Approved by Planning: ''J !� `--' Date: (0 l lv 120
V
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: E Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: {p//a/7c
Site Plans: #
Building Plans: # . .Z
Building Permit#: P--Enter building permit# above.
Workflow Routing: 12 Planning ❑ Permit Coordinator '0 Building
Workflow Sign-off: (0—"Si -off for Planning(include notes from planning review)
Route Application Documents: Iiikj3uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: • �--(0).' ea R.a—J Date: G/s/
1:1Building\Forms\BldgPertnitRvw_COM_NoLandUse_l 11819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: • Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to App ' ant:
Revision Notice 2: Date Sent to .plicant:
Revision Notice 3: Date Sent . Applicant:
❑ SDC Fees Entered: Wash 'o Trans Dev Tax: ❑ Yes ❑ N/A
Ti;<rd Trans SDC: 0 Yes ❑ N/A
arks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit 'oordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandU se_111819.docx
Julie Drinkwater
From: Michael Malstrom <mmalstrom@willamettehvac.com> d Sent: Monday, July 20, 2020 6:56 AMTo: Julie Drinkwater
Subject: RE: MEC2020-00366, 12625 SW 69, Dr. Hayden
Caution! This message was sent from outside your organization. Allow sender I Block sender
Hello Julie,
I just paid the mechanical and electrical fees. Please make sure both permits get issued for this project.
Thank you,
Michael Malstrom
Willamette HVAC, LLC
3075 SE Century Blvd, Suite 206
Hillsboro, OR 97123
P: 503.259.3200
F: 503.848.2597
E: mmalstrom@willamettehvac.com
WILLAME"ITE lei
HVAC
From:Julie Drinkwater<JulieD@tigard-or.gov>
Sent:Thursday, July 16, 2020 5:35 PM
To: Michael Malstrom <mmalstrom@willamettehvac.com>
Subject: MEC2020-00366, 12625 SW 69, Dr. Hayden
Hello Michael
The permit for Dr. Hayden project is ready to be issued. The balance due is $472.47. Attached please find the
invoice for your review.
To pay the fees online, you can go to our website: https://aca.accela.com/TIGARD/Default.aspx. From there,
click on the Building tab, enter the permit number in the Record Number field, and click Search.
Please let us know once the fees have been paid so that we can make the permit ready for you to pick up.
Thank you
Julie Drinkwater
Permit Technician Assistant
City of"Tigard Building Department
1
13125 SW Hall Blvd
Tigard, OR 97223
503-718-2804
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
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