Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2020-00583
Date Issued: 9/9/2020
T f C1 A P.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 570
Project: Dr Andrew Henderson Subdivision: None Lot: None
Project Description: Replacing grills and new exhaust fans.
Contractor: ARJAE HVAC AND MECHANICAL SERVICES LLC Owner: LITHIA REAL ESTATE INC
8545 SE MCLOUGHLIN BLVD ATTN DEBOER, MARK
MILWAUKIE, OR 97222 150 N BARTLETT ST
MEDFORD, OR 97501
PHONE: 503-231-7717 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/09/2020 $176.51
Class of Work: ALT Type of Const: Plan Review 09/09/2020 $44.13
Occupancy Grp; Occupancy Load: 12%State Surcharge-Mechanical 09/09/2020 $21.18
11
Stories: Info Process/Archiving-Lg$2.00(over 09/09/2020 $2.00
11x17)
Project Valuation: $4,000.00 Info Process/Archiving-Sm$0.50(up to 09/09/2020 $1.00
11x17)
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: 4 Vent Systems: Total $244.82
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
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 calllliinng/�503.232.1987 or 1.800.332.2344.
Issued By: i{ /^ _ _ -�. Permittee Signature: �f� 7p L, �.n o�
! 1/ /I/YiCallll C503.639.4175 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.
43f24o 1 c
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received y N
- Date/By: 3 Y v 477 Permit No.:�,F"A..1.�— nl5Ty
n 13125 SW Hall Blvd.,Tigard,OR 97223li f Plan Review OG1�� (/UUO
_ Phone: 503.718.2439 Fax: 503.598.1 >F" '* �„ j9... Other Permit: o{�P �y�� 1
'�"° �" r d...,� DatciBy: / °f,( t —W
TIGARD Inspection Line. 503639.4175 ..+t .«- - Date Read /B . duds:
Internet: www.tigard-or. ov } o See Pent i2 for
e g a ' Notified/Method: 47/7 '],t �(� supplemental Information
",III, n ?r. 0 �p e
I A PI: OF R'ORK CO_ NIERC I AL EEL' SCUM LI: - LSt:CHEC611,I83.
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:$4,000
C,A"1'Et;0RV OF CONSJR( (7110\ ROIDENTIAI.EQI II']11iNT/s\STI:ALS FEES*
❑ I-and 2-lam i I) dwel li ng g Comnterciallinduslrial ❑ .A cite ssory buil ding For special information use checklist.
❑ Multi-family ❑Master builder 0 Other: Description Qty. Fa. Total
JOU SITE I\IORNI:.IJ0N AND IO(l Q\ Heating cooling:
Air conditioning 46.75
Job site address:9020 SW Washington SQ. RD. Furnace 100,000 BTU iducus/vcws) 46.75
City/State/ZIP:TIGARD, OR Furnace 100,000+BTU I ducts.beats) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: S30 Project name:DR. HENDERSON Ductwork 2332
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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
REPLACE GRILLS, INSTALL NEW EXHAUST FANS fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
❑ PROPER El OWNER ® ITN.ANI`
Environmental exhaust and ventilation:
Name:DR. HENDERSON Range hood/ottterkitchen
equipment 33.39
Address:**same as above** Clothes dryer exhaust 33.39
City/State/ZIP:**same as above** Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
('hone:( ) Far ( ) Attic/crawlspace fans 23.32
NI .tPI'L.I( N.NT ❑ CONTACT PERSON Other: 2332
Business name:Arjae Sheetmetal Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address:85j45 SE Mcloughlin Blvd. Wall/suspended/unit heater
City/State/ZIP:Milwaukie, Or 97222 Water heater
Phone:( )5032317717 Fax: :( ) Fireplace
Range
Email: permits@arjae.com Barbecue
CON"I'R:ICFOR Clothes dryer(gas t
liminess name:**same as above** Other:
Alf.( IINSA( 11 PERMIT FEES'
Address:**same as above** Subtotal
City/State/Z1P:**same as above** Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( )**same as above** Fax:( )
State surcharge(12%20/o of permit fee)
CCB lie.:224490 TOTAL PERMIT FEE
'Phis permit application expires if a permit is not obtained within 180
J�I 2 e„J�+(� e days after it has been accepted as complete.
Authorized signature: //e2.644 /L 2.1.,4.2 .4.40fi * Fee methodology set by Tri-County Building Industry Service Board
Print name:David Scheuermann Date:08-20-20
I:\Building'PermildMEC_PermitApp_040113.doc 440-4617T(I t/02/COM/WEl3)
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 lee$69.06
$500.01 to$5,000.00 $69.06 for the first S500.00 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.
C\BuildingV'erm its\MEC PermitApp_040II3.doc 2