Permit CITY OF TIGARD MECHANICAL PERMIT
14 s ' ' COMMUNITY DEVELOPMENT Permitq: MEC2021-00152
Date Issued: 3/15/2021
T I G A R r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD, STE#301
Project: Embassy Canter Subdivision: None Lot: None
Project Description: Relocate supply diffuser&plenum returns, limited demo of air distribution and provide and air distribution drawn.
Contractor: OREGON HEATING&AIR CONDITIONING LLC Owner: LITHIA REAL ESTATE INC
6950 SW 111TH AVE ATTN DEBOER, MARK
BEAVERTON, OR 97008 150 N BARTLETT ST
MEDFORD, OR 97501
PHONE: 503-691-9699 PHONE:
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/15/2021 $639.81
Class of Work: ALT Type of Const: Plan Review 03/15/2021 $159.95
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 03/15/2021 $76.78
Info Process/Archiving-Lg$2.00(over 03/15/2021 $2.00
Stories: 11x17)
Project Valuation: $21,415.00
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 $878.54
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: \\,.T\�\\ 1 a� , () , Permittee Signature: .ti ��0 r
V 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.
`•_ ZI ' C3
Mechanical Permit Application Folt orFICE USE Oyl.l
City of Tigard ECEI\ED Received AT ii 2o2.1_ N1�2 2i" /6' .
INI II Dat,Re Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 9722 plan Review
Phone: 503.718.2439 Fax: 503.598.1960 ^^ppq (t Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 �yl r1 i� " ���� Date Ready/By: hate Ed See Page liar
Internet: www.tigard-or.gov 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 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$21,415.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family D Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 9020 SW Washington Square Rd Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
5uitePoldg./apt.no.: Project nam eEMBASSY TOWER 3RD FLOOR Heat pump 61.06
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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.:1 S126BC01506 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert , 33.39
Flue vent for water heater or gas
Relocate supply diffusers and plenum returns fireplace 23.32
Limited demo of air distribution Log lighter(gas) 23.32
Wood/pellet stove 33.39
Provide and install air distribution as drawn Wood fireplace/insert 23.32
ChRelocate thermostats —eil 1,y,� 6e_*rrvv }, Other: yrl ner/flne/vent 23.32
El PROPERTY OWNER J 0 TENANT Other. 23.32
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
0 APPLICANT lla CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Oregon Heating and Air Conditioning
S14.15 for first four;$4.03 for each additional
Contact name: Jeff Sanchez Furnace,etc.
Address: 6950 SW 111th Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Beaverton OR 97008 Water heater
Phone:(503) 572-6984 Fax::( ) Fireplace
Range
E-mail: jsanchez@oregonheating.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Oregon Heating and Air Conditioning Other:
MECHANICAL PERMIT FEES*
Address: 6950 SW 111th Ave Subtotal b37-jorD
City/State/ZIP: Beaverton OR 97008 Minimum permit fee($90.00)
Plan review(25%ofpermit fee) t SCI .[(t
Phone:(503) 572-6984 Fax:( ) State surcharge(12%of permit fee) 7frj,rj/..—
CCB lie.: 137653 TOTAL PERMIT FEE tp'7 5. 5$
This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
/ffAuthorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: 14114Li ii('LnOn eta Date: -3,3, h'
t:iBuldingtPermusuMEC_PermitApp_040113.doc 440-4617r(11/02VCOM/WEB)