Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2021-00241
TF t AR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/26/2021
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Parcel: 1 S136DA00101
Jurisdiction: Tigard
Site address: 11410 SW 68TH PKWY
Project: Oregon PERS Subdivision: None Lot: None
Project Description: Replacing(2)rooftop units,(32)fan power terminals,(23)single duct terminal units,and existing HVAC controls.
Contractor: ROBERT LLOYD SHEET METAL INC Owner: OREGON,STATE OF PUBLIC
PO BOX 307 EMPLOYEES'RETIREMENT FUND
INDEPENDENCE, OR 97351 11410 SW 68TH PKWY
TIGARD, OR 97223
PHONE: 503-606-5007 PHONE:
FAX: 503-838-3964
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/25/2021 $16,817.43
Class of Work: ALT Type of Const: VB Plan Review 05/25/2021 $4,204.36
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 05/25/2021 $2,018.09
Stories: 3 Info Process/Archiving-Lg$2.00(over 05/25/2021 $26.00
11x17)
Project Valuation: $586,530.00 Info Process/Archiving-Sm$0.50(up to 05/25/2021 $12.50
11x17)
Fuel Air Handlers
Fuel Types: Electricity Units<10000 cfm: 32
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: 23 Vent Systems: Total $23,078.38
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 100
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: bo n , Permittee Signature: Mh ac't '\
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.
- 4-7-- 2,
er
Mechanical Permit A licati0 WE • FOR OFFICE USE ONLY
City of Tigard EWE LDateBy�v7 ! 2aL fi, Permit>,er4tczou O6/24,l
1111 13125 SW Hall Blvd.,Tigard,OR 97223
1L • Plan Review
• Phone: 50.3718.2439 Fax 503.598.1960 r!, , Date/By J •20 -al Other Permit
TIGARD Inspection Line: 503 639 4175 Date Ready/By turfs. Ed See Page 2 for
Internet: www.tigard-orgov Cell "irARD NolG ood edlMeth : 6"r(/_ Supplemental Information
kii
:a01311001/4 '1111CV'.` ; �y1 a 1S
TYPE OF WORK r,vt C:OMYfF,RCtAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit tees*are based on the value of the work
0 New construction Additionlalteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$586,530.00
CATEG RY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checkliss.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 11410 SW 68th Parkway Furnace 100,000 BTU(ductslvents) 46.75
City/State/ZIP: Tigard, Cr7223 Furnace 100,000+BTU(ductsrvents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:PERS HVAC Sys Repacement Ductwork 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
SW 68th Parkway, between SW Atlanta St and Hwy99W 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.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 3339
Flue vent for water heater or gas
Replacing two rooftop HVAC units (like-for-like) fireplace 2332
Replacing 32 Fan Powered Terminal Units (like-for-like) Log lighter(gas) 23.32
Wood/pellet stove 33.39
1„ Replacing 23 Single duct Terminal Units (like-for-like) Wood fireplace/insert 23.32
Cleaning Existing Duct, Replacing existing HVAC Controls Chimney/liner/flue/vent 23.32
le:1 ❑ PROPERTY OWNER — ❑ 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, i
toilet compartments,utility rooms) 23.32
Phone. ( ) Fax:( ) Attic/crawlspace fans 23.32
APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: Robert Lloyd Sheet Metal Inc Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Joshua Cook (estimator) Furnace,etc.
Address: 4485 Independence Highway Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Independence, OR 97351 Water heater
Phone:(503) 838-3863 ext 5014J Fax: :(503)838-3964 _ Fireplace
' E-mail: Josh.Cook@RLSM.net Range
Barbecue
CONTRACTOR - Clothes dryer(gas)
Other
Robert Lloyd Sheet Metal Inc
Business name: MECHANICAL PERMIT FEES-I
Address: 4485 Independence Highway subtotal 16,829.1i
City/State/ZIP: Independence, OR 97351 Minimum permit fee($90.00)
' Plan review(25%of permit fee) 4,207.28
Phone:(503)838-3863 ext 5014 Fax:(503) 838-3964 State surcharge(12%of permit fee) 2,019.49
CCB lie.: 62476 (exp 1 1/08/2021) TOTAL PERMIT FEE 23,055.88
This permit application expires if a permit is not obtained within 180
IP days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: Date: 03/29/2021
I.1BuildIngTerm \MEC PermdApp 0401 c 440-4617r(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information ry
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 ;Winntle
$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_PermitApp_0401 I3.doc 2
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City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
'PIC
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: IV/iECZOZ(-OQZ, 41
Site Address: 11410 SW 68th Parkway Suite/Bldg#:
Project Name: PERS
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Plarirlke Review
Proposal: HVAC
Existing Business Activity: n/a
Proposed Business Activity: n/a
® Verify site address/suite#exists and active in permit system.
J River Terrace Neighborhood: ❑ Yes T<l No
1 Zoning: TMU
I1 Permitted Use: ❑ Yes ❑ No ❑ Spec Space
® Confirm no land use required.
rlB Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes: Roof top; screening not required in TMU zone.
Approved by Planning: ,yl(6 Amok Date: 4/8/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: E Approved ❑ Not Approved
8tri7dir Permit Stibixtittal Original Submittal Date: ZNI/' 20'i
Site Plans: # 2
Building Plans: # 2----
Building Permit#: 19'Enter building permit# above.
Workflow Routing: M-Planning ❑ Permit Coordinator P.-Building
Workflow Sign-off: Et-Sign-off for Planning(include notes from planning review)
Route Application Documents: a-Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: /
By Permit Technician: �:%i'�'' / Date:
y' - I:1Building\Forms1BldgPermitRvw COM_NoLandUse_111 19.docx °t
-.-t Cborc itlatot Review
❑ Conditio et"prior to issuance of building permit
❑ Approved,NO ased:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Appli
Revision Notice 3: Date Sent to s . cant:
❑ SDC Fees Entered: W o Trans Dev Tax: ❑ Yes ❑ N
igard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to - e Permit
. roved by Permit Coordinator: Date:
1:1Building\Forms\BldgPermitRvw COM_NoLandUse_I11819.docx