Permit .0,
IN CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Pe
COMMUNITY M EC2021-00275
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/15/2021
T I c-,A R I7 g Parcel: 2S 113AA00200
Jurisdiction: Tigard
Site address: 16364 SW 72ND AVE B8
Project: General Parts Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: Install(1)exhaust fan, (1)exhaust hood,and gas pipe.
Contractor: EXCEL HVAC INC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 1188 ATTN: N PIVEN
CANBY, OR 97013 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 971-930-7194 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/28/2021 $215.64
Class of Work: ALT Type of Const: VB Plan Review 05/28/2021 $53.91
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 05/28/2021 $25.88
Stories: Info Process/Archiving-Lg$2.00(over 05/28/2021 $4.00
11x17)
Project Valuation: $5,250.00 Info Process/Archiving-Sm$0.50(up to 05/28/2021 $5.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 cfm: 1
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: 1 Vent Systems: Total $304.43
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 10
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC ailing 503.232. 87 or 1.80 32.23 .
Issued By: Permittee Signature: ..-(" 4G2
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
16 -4/20
Mechanical Permit ApplicationR ECEIVE 'n FOR OFFICE USE ONLY ��—�--
City of Tigard Date/By: 2®LV21 gji Permit No.:M 21.-60275
111 " 13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 0 7,0V Plan Revie
IIPhone: 503.718.2439 Fax: 503.598.1960 Date/By: -- I Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-orgov Notifi /Metho • 16. Supplemental Information
BUILDING DIVISIOl\'
TYPE OF WORK MME CI E* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 5,250.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 16364 SW 72ND AVE. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: PORTLAND/OR/97224 Furnace 100,000+BTU(ducts/vents) 54.91
lOBP12.1 General Parts TrainingRoom Heat pump 61.06
Suite/bldg./apt.no.: Project name:
Duct work 23.32
Cross street/directions to job site: SW UPPER BOONES FERRY RD.AND SW 72ND AVE. 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
INSTALL(1)EXHAUST FAN,(1)EXHAUST HOOD,AND GAS PIPE fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER 0 TENANT Other:
Environmental exhaust and ventilation: 23.32
Name: PACTRUST Range hood/other kitchen
Address: 15350 SW SEQUOIA PARKWAY SUITE#300 equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: PORTLAND/OR/97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 503 ) 624-6300 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT ell CONTACT PERSON Other: 23.32
Business name: EXCEL HVAC,INC. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: ZACH BARBER Furnace,etc.
Address: 15832 SW UPPER BOONES FERRY RD. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: LAKE OSWEGO/OR/97035 Water heater
Phone:( 503 ) 550-6042 Fax: :( ) Fireplace
Range
E-mail: ZACH rr EXCELHVAC.NET Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: EXCEL HVAC,INC. Other:
MECHANICAL PERMIT FEES*
Address: 15832 SW UPPER BOONES FERRY RD. Subtotal
City/State/ZIP: LAKE OSWEGO/OR/97035 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 503 ) 828-5121 Fax:( ) State surcharge(12%of permit fee)
CCB lit.: 214345 TOTAL PERMIT FEE
(.,
This permit application expires if a permit is not obtained within 180
Zachary Barber Digitally signed by Zachary Barber days after it has been accepted as complete.
Authorized signature: Date:2021.04.14 12:53:00-0T00' * Fee methodology set by Tri-County Building Industry Service Board
Print name: ZACHARY BARBER Date: 04/14/2020
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I1/02/COM/WEB)
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
Tlcnra Building Permit Review — Commercial - No Land Use
Building Permit #: M --00275-
Site Address: 16364 SW 72nd Ave Suite/Bldg#:
Project Name: General Parts
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Mechanical work - install new exhaust fan, exhaust hood, and gas pipe
Existing Business Activity: N/A
Proposed Business Activity: N/A
erify site address/suite#exists and active in permit s stem.
'ver Terrace Neighborhood: ❑ Yes L"I No
ning: I-L
ermitted Use: U Yes U No U Spec Space
Clnfirm no land use required.
:usiness License:
Exists: ❑ Yes ❑ No, applicant was provided a business license application
Notes:
•
Approved by Planning: —i Date: 4/21/21
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: El Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: Oy020,202/
Site Plans: # 2
Building Plans: # 2-
Building Permit#: I Enter building ermit# above.
Workflow Routing: laPlanning Permit Coordinator Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Q'Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: b eA02-/
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_I 1 1 819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
El Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applica r :
Revision Notice 3: Date Sent to Appli-ant:
❑ SDC Fees Entered: Wash Co Tram 1ev Tax: ❑ Yes ❑ N/A
Tigard Tra : SDC: ❑ Yes ❑ N/A
Parks SD(: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordin. or: Date:
L\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx