Permit CITY OF TIGARD MECHANICAL PERMIT
14 . COMMUNITY DEVELOPMENT Permit#: MEC2021-00517
T f ;A R I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/5/2021
[
Parcel: 2S103DD01201
Jurisdiction: Tigard
Site address: 13920 SW PACIFIC HWY
Project: Goodwill Cash Room Subdivision: None Lot: None
Project Description: Install 2 ton mini split into existing cash room
Contractor: WILLAMETTE HVAC LLC Owner: GOODWILL INDUSTRIES OF THE
3075 SE CENTURY BLVD STE 206 COLUMBIA WILLAMETTE
HILLSBORO, OR 97123 1943 SE 6TH AVE
PORTLAND, OR 97214
PHONE: 503-259-3200 PHONE:
FAX: 503-848-2597
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/04/2021 $319.61
Class of Work: ALT Type of Const: VB Plan Review 08/04/2021 $79.90
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 08/04/2021 $38.35
Stories: Info Process/Archiving-Lg$2.00(over 08/04/2021 $6.00
11x17)
Project Valuation: $9,000.00 Info Process/Archiving-Sm$0.50(up to 08/04/2021 $5.50
11x17)
Fuel Air Handlers
Fuel Types: Electricity 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: 1
Appliances
Vent Fans: Vent Systems: Total $449.36
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
Issued By: H,,77„142.11/De/WP.gC Permittee Signature: OfvA pp Z.C.A f.UY1.
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.
--7l 4 r2
Mechanical Permit Applicat CEI\/E ) FOR OFFICE USE ONL1
t
City of Tigard ReceivedRee 1 1 Z Permit No.:
III 13125 SW Hall Blvd.,Tigard,OR 97223 ' Ml--(.ZOZ�_��
C Phone: 503.718.2439 Fax: 503.598.1960 JUL�U� ® 6 2021 DPlate/By:
Review
DateBy: J Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: g ' a JunT I 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: /.7/4/ .i L (7*, Supplemental Information
':_DING DIV " :a . fM L. A/9,7 4 6.,
TYPE OF WORK COMMERCIAL FEE* SCHEDULE —USE CHECKLIST
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:$$9,000.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
Heating/cooling;
JOB SITE INFORMATION AND LOCATION
Air conditioning
Job site address:13920 SW Pacific HWY (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:Goodwill Cash room Heat pump
(requires site plan showing placement) 61.06
Cross street/directions 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: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Install 2 ton mini split into existing Cash room. Gas fireplace/insert 33.39
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
❑ PROPERTY OWNER l 0 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
Business name:same as below Other: 23.32
Fuel piping:
Contact name: $14.15 for first four;$4.03 for each additional
Address: Furnace,etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone:( ) Fax::µ( ) Water heater
E-mail:n rr�t%A-ram'(1�WtItarrp.�tehva .. (_.6T1-N Range
CONTRACTOR Barbecue
Clothes dryer(gas)
Business name:Willamette HVAC,LLC
— Other:
Address:3075 SE Century Blvd Suite 206 MECHANICAL PERMIT FEES*
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)259.3200 Fax:(503)848.2597 Minimum permit fee($90.00)
Plan review(25%of permit fee)
CCB lic.: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:6/21/2021 * Fee methodology set by Tri-County Building Industry Service Board
1:\Building\Pennits\MEC-PermitApp.doc 03/07/12 440-4617T(11/02/COM/WEB) � oi
City of Tigard
1111 r COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Commercial - N o Land Use
Building Permit #: MEC2L \- OC)S\-1
Site Address: 13920 SW Pacific Highway Suite/Bldg#:
Project Name: Goodwill Cash Room
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Plannir.)_Re view-
Proposal: Roof top mechanical
Existing Business Activity: N/A
Proposed Business Activity: N/A
® Verify site address/suite # exists and active in permit system.
® River Terrace Neighborhood: ❑ Yes n No
bl Zoning: G-G
rill Permitted Use: ❑ Yes ❑ No ❑ Spec Space
❑X Confirm no land use required.
ID Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes: Set back on roof and screened by parapet.
Approved by Planning: � , oetivipijeu Date: 7/12/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Buildiri Permit Submittal
Original Submittal Date: t-7 `(o`Z\
Site Plans: #
Building Plans: # 3
Building Permit#: C'Enter building permit# above.
Workflow Routing: L-'Planning CWPermit Coordinator G /Building
Workflow Sign off: [l4ign-off for Planning(include notes from planning review)
Route Application Documents: IIE/Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: \ j\\ ar,\��-w-e° — Date: 1\ \3'ZJ1
I:\Building\Forms\Bldg PermitRvw_COM_NoLandUse_111819.docx
Pe -- 't Coordinator IIeviety
❑ Conditio ` et"prior to issuance of building permit
❑ Approved,NO - : ased: D
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 : .. cant:
0 SDC Fees Entered: W. o Trans Dev Tax: 0 Yes ❑ N
igard Trans SDC: 0 Yes 0 N/A
Parks SDC: 0 Yes 0 N/A
❑ OK to •. i e Permit
• i roved by Permit Coordinator: Date:
L:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx