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Permit
FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmit tal Letter r i i.;A RI) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • cu ww.tioard-or.gov TO: �b104 /j /i. DATE RECEIVED: DEPT: BUILDIN DIVISION EdflifECI FROM: C t.IM h1� 'r (i4ft - ecriitil COMPANY: krrfit46 g /41/4 , CI 'vor �1i TY;��F� PHONE: 97/ ZAP/ 'Oil 7C BUILDI� RE: l,1f Z 7" t ,(4! 3., ileity4 eA Ataliort �6, (Site Address) (Permit Number) #4® 7crd/6-a1p Tr (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s)of plans. X Revisions: C (4 Alidt Cross section(s) and details. — Wall bracing and/orlateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. v Other(explain): bac f/r i✓ — 5 i /`mil u REMARKS: e,4d Gid '-` -Irc. y tit, 7K-iC '4 pirojee-iv -a I .' (a c oef5 . 1 � FOR OFFICE USE ONLY Rout to Perrrut� c ician: Date: j p - 1 9- a, Initials. 1 Fees Due: e'I s E No Fee Description: Amount D e: 0.Z I--.I r Pi c.» rc y i P V ' $ , " $ $ $ Special Instructions: Reprint Permit(per P : ❑ Yes /NN No 0 Done /.79A ____ Applicant Notified: Date: 01/ 1�) Initials: 1:\Building\Forms\TransmittalLettcr-Revisions 061316.doc City of Tigard IIICOMMUNITY DEVELOPMENT DEPARTMENT a T l cx A u 17 Building Permit Review — Commercial - No Land U s e Building Permit #: Hec,W2J-00566 Site Address: i b 120 J W/j , n jbn,SQ• 0Suite/Bldg#: Project Name: gI M (gDl)e (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review ON I.— 'C2 A%t7 Pl s�aet A 6t1:Q f4ICAc.. Proposal: C,Act- g ivvoi Existing Business Activity: Propos d Business Activity: ify site address/suite#exists and active in permit syyste 01 er'' er Terrace Neighborhood: 0 Yes �T No Zoning: MUC: J. mitted Use: es ❑ No 0 Spec Space Confirm no land use required. usiness License: Exists: 0 Yes 0 No, applicant was provided a business license application Notes: Approved by Planning: — -- Date: -9 7 7 f? I Revisions (after Building Submittal ly) 460., viie}wer _ Daattee Revision 1: Approved ❑ Not Approved V Ci ����^� ��/Y ` -` a4 Revision 2: ] Approved El Not Approved / PPPP Revision 3: 0 Approved 0 Not Approved Building Permit Submittal Original Submittal Date: D///202/ Site Plans: # 2- Building Plans: # 2- Building Permit#: lsnter building permit#above. Workflow Routing. El Planning ( Permit Coordinator [ Building Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review) Route Application Documents: ❑ Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: GCS/al/ZD2/ l:\Building\Forms\BldgPennitRvw COM_NoLandUse_l 11819.docx P• r lit Coordinator.Review ❑ Condition. "►let"prior to issuance of building permit ❑ Approved,NOT Re - • • : Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to • cant: Revision Notice 2: Date Sen • Applicant: Revision Notice 3: Da 'ent to Applicant: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: 0 Yes 0 N/A ❑ OK ssue Permit Approved by Permit Coordinator: Date: 1:\Building\Forms\BldgPermitRvw COM_NoLandUse_l I I819.docx CITY OF TIGARD MECHANICAL PERMIT 114 ' COMMUNITY DEVELOPMENT Permit#: MEC2021-00586 Date Issued: 8/23/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135BA00102 Jurisdiction: Tigard Site address: 10120 SW WASHINGTON SQUARE RD Project: Sim Golf Subdivision: OAKBURG Lot: 9 Project Description: Replacing existing new rooftop gaspack unit on existing curb. Use curb clips provide(1)ceiling mount exhaust fan for kitchen area ducting and air distribution modifications as drawn. Contractor: LATIMER HVAC LLC Owner: PPR SQUARE TOO LLC 11230 SW MORGEN CT BY MACERICH RET TIGARD, OR 97223 PO BOX 4085 SANTA MONICA, CA 90411 PHONE: 503-290-1085 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 08/19/2021 $911.59 Class of Work: ALT Type of Const: Plan Review 08/19/2021 $227.90 Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/19/2021 $109,39 Stories: Info Process/Archiving-Lg$2.00(over 08/19/2021 $4.00 11x17) Project Valuation: $32,200.00 Info Process/Archiving-Sm$0.50(up to 08/19/2021 $12.50 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: Appliances Vent Fans: 1 Vent Systems: Total $1,265.38 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: rmittee Signature: 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. Y . . 15-7/2/ Mechanical Permit Applicatio FOR OFFICE USE ONIA' LCEIVED Received ��5 City of Tigard Date/By:4�jd .Zd.Z/ ►� Permit No.: k sac III13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 JUL 21 2021 Plan Review Date/By: in It•2 Other Permit: T i G A I:l) Inspection Line: 503.639.4175 Date Ready/By: ions: H See Page 2 for Internet: www.tigard-or.gov CITY OF T IGARD tified/Method: // 77.6. Supplemental Information 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:$$32,200.00 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ®Commercial/industrial El Accessory building For special information use checklist ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total .1QB SITE INFORMATION AND LOCATION Air con iti Heating/cooling: �� Air conditioning 46.75 Job site address:40444-SW Washington Square Rd*MP Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: 1 Project name:Sim Golf 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 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 existing with new rooftop gaspack unit on existing curb.Use curb clips. fireplace 23.32 provide(1)ceiling mount exhaust fan for kitchen area Log lighter(gas) 23.32 1, Wood/pellet stove 33.39 ducting and air distrubtion modifications as drawn Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ® PROPERTY OWNER I 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Sim Golf Tigard,LLC Range hood/other kitchen equipment 33.39 Address:10124 SW Washington Square Road Clothes dryer exhaust 33.39 City/State/ZIP:Portland,OR 97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 I'D APPLICANT 0 CONTACT PERSON Other: 23.32 Business name:Latimer HVAC LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Carlie Latimer Furnace,etc. Address:11230 SW Morgen Ct Gas heat pump WalUsuspended/unit heater City/State/ZIP:Tigard,OR 97223 Water heater Phone:(503)290-1085 Fax::( ) Fireplace Range E-mail:carlie@latimerhvac.com Barbecue CONTRACTOR Clothes dryer(gas) Business name:Latimer HVAC LLC Other: MECHANICAL PERMIT FEES* Address:11230 SW Morgen Ct Subtotal City/State/ZIP:Tigard,OR 97223 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)290-1085 Fax:( ) State surcharge(12%of permit fee) CCB lie.:220839 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: C_../ / * Fee methodology set by Tri-County Building Industry Service Board Print name:Carlie Latimer Date:7/20/21 I:\Building\Pennits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 -Supplemental Information Commercial& Multi-Family Fee Schedule: t fis. 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 $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_040113.doc 2 City of Tigard III COMMUNITY DEVELOPMENT DEPARTMENT ■ TI GARD Building Permit Review — Commercial - N o Land Use Building Permit #: F4 WZ(-o105 Site Address: 1012U SO LAJ/S n iDn jQ• e9Suite/Bldg#: Project Name: s'i M (90LE (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: R-t/CLAC,t TecM Existing Business Activity: Proposed Business yerify site address/suite# exists and active in permit system' 01 er Terrace Neighborhood: ❑ Yes L�f No Zoning: mtJL E mitted Use: ;es ❑ No ❑ Spec Space Confirm no land use required. Business License: Exists: ❑ Yes ❑ No,applicant was provided a business license application Notes: Approved by Planning: v ._.__ ---- Date: -74 yZ/2 I Revisions (after Building Submittal ly) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: D///2o21 Site Plans: # 2- Building Plans: # 2— Building Permit#: ©' 'nter building permit#above. Workflow Routing: [ Planning I Permit Coordinator Et-Building Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review) Route Application Documents: ❑ Building: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: G�f/dl/ZOZ/ I:\Building\Forms\B1dgPermitRvw_COM_NoLandUse_111819.docx P- « it Coordinator Review ❑ Condition "► et"prior to issuance of building permit ❑ Approved, NOT Re - . • •: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to ' :. cant: Revision Notice 2: Date Sen o Applicant: Revision Notice 3: Dat- •ent to Applicant: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A ❑ OK ssue Permit Approved by Permit Coordinator: Date: 1_•\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx