Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2021-00641
T I G A R f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/9/2021
Parcel: 2S102CB00100
Jurisdiction: Tigard
Site address: 12850 SW GRANT AVE
Project: Broadway Rose Theater Subdivision: NORTH TIGARDVILLE ADDITION Lot: 43
Project Description: Install(2)new rooftop gaspack unit on factory curbs,ducting and air distribution as draw,duct silencers for
rehearsal are and gas piping extension to new RTUs
Contractor: LATIMER HVAC LLC Owner: TIGARD-TUALATIN SCHOOL DISTRICT 23J
11230 SW MORGEN CT 6960 SW SANDBURG ST
TIGARD, OR 97223 TIGARD,OR 97223
PHONE: 503-290-1085 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/08/2021 $1,401.06
Class of Work: ALT Type of Const: VB Plan Review 09/08/2021 $350.27
Occupancy Grp: A-3 Occupancy Load: 12%State Surcharge-Mechanical 09/08l2021 $168.13
Stories: Info Process/Archiving-Lg$2.00(over 09/08/2021 $4.00
Project Valuation: $51,500.00 11x17) •
Info Process/Archiving-Sm$0.50(up to 09/08/2021 $17.50
Fuel Air Handlers 11x17)
Fuel Types: Natural Gas 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 $1,940.96
Hoods: Comm Incinerators:
Woodsloves: Gas Fireplaces: Required Items and Reports(Conditions)
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: 1-folly Vc,rl,De,wp je Permittee Signature: OWAprjtt-p-i.
Call 503.639.4175 by 7:D0 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.
? • 66l1
Mechanical Permit Application`#C FOR OEEICi rsr: ON 1
City of Tigard 1 CC E I V E L.R Received 0 r • 202/ �e Zf 69f
Date/By: I Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 A U G 11 2021 Date/By: . - 7-e21 Other Permit:
t G tt I, Inspection Line: 503.639.4175 Date ReadyB uri- 61 See Page 2 for
Internet: www.tigard-or.gov c;'' c` - : j )i t edfiv4ethod: / Supplemental Information
TYPE OF WORK CO 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 pmfrt.
Value:$$51,500.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES'
❑ 1-and 2-family dwelling ®Commerciallindustrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:12850 SW Grant Ave Furnace 100,000 BTU(d ets/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.: I Project name:Broadway Rose Theatre Duct work 23.32
Cross street/directions to job site: Hydonic 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: I 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
provide&install 2 new rooftop gaspack unit on factory curbs.Use curb clips. fireplace 23.32
ducting and air distribution as drawn Log lighter(gas) 23.32
Wood/pellet stove 33.39
duct silencers for rehearsal area Wood fireplace/insert 23.32
gas piping extension to new RTUs Chimney/liner/flue/vent 23.32
® PROPERTY OWNER 0 TENANT 23.32
Environmental exhaust and ventilation:
Name:Tigard-Tualatin School District Range hood/other kitchen
— equipment 33.39
Address:6960 SW Sandburg Street
Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
® 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:Carle Latimer Furnace,etc.
Address:11230 SW Morgen Ct Gas heat pump
Wall/suspended/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)
Phone:on)294 0879 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:220839 TOTAL PERMIT FEE
This permit application expires If a permit Is not obtained within 180
\('�f, days after it has been accepted as complete.
Authorized signature
Fee methodology set by Tri-County Building Industry Service Board
Print name:Carle Latimer Date:8/10/2021
I:\Building\Permits\MEC_PermitApp_040113.dac 440-4617T(11/02/COM/WtB) A
•
Mechanical Permit Application - City of Tigard
Page 2 -Supplemental Information
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
$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\Pemiits\MEC_PennitApp_040I 13.doc 2
City of Tigard
IIIIv COMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: p k.202/,00(/,1 I
Site Address: j 28Sa SW Cs.124v1t- Mr' Suite/Bldg#:
Project Name: y .sz -)e4 r
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 141-F1W n'.i { 1nsr u_4 rnetort tirAc /nyedvcr41117
Existing Business Activity:
Proposed Business Activity:
site address/suite# exists and active in permit syysste
es Terrace Neighborhood: D Yes ,Li No
o g: )2- 12
emutted Use: l Yes ❑ No ❑ Spec Space
Confirm no land user aired.
e9
❑ Business License:
Exists: ❑ Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: - Date: ?AA Z(
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: 44—//-.1.4:72/
Site Plans: # Z
Building Plans: # 2
Building Permit#: enter building permit#above.
Workflow Routing: O'Planning ❑ Permit Coordinator [irk-Building
Workflow Sign-off: 2"-Sign-off for Planning(include notes from planning review)
Route Application Documents: Tr-Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: /
By Permit Technician: Date: 4///?/,Z("J2/
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx
-rmit Coordinator Review
❑ Con.. ons"Met"prior to issuance of building permit
0 Approved, 4 T Released: Date:
Notes:
Revisions (after Building Submittal on
Revision Notice 1: Date Sent to Ap.: a.
Revision Notice 2: Date Sent to Ap. : an .
Revision Notice 3: Date Sent t. pplicant:
❑ SDC Fees Entered: Was• o Trans Dev Tax: ❑ ` , ❑ N/A
igard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ai /A
❑ OK to Issue P mit
Approv y Permit Coordinator: 1.4 ate:
I:\Bui1dm g\Forms\BldgPermitRvw_COM_NolandUse_111819.docx