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
NE Transmittal Letter
T I G n t i) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: iAN S V 4 VOW DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM:
MAR 15 2022
COMPANY: i' N ;;IT Y OF TIGARD
PHONE: q7-0 - 3UILDING DtVISIOI1I By:
EMAIL: Pt- itO te,Thi> @ IN( --'i-ivm • M
RE: ( �7.1.-t 0 Sint *1 rl> kwy
(Site Address) (Permit Number)
Vv-� ,b su z-N1 mac ao a l - 0 0 4S-
(Project name or subdivision name and lot tuber)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
i' Additional set(s) of plans. 3 Revisions: V 5 ON 1V 13V1(,N rj,
Cross section(s) and details. Wall bracing and/or lateral analysis. 11.171tm
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: 3 `j(NS Sj ukv\iINWS
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: 3 - - 3Z. Initials:- '
Fees DuJ Yes ❑ No Fee Description: Amount Due:
$ yam
$Special �5' .3 J/
Instructions:
Reprint Permit(per PE): ❑ Yes NIVI No ❑ Done
Applicant Notified: ( Date: ,'3/�� Initials: 4/7
I:\Building\Forms\TransmittalLetter-Revs lens I20.doc
CITY OF TIGARD MECHANICAL PERMIT
1111
I " COMMUNITY DEVELOPMENT Permit#: MEC2021-00665
Date Issued: 9/22/2021
T I ' A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718 2439 Parcel: 2S102CB02300
Jurisdiction: Tigard
Site address: 13240 SW PACIFIC HVVY
Project: Westside Surgery Subdivision: FREWING'S ORCHARD TRACTS Lot: 8
Project Description: Rooftop mechanical equipment
Contractor: AMERICAN HEATING INC Owner: WESTSIDE BUILDING PROPERTIES LLC
5035 SE 24TH AVE BY VALLABHANATH, PRASHANTH
PORTLAND, OR 97202-4765 11086 SE OAK ST
MILWAUKIE, OR 97222
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/22/2021 $4,068.71
Class of Work: ALT Type of Const: VB Plan Review 09/22/2021 $1,017.18
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 09/22/2021 $488.25
Stories: 1 Info Process/Archiving-Lg$2.00(over 09/22/2021 $20.00
11x17)
Project Valuation: $150,000.00 Info Process/Archiving-Sm$0.50(up to 09/22/2021 $60.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units<10000 cfm: 2
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: 3
Appliances
Vent Fans: Vent Systems: Total $5,654.64
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
Issued By: HoLLy VawDe.We.ge Permittee Signature: an. AtariLiin i .
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.
•
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
�aN -�.-.�,�a�ir4a , �iL,
tital "athaio j` Permi Y3.
$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