Permit VAe.*ria3tahuau n u ua + • •� •• ...,xraw.ww'.wart«wv x+e .,rc.w..�.„.v wvs iaa«zwx3 ukxLtxw.i. uxx uxaw,.ru..wx...x.a ea:,wr u x.pIIII CITY OF TIGARD MECHANICAL PERMIT
= COMMUNITY DEVELOPMENT MECHANICAL
MEC2021-00841
Date Issued: 10/26/2021
T I G A Ii D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16505 SW 72ND AVE
Project: Good Feet Subdivision: None Lot: None
Project Description: (1)new roof mounted ductless mini split system for IT room.
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 10/25/2021 $240.93
Class of Work: ALT Type of Const: VB Plan Review 10/25/2021 $60.23
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 10/25/2021 $28.91
Stories: Info Process/Archiving-Lg$2.00(over 10/25/2021 $2.00
11x17)
Project Valuation: $6,200.00 Info Process/Archiving-Sm$0.50(up to 10/25/2021 $5.00
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 $337.07
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans, This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: j ,-t(,y Va..4A,De,We e, Permittee Signature: Ow App n,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
' t!J
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received �jJ� Permit No.: a—
IIII • 13125 SW Hall Blvd.,Tigard,OR 97EZ1 E C E I Y E D p Review d/i/ i `�'� � ^aA' 00
���}1r
1 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: f7 -ar'�) Other Permit: 1rti,04X).. )jt37
TIGARD Inspection Line: 503.639.4175 OCT 2 0 2021 Date Ready/1y: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/M�t�16d�j )gel Supplemental Information
CITY OF TIGARD v' Cet:--„,,- ' -
TYPE OF 'MfING DIVISION ow ERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction X❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 6,200.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
.IOB SITE INFORMATION AND LOCATION
Heating/cooling:
Air conditioning 46.75
Job site address: 16505 SW 72ND AVE. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:
TIGARD/OR/97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: GOOD FEET 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)DUCTLESS MINI SPLIT FOR IT ROOM fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
( Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name: PACTRUST Range hood/other kitchen
equipment 33.39
Address: 15350 SW SEQUOIA PARKWAY SUITE#300 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
❑ APPLICANT ® CONTACT PERSON Other: 23.32
Fuel piping:
Business name: EXCEL FIVAC,INC.
$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@EXCELHVAC.NET Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: EXCEL IIVAC,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 lie.: 214345 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: I� 9Ct/LSQ/L : Fee methodology set by Tri-County Building Industry Service Board
Print name:
ZACHARY BARBER Date: 10/20/2021
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(1 I/02/COM/WEB)
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\Permits\MEC PermitApp_040113.doc 2
City of Tigard
III a COMMUNITY DEVELOPMENT DEPARTMENT
11
T1GARD Building Permit Review — Commercial - No Land Use
Building Permit #: 7vi:aC g-Ivq_ poitlj
Site Address: I4 055W -1-2v"1- Avt_ Suite/Bldg#:
Project Name: FFe4-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: FuGt( .411A C f r p Pdco 100 4- V t/4V`e_6"L kvfic,
Existing Business Activity: &COO( Fe f—
Proposed Business Activity:
72 Verify site address/suite#exists and active in permit system.
❑ River Terrace Neighborhood: ❑ Yes Ag No
S Zoning: 'C i P
l Permitted Use: W Yes ❑ No ❑ Spec Space
® Confirm no land use required.
(Vi Business License:
Exists: erg Yes ❑ No,applicant was provided a business license application
Notes: b q kon Dl)r i r . G . 'vt , ll u v /U t -
Approved by Planning: I - iv ' , ,4 Date: 10 / 2-e/z.e aI
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: /vl /,/
Site Plans: #
Building Plans: #
Building Permit#: —'nt building permit#above.
Workflow Routing: anning ❑ Permit Coordinator u `ding
Workflow Sign-off: off for Planning(include notes from planning review)
Route Application Documents: uilding: original permit application,site plans,building plans, engineer and
pp beam calculations and trust details,if applicable, etc.
Notes: kTu ,Jh....,4) `.err✓ ✓ , .
By Permit Technician:_ ' Date: /a)ri/eil
I:\Building\Fonns\BldgPermi tRvw_COM_NoLandUse_111819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submitt. only)
Revision Notice 1: P.to Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees E --red: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ • to Issue Permit
• pproved by Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw_COM NoLandUse_111819.docx