Permit CITY OF TIGARD MECHANICAL PERMIT
a
11111 1
II COMMUNITY DEVELOPMENT Permit#: MEC2021-00714
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503,718.2439 Date Issued: 11/10/2021
Parcel: 2S101AD02800
Jurisdiction: Tigard
Site address: 12665 SW 69TH AVE
Project: US Investors Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Replacing existing ductwork with new.
Contractor: OXBOW HEATING AND COOLING LLC Owner: OMEGA ALPHA LLC
34725 SE HOMAN RD 760 NE 23RD AVE
GRESHAM,OR 97080 CANBY,OR 97013
PHONE: 503-867-0026 PHONE
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/16/2021 $769.35
Class of Work: ALT Type of Const: VB Plan Review 09/16/2021 $192.34
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 09/16/2021 $92.32
Stories: Info Process/Archiving-Sm$0.50(up to 09/16/2021 $0.50
11x17)
Project Valuation: $26,520.00
Fuel Air Handlers
Fuel Types: 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 $1,054.51
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: Ho-L Va-w De Wege, Permittee Signature: i Appac-cutio-t4,
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.
DocuSign Envelope ID:CE67ADC5-B36E-4124-8AAF-E540CC707566
Mechanical Permit Apnlicati ECEIVE
City of Tigard V G Received Permit No�f
II • 13125 SW Hall Blvd.,Tigard,OR 97223 r, DatelBy: -,151 I Z/ 'C� - `E C lc.7(-Q 0 91
a Phone: 503.718.2439 S E P 4 U I Date/By:Plan Review^, ,,,2) Other Permit:
1 i,,,,,!,j 1 Inspection Line: 503.639.4175 CITY n Hate Read `� mds:
age 2 for
Imemet: www.ti and-or. ov �✓11 t OE: �Gp Y o 9/ /� 4#0 ®See Supplemental
$ $ Notified/Method: "S Supplementd Information
BUILDING DIVISION
__ _ __ _____ /[._ ey,/=4/
TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
❑New construction Addition/alteration/replacement Mechanical permit fees'are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other mechanical materials,equi anent,labor,overhead.andjrofit. _
CATEGORY OF CONSTRUCTION Yaluc:$ . „r
I
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building --
RESIDENTIAL.EQUIPMENT/SYSTEMS FEES*
❑Multi-family ❑Master builder 0 other For special information use checklist
Description Qty. Ea. j Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: \Z C5 SW, i ,E k-v.'t Air conditioning__ 46.75
4v 1 Furnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP: -1'1 5 0. r-ci (�.gam, C 12 ,3 Furnace 100,000+BTU(ducts/ventsl 54.91
Suite/bldg./apt.no.: Project name:u S )N v 6S 7-0 re-...S. Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: t Hy dronic hot water system 23.32
4 Ype- .� V ya�q V Residential boiler(radiator or
t •+ - -', hydronicl 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
I Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appllanew
Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert _ 33.39
(( j Flue vent for water heater or
a" }1 ' (( ....,,�tiG'liT +'L� !i jgas
fireplace 23.32
W Log lighter,() 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/ventTvw 23.32
PROPERTY OWNER a_-.1 0 TENANT Other: 23.32
Name: ,r�. ��
Range Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 'f. C".C. ‘ ..• equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: CsA.tr, ).,%1 Q i G��-"'(b\3 Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments.utility rooms) , l 23.32
. Attic/crawispace fans 23.32
,APPLICANT 0 CONTACT PERSON - Other: 23.32
Business name:C 'K ?Eyl t:•� 4 , �t1 'AtaS t S(`� lad piping:
Contact name: `.5�
etc. for first fear:$4.a3 for each i ddltiooal
y Furnace,etc. I
Address: ' $C}k .t-___. .. "1.. �s �._-__.... Gas heat pump ,
City/State/ZIP: WalUsuspended/unit heater
r 1 d�- a�"1;�� Water heater
Phone:P7 t) �"" f"t Fax::( ) Fireplace
E-mail: Cr t , a O) C * e . ,,,„0 UV1 _~ Range
CONTRACTOR Barbecue
r'• Clothes dryer utast
Business name
____ , k .Y- . __ Other:
A MECHANICAL PERMIT FEES*
Subtotal 7(1.is
City/State/ZIP:
Phone:( ) Fax:( ) Plan review(25%of permit fee) /%,2.3,1
CCiI lie 235867 State surcharge(12%of permit fee) y,,2, aj. --
oocuslyned by: �� TOTAL PERMIT FEE / OS_Y4.1'
�r�.� /H� This permit application expires if a permit is not obtained within 180
Audluri,ctl St n tltu\ �'
���ryryy`^' �1" days after it has been accepted as complete.
CJ(31CF4E44DC�:. * Fee methodology set by Tri-County Building Industry Service Board
Print rattle COI-By R1 !Mc 9/14/2021 }
1:\Building\Pennits\MEC PermitApp 082520Anc 440-46172(11l02/COM/WEB)
He Ther Adovnik
From: Corey Rife RECEIVED
Sent: Thursday, September 9, 2021 12:29 PM RECEIVED
To: Heather Adovnik SEP 1 4 2O2.1
Subject: Fwd: 12665 SW 69TH
Attachments: image001 jpg; MEC_PermitApp_082520.pdf CITY OF TIGARD
3IJILDING DIVISION
Begin forwarded message:
From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Date:September 9,2021 at 12:18:12 PM PDT
To:Corey Rife<crife@oxbowhc.com>
Cc: Hayden Weaver<hweaver@oxbowhc.com>,Tom Hochstatter<TomH@tigard-or.gov>
Subject: RE: 12665 SW 69TH
Hello Corey,
This is a commercial project therefore we require the following: (y S P
• Completed mechanical permit application including project valuation (see application attached).
• (2)sets of plans
=ts o , ,Vvr' /C`11-44- T
If you have any questions, I have copied our commercial plans examiner Tom Hochstatter on this email.
We require hardcopies of all documents be submitted to a drop box located in the lobby of the Permit
Center, Monday-Thursday,8 am to 5 pm. We are closed on Fridays. No appointment is necessary for
submittal.
Please allow approximately 4 weeks for processing and the permit technicians will contact you when the
permit is ready to issue.
Thank you.
Dianna 1.Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
From: Planner on Duty<tigardplanneronduty@tigard-or.gov>
Sent:Wednesday,September 8, 2021 1:45 PM
To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject: FW: 12665 SW 69TH
Building can you please respond.Thanks.
1
From:Corey Rife<crife@oxbowhc.com>
Sent:Wednesday,September 8, 2021 1:41 PM
To: Planner on Duty<tigardplanneronduty@tgard-or.gov>
Cc: Hayden Weaver<hweaver@oxbowhc.com>
Subject: 12665 SW 69TH
Hello,
We are going to be removing the flexible ductwork downstairs at this location and replacing it with
ridged ducting. Please let me know what we need to do for permitting.
Thanks Corey
Cory 70:
Phone 503-867-0026 Mobile 971-808-7473
Email crife(a-oxbowhc.com CCB#235867
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If
requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public
Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative
Rules"City General Records Retention Schedule."
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