Permit q CITY OF TIGARD MECHANICAL PERMIT
! COMMUNITY DEVELOPMENT Permit#: MEC2021-00964
Date Issued: 12/16/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S101AD03200
Jurisdiction: Tigard
t Site address: 12909 SW 68TH PKWY 170
Project: WWEX Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
( Project Description: Install(1)2 ton heat pump,duct&modify existing 3 ton ductwork
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES L P
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-233-6911 PHONE:
FAX: 503-238-9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/16/2021 $469.63
Class of Work: ALT Type of Const: VB Plan Review 12/16/2021 $117.41
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 12/16/2021 $56.36
Stories: Info Process/Archiving-Lg$2.00(over 12/16/2021 $6.00
Project Valuation: $14,800.00 11x17)
Info Process/Archiving-Sm$0.50(up to 12/16/2021 $30.50
11x17)
Fuel Air Handlers
Fuel Types: Other 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: 2 Vent Systems: Total $679.90
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 100
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By:ltiezigideee...„
Permittee Signature: ` f
--1466
al 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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di
Mechanical Permit Application FoR OFF1(E t.st.: ONI.v
Received h !Y// 'n �202f—DOp/
City of Tigard �� �� DateBy:� v 20�' G+•/% Permit No.:'y(� s(6,
II
D
i 13125 SW Hall Blvd.,Tigard,OR 97223
NOV 15 2021 Plan Review il Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ,a a.—ly -a' Other Permit:
l I C n It D Inspection Line: 503.639.4175 Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:1 1J/ov 1 Supplemental Information
BUILDING DIVISION 7�o�
TYPE OF WORK COM RCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction N Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equi ment,labor,overhead,and nrofit.
CATEGORY OF CONSTRUCTION Value:$ Jr
RESIDENTIAL EQUIPMENT SYSTEMS FEES*
❑ 1-and 2-family dwelling Ar_Commercial/industrial 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: / l 9' �� `�
(� i -„ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: fort/ I 2 , Furnace 100,000+BTU(ducts/vents) 54.91
. A W f X Heat pump 61.06
Suite/bldg./apt.no.: /4J0 Project name: V" Duct work 23.32
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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
Subdivision: Lot no.:
Other: 23.32
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
,�
1 j4 q II Cruz. f oh ' Y r'� /0(--'hye Is fireplace 23.32
a cal/ ,/t y 7„x)J 71 psi
3 a h 1 , �O t Log lighter(gas) 23.32
7 ? C,` C / Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER , Other: 23.32
TENANT Environmental exhaust and ventilation:
Name: in1 V%X Range hood/other kitchen
pp,, 'tt equipment 33.39
Address:
Ya 1 S(� C0 /'4WAJ / Clothes dryer exhaust 33.39
City/State/ZIP: ii/9 ":71 ic-1 OR ? 2Z2? Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
APPLICANT 0 CONTACT PERSON Other: 23.32
�— y Fuel piping:
Business name: ,f'/-c; J Loi„t y' /.—3 j— Ci4t 1.f f. //1[r.
/ $14.15 for first four;$4.03 for each additional
Contact name: k 0 4,./.5 -t Crl-, Furnace,etc.
Address: 971?- 5 - /7 7'Jr v-e Gas heat pump
f / Wall/suspended/unit heater
City/State/ZIP: "40r 1/ni d 0 P 72 2 Z Water heater
Phone:(ip0 ) — 340 Fax::(5-03).2 jdb--9'777 Fireplace
Range
E-mail: fGc ,tS' 11t--£71 7 . (, ,;-I''"t-I Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: •5-'4 l' c S t4p r//1 c ti'f? MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.: 3 ! I-C 1 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: 9 * Fee methodology set by Tri-County Building Industry Service Board
Print name: 4 0 c,/S 2 y 07, Date: //-•/_,--=20z/
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(1 l/02/COM/WEB)
City of Tigard
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III COMMUNITY DEVELOPMENT DEPARTMENT
I
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #: -C,2,C',Z 1--00g6/4
Site Address: ic?i f NA) 663'k eVu,, Suite/Bldg#: 4-
� 4
Project Name: ,A t/0.6)( FvVLOk 404 3
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: �6 r- P o`?pili 14.f I - vutoet(% f1 c vio rh-
Existing Business Activity: 49-r6 G-e..—
Proposed Business Activity:
lX Verify site address/suite#exists and active in permit system.
E River Terrace Neighborhood: ❑ Yes n No
vo Zoning: ..1"M u
Permitted Use: J Yes ❑ No E Spec Space
IN Confirm no land use required.
;:ii Business License:
Exists: [ Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: Date: 1 G l 3 -CO Z-
6
Revisions (after Building Submittal only) Reviewer Date
1 Revision 1: E Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved E Not Approved
Building Permit Submittal
Original Submittal Date: l/J5/1U2-I
Site Plans: #
Building Plans: # 2-
Building Permit#: ,fiE:nter building permit#above.
L7
Workflow Routing: P lanning LPermit Coordinator [Building
Workflow Sign-off: Lign-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: / 102/
1:\Building\Fonns\BldgPermitRvw_COM_NoLandU se_1 1 1 819.docx
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent 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 to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Fonns\BldgPermitRvwCOM NoLandUse_111819.docx