Permit CITY OF TIGARD MECHANICAL PERMIT
$ COMMUNITY DEVELOPMENT Permit#: MEC2021-00954
Date Issued: 12/2/2021
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 1S136CD00101
Jurisdiction: Tigard
Site address: 11675 SW PACIFIC HWY
Project: AFC Subdivision: None Lot: None
Project Description: New 3 ton RTU,(3)exhaust fans,duct work for existing RTU,and a new ductless fan coil to breakroom.
Contractor: SUN GLOW INC Owner: COLUMBIA STATE BANK
2428 SE 105TH PO BOX 2156 MS 3300
PORTLAND, OR 97216 TACOMA, WA 98401
PHONE: 503-253-7789 PHONE:
FAX: 503-253-7693
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/02/2021 $1,637.61
Class of Work: ALT Type of Const: VB Plan Review 12/02/2021 $409.40
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 12/02/2021 $196.51
Stories: 1 Info Process/Archiving-Sm$0.50(up to 12/02/2021 $12.50
11x17)
Project Valuation: $60,944.00
Fuel Air Handlers
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 $2,256.02
Hoods: Comm Incinerators: Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 10
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
I Issued By: H V . Pe V`/ e Permittee Signature:
� � on application
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVED Received Date/By:/1A-7 - / i�' Permit No.t4eCZ0` 1 oo 954
f
14 13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
■ ID Other Permit:
NOV 15 2021 Date/By: )a j',.'
T L GA K D Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
a ��jH�.������ j' �
TYPE,OF WORK COst R L FEE*SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ,Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ li�lly %Il-j ✓>Z
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Commercial/industrial ❑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: 1167 f-- s&), r aC t-.(tk_ 1.-(1 W ii. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: vid Or '9-70 Furnace 100,000+BTU(ducts/vents) 54.91
.� Heat pump 61.06
Suite/bldg./apt.no.: Project name: C• ! /�a f • Duct work 23.32
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
I Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
1 DESCRIPTION OF WORK Gas fireplace/insert 33.39
�g Al {� � }} ��//jj�� /� Flue vent for water heater or gas
. Tt Ai RYA• n b4.1 L):hQ /1`Ja 14-1'or�t,,A') ��u:.- ( )C1r' fireplace 23.32
'l n ` S4- Log lighter(gas) 23.32
nn loll a.rt� tScL�' 3 �iroci h, X
l ,/� _l I-1 Wood/pellet stove 33.39
ALJ-er q /1 d (,t•)Ocke- - oe K. lb ext j4 I �_hJ Wood fireplace/insert 23.32
i--r-a. /7(')1 i0 41—e cs Celir%Cy` 61r
a n Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
„Rt APPLICANT CONTACT PERSON Other: 23.32
Fuel piping:
Business name: 64-41 1-0tt.'"" $14.15 for first four;$4.03 for each additional
Contact name: --rr.i s.art, .1.6Furnace,etc.
Address: a�0g g i o .44-•I'✓In . Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: PO r- -t,0,N,(J e al( Water heater
�p
Fireplace
, Phone:(�' ) 4 7—•f as a_ Fax::( ) Range
E-mail �1-6,4 -I'V�``',-�q,,e_Lot,, I,►,[..CC kY' Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: A t46�V� Other: MECHANICAL PERMIT FEES*
Address: a zaq . (b h''44 4v C Subtotal
City/State/ZIP: %tiL+-ket.4 ) e L9 7,9 /o Minimum permit fee($90.00)
9 3 �7 '9 Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: Li 6 1 1 TOTAL PERMIT FEE a
This permit application expires if a permit is not obtai d wi hin 180
days after it has been accepted as complete.
Authorized signature: 6 'i�i — * Fee methodology set by Tri-County Building Industry Service Board
Print name: /Yt -f z ' Pvu Date:/,1 G-X a`
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
i
T1GARD Building Permit Review — Commercial - No Land Use
Building Permit #: rl, CZdZj_OU Gj'tj(4-
Site Address: l( 61 cs W F&c c }-I VA)(/j Suite/Bldg#:
Project Name: A F 6 o a rrk
(Name of commercial business oc(uying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Ad(i,.3 1-Dvk P-r-u -I-o v i(Gthtt j fit .I`r"1\0/zI %CAG. - (A 0 1<
Existing Business Activity: .k C ()Ty) (R(t`e-
Proposed Business Activity: -- -
iVerify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ Yes K No
pZoning: C ` 6
❑ Permitted Use: Yes ❑ No ❑ Spec Space
Confirm no land use required.
Li Business License:
1 Exists: tg Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: p��/� J/ AI 411$ Date: I 7-�J-a,/
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: /l/.Sj1OZ/
Site Plans: # 2
Building Plans: # 2-
Building Permit#: It-Enter building permit#above.
Workflow Routing: ETPlanning ❑ Permit Coordinator 1-Building
Workflow Sign-off: [Er-Sign-off for Planning(include notes from planning review)
Route Application Documents: cj-"Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: ///2.q u
I
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 111819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions(after Building Submittal onl
Revision Notice 1: Date Se' to Applicant:
Revision Notice 2: Date :ent to Applicant
Revision Notice 3: D e 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 P it
Approved b ermit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx