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Permit Mechanical Permit Application FoR OFFI(I'1 USE.o\l.i City of Tigard C/p _ Received ['\ a 1 V. E®DataBy: 2� Permit No.: ,/h.-._ M * 13125 SW Hall Blvd.,Tigard,OR 972 3 iw�0 i / �r►/ZG �`W Or 1 I Phone: 503.718 2439 Fax: 503.598.1960 Plan Review Datul3y; Other Permit : y,.� ,�y T I ;.�R D Inspection Line: 503 639.4175 _AN 1 9 202'2 Date ReadyBy: luris kge� i— v Internet: www.tigard-or.gov �^t Notifed'Method: Suppkmental Information CITYOF :„JaRD TYPE OF WC1 '� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ILDING DIY ISIONI Mechanical permit fees*are based on the value of the work 0 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. Value:S 2000.00 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* 0 I-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address:15875 SW 74TH AVE Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:TIGARD, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat PAP 61.06 Suite/bldg./apt.no.: Project name:22-532 �/'�n�3 .,L( Duct work �1 23.32 Cross street/directions to job site: is---, 4• flydronic 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 ntapiparcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas GAS TO GENERATOR, NW MOTHERS MILK BANK fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood.fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER 0 TENANT Other: 23.32 --- Environmental exhaust and ventilation: Name: Range hood/other kitchen Address: — equipment 33.39 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 0 APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name:POWER PLUMBING CO Fuel piping: 514.1S for first four;S4.03 for each additional Contact name:JOSH CRUME . Furnace,etc. Address:P.O. BOX 19418 Gas heat pump Wall/suspended/unit heater City/State/ZIP:PORTLAND, OR 97280 Water heater Phone:(503)244-1900 Fax::(503)244-8825 Fireplace Range E-mail: SERVICE a( POWERPLUMBINGCO.COM Barbecue CONTRACTOR Clothes dryer(gas) Business name:POWER PLUMBING CO Other — ---- MECHANICAL PERMIT FEES* Address:6611 SW MULTNOMAH BLVD Subtotal City/State/ZIP:PORTLAND, OR 97223 Minimum permit fee($90.00) Phone:( lax:( 503}244 8825 Plan review(25%ofpermit fee) 503 244 1900 State surcharge(12%of permit fee) CCB lie.:52378 TOTAL PERMIT FEE This permit appliation expires if a permit is not obtained a ithin ISO („ s days after it has been accepted s complete. Authorized signature: 'I(-�' Fee methodology set by Tri County'Building Industry Serviceis:: Board Print name:KRISTIE RAMWELL Date:1-7-2022 I I'Bu Iding'.Permus'J41EC_Permn.4pp-040113 doc 4404617T(I I/02.COMM'Ea) tg d 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 rt 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. 13 Note: All new commercial buildings require 2 sets of plans. It $i 1.\Building\Permits\MEC_PermitApp_040113.doc 2 { ii City of Tigard 114 COMMUNITY DEVELOPMENT DEPARTMENT TjD Building Permit Review — Commercial - Ig o Land Use Building Permit #: iv) h)d'2-- � Site Address: 'J t1 S Suite/Bldg#: Project Name: NMI Mei-6-14S AA I k �t C4k (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: Ga< tfetattwoi vLLAik ` 4)66gragilia_b*_ Existing Business Activity: "----- Proposed Business Activity: = X)Verify site address/suite# exists and active in permit system. ❑ River Terrace Neighborhood: ❑ Yes ] No I4 Zoning. tio Permitted Use: Yes ❑ No ❑ Spec Space Confirm no land use required. 'I Business License: Exists: Yes ❑ No,applicant was provided a business license application Notes: PlU'GIdPV14444—c e (iv — oP cre,mIS t turd per cri-R i R'8 AI D Approved by Planning: � ' ° /��/ Date: ? /I/ze 22- 1 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: Site Plans: # Building Plans: # Building Permit#: ❑ Enter building permit# above. Workflow Routing: ❑ Permit Coordinator Ceding Workflow Sign-off: t kita -off for Planning(include notes from planning review) Route Application Documents: L(YBuilding: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: i11ij 1:\Building\Forms\Bl dgPermitRvw_COM_NoLandUse_111819.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 Se o Applicant: Revision Notice 2: Date :ent to Applicant: Revision Notice 3: P.to 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 Is-s e Permit Appro ed by Permit Coordinator: Date: 1:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx 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 Transmittal Letter TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 •www.tigard-or.gov TO: Brandon Taggert, Senior Permit Technician DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Lesley Mondeaux FEB 1 7 202Z COMPANY: Northwest Mothers Milk Bank CITY OF TIGARD BUILDING DIVIS PHONE: 503-469-0955 x113 EMAIL: lesley©nwmmb.org RE: 15875 SW 74th Ave Suite 100 (Site Address) (Permit Number) Generator Hook-up (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: 64,1 3 Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. X Other(explain):Hook-up of Natural Gas generator to operate freezers in case of emergency REMARKS: Original discussion in 2020 indicated a need for an over-the-counter permit to install and connect the generator. Due to the pandemic,the generator took over 11 months to receive and install. It is now in place but needs to be connected to natural gas source. FOR OFFICE USE ONLY Routed to PermitTechnician: Date: - y S`- Z Initials:Fees Due: Li Yes `�No Fee Description: Amount Due: Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No ❑ Done Applicant Notified: 9.e?„ Date: /� j� z Initials: � j 7 - T�,pI:\Building\Forms\TransmittalLetter-Revisions_073120.doc / ` 1