Permit INrCITY OF TIGARD
COMMUNITY DEVELOPMENTMECHANICAL PERMIT
Permit#: MEC2022-00103
Date Issued: 4/4/2022
T f GA R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1 S126DC00901
Jurisdiction: Tigard
Site address: 9650 SW GREENBURG RD
Project: Terrace Glen Apartments Subdivision: TERRACE GLEN APARTMENTS Lot: None
Project Description: For rangers and dryers. Building ventilation and HVAC equipment.
Contractor: JACOBS HEATING&AIR CONDITIONING Owner: TERRACE GLEN HOUSING PARTNERS LP
4474 SE MILWAUKIE AVE 9640 SW GREENBURG RD
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503-234-7331 PHONE:
FAX: 503-296-5351
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/24/2022 $5,855.75
Class of Work: ALT Type of Const: VA Plan Review 03/24/2022 $1,463.94
Occupancy Grp: R-2 Occupancy Load: 12%State Surcharge-Mechanical 03/24/2022 $702.69
Stories: 4 Info Process/Archiving -Lg$2.00(over 03/24/2022 $22.00
11x17)
Project Valuation: $211,131.00 Info Process/Archiving-Sm$0.50(up to 03/24/2022 $116.00
11x17)
Fuel Air Handlers
Fuel Types: Electricity Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers 8 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: 10
Appliances
Vent Fans: Vent Systems: Total $8,160.38
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: exhaust fan
Duct Work: 1000
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rule are set fo in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: ..4../,
1 Permittee Signature: ,._c � 4
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. /
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
7
13-213
Mechanical Permit ApplicatiRECEIVE • Q FOR OFFICE: I SI.ONIA
City of Tigard ReceiDate/By
dO O/ r jI 'emit No.:M ��3
II v 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 03 2022 Plan Revie
1 III Phone: 503.718.2439 Fax: 503.598.1960 �2+
Date/By: Other Permit:
TIUARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By ^Is See Page 2 for
Internet: www.tigard-orgov eti�� �J,) r ?) /r /+ Supplemental Information
BUILDING DIVISION -4 ,-• (�
TYPE OF WORK COMMERCIAL FEE*"SCHEDULE - USE CHECKLIST
®New construction D Addition/alteration/replacement Mechanical permit the*are based on to value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 211,131
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES
❑ I-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: 9650 SW Green burg Road Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(ducts/vent) 54.91
Suite/bldg./apt.no.: Project name: TERRACE GLEN APTS Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
SW Greenburg Rd Between SW Lehman St&SW Washington Sq Rd 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.: 1S126 DC00901 Water heater 23.32
ttA s"c - DESCRIPTION' OF WOir , �'. ` ' .:� . Gas fireplace/insert 33.39
'"a''' r "'`' .., ....... •.`"' "'`-. " Flue vent for waterheaterorgas
fireplace 23.32
for ranges &dryers. Building ventilation and HVAC equipment Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
In PROPERTY OWNER - ❑ TENANT Other: 23.32
- - Environmental exhaust and ventilation:
Name: Related Northwest 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
In APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
— Jacobs Heating &Air Conditioning $14.15 for first four;$4.03 for each additional
Contact name: Andrea Bowlds Furnace,etc.
Address: 4474 SE Milwaukie Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Portland, OR 97206 Water heater
Phone:( 503) 234-7331 Fax::( ) Fireplace
Range
` E-mail: andreab@jacobsheating.com Barbecue
CONTRACTOR - Clothes dryer(gas)
Business name: Jacobs Heating &Air Conditionin other
g i : .' CHANICAL PERMIT FEES"
Address: 4474 SE Milwaukie Ave Subtotal
City/State/ZIP: Portland, OR 97202 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503) 234-7331 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 1441 r TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within I80
��k��tCJXtLL��
1 / days after it has been accepted as complete.
Authorized signature:✓ (J(� '1 Fee methodology set by Tri-County Building Industry Service Board
Print name: ANDREA BOWLDS Date: 2/3/2022
I:Building\Perm,is'MEC_PenmtApp_040113.doc 440-46171'(l I.!OLCOMPWEB)
City of Tigard
III COMMUJNITY DEVF.i OPMENT DEPARTMENT
C
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: M C2O22 U3/o3
Site Address: Suite/Bldg#:
Project Name: 're- ,,c &(€4 4
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review �� ( � J
Proposal: -r ( C5(' g `/ Fly(CGU\(/5 !(eG (/,
yi - /� ¢mil, is CH�QG �
Existing Business Activity: -P�r(c(.e_- V,
Proposed Business Activity:
) Verify site address/suite# exists and active in permit system.
❑ River Terrace Nenig borhood: ❑ Yes �1 No
V Zoning: U 1
LibPermitted Use: P Yes ❑ No ❑ Spec Space
Fib Confirm no land use required.
Business License:
Exists: )Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: 44Jt Date: 2/-/2Q Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: Oyo OOZE
Site Plans: # 2-
Building Plans: # Z
Building Permit#: IL—Enter building permit#above.
Workflow Routing: [Planning ❑ Permit Coordinator [ - uilding
Workflow Sign-off: l 'Sign-off for Planning(include notes from planning review)
Route Application Documents: l Building original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: siL.
Date: "27 /
1:\Building\Porms\BldgPennitRvw_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 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: 0 Yes 0 N/A
Tigard Trans SDC: ❑ Yes 0 N/A
Parks SDC: 0 Yes 0 N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:1Building\Forms\BldgPemiitRvw_COM NoLandUse_111819.docx