Permit CITY OF TIGARD MECHANICAL PERMIT
■' COMMUNITY DEVELOPMENT Permit#: MEC2022-00279
Date Issued: 5/9/2022
T I C AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S113AA00500
Jurisdiction: Tigard
Site address: 16112 SW 72ND AVE B18
Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: PT A&F
Project Description: Mechanical for TI:(1)unit heater,(2)bathroom exhaust fans,ductwork,and gas piping.
Contractor: EXCEL HVAC INC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 1188 ATTN: N PIVEN
CANBY, OR 97013 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 971-930-7194 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/04/2022 $561.07
Class of Work: ALT Type of Const: VB Plan Review 05/04/2022 $140.27
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 05/04/2022 $67.33
Stories: Info Process/Archiving-Lg$2.00(over 05/04/2022 $2.00
11x17)
Project Valuation: $18,400.00 Info Process/Archiving-Sm$0.50(up to 05/04/2022 $12.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 1 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: 2 Vent Systems: Total $783.17
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
•t
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspec ion date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City
of Tigard Received
. B per.. Permit No.:
II13125 SW Hall Blvd.,Tigard,OR 97223 evie �� �JJ � ~
Phone: 503.718.2439 Fax: 503.598.1960 ii t:. Other Permit:
T I GARD Inspection Line: 503.639.4175 Date Ready/By: kris: 0 See Page 2 for -«
Internet: www.tigard-or.gov 4 pp---]q ?or Notifled/Method:5/yip,, -�•"'1„ Supplemental Information
E �/ 2 r-,C.�1 C'� f ' . �GYC�s
TYPE OF WORK i ,_i' ` COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
Mechanical permit fees*arc based on the value of the work
❑New construction ❑X Addition/alteration/repA9T N( [)IV 16(,) performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 18,400.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
Description Qty. Ea. Total
❑Multi-family El builder 0Other: P
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 16112 SW 72ND AVE. Furnace 100,000 BTU(ducts/vents) 46.75
I City/State/ZIP: PORTLAND/OR/97224 Furnace 100,000+BTU(duets/vents) 54.91
lOBP128-SPEC SPACE Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: SW 72ND AVE.AND SW DURHAM RD. 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
Other: 23.32
Subdivision: Lot no.:
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
INSTALL(1)UNIT HEATER,(2)BATH FANS,(N)DISTRIBUTION DUCTWORK, fireplace 23.32
AND GAS PIPE Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
® PROPERTY OWNER 0 TENANT
Environmental exhaust and ventilation:
Name: PACTRUST Range hood/other kitchen
equipment 33.39
Address: 15350 SW SEQUOIA PARKWAY SUITE#300 Clothes dryer exhaust 33.39
City/State/ZIP: PORTLAND/OR/97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 503 ) 624-6300 Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT g/ CONTACT PERSON Other: 23.32
Business name: EXCEL HVAC,INC. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: ZACH BARBER Furnace,etc.
Address: 15832 SW UPPER BOONES FERRY RD. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: LAKE OSWEGO/OR/97035 Water heater
Phone:( 503 ) 550-6042 Fax::( ) Fireplace
Range
E-mail: ZACH@EXCF:I.IIVAC.NET Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: EXCEL HVAC,INC. Other:
MECHANICAL PERMIT FEES*
Address: 15832 SW UPPER BOONES FERRY RD. Subtotal
City/State/ZIP: LAKE OSWEGO/OR/97035 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 503 ) 828-5121 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 214345 TOTAL PERMIT E gl• /7�
This permit application expires if a permit is not Authorized signature: I L
_ � [ days after it has been accepted as complete.
� �Q/LdQ/ti * Fee methodology set by Tri County Building Industry Service Board
Print name: ZACHARY BARBER Date: 04/06/2022
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
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
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.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2