Permit CITY OF TIGARD MECHANICAL PERMIT
1,1 : COMMUNITY DEVELOPMENT Permit#: MEC2022-00391
Date Issued: 6/13/2022
T f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DD00701
Jurisdiction: Tigard
Site address: 15812 SW UPPER BOONES FERRY RD
Project: Sleep Metrics Systems Subdivision: None Lot: None
Project Description: Installing(2)bath fans and modify existing ductwork for tenant improvement.
Contractor: EXCEL HVAC INC Owner: PACIFIC REALTY TRUST
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 06/10/2022 $173.44
Class of Work: ALT Type of Const: VB Plan Review 05/19/2022 $43.36
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 06/10/2022 $20.81
Info Process/Archiving-Lg$2.00(over 06/10/2022 $2.00
Stories:
11x17)
Project Valuation: $3,900.00 Info Process/Archiving-Sm$0.50(up to 06/10/2022 $1.00
11x17)
Fuel Air Handlers
Fuel Types: Electricity 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: 2 Vent Systems: Total $240.61
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 10
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspe n date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USEONI.I
lipCity g Received a. �'1 ec, ��aa 34 of Tigard Pe ntNo.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review f
Phone: 503.718.2439 Fax: 503.598.1960 Dst,ny: V 3' Z� Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: ��yC/q r-� nuns BI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: '�'i l . _/ (.� Supplemental Information
� `1 'I�f
TYPE OF WORK COMMERCIAL FEE* SCHEDULE.— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction X❑Addition/alteration/replacement performed_Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 3900.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist I
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 15812 SW UPPER BOONES FERRY RD. Furnace 100,000 BTU(ducts/vents) , 46.75
City/State/ZIP: LAKE OSWEGO/OR 197035 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: 20BP172 Project name: SLEEP METRICS SYSTEMS, INC. Heat pump 61.06
Duct work i 23.32
Cross street/directions to job site: SW SEQUOIA PKWY.AND SW UPPER Hydronic hot water system 23.32
BOONES FERRY RD. 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
INSTALL (2)BATH FANS AND MODIFY EXISTING DUCTWORK FOR TENANT fireplace 23.32
IMPROVEMENT. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: PACTRUST Range hood/other kitchen
Address: 15350 SW SEQUOIA PKY.#300 equipment 33.39
W
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 0 CONTACT PERSON Other: 23.32
Business name: EXCEL HVAC, INC. Fuel piping:
514.15 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@EXCELHVAC.COM Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: '; p� Other:
•ale!to �-S %01'l MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00) _
Plan review(25%of permit fee) i-(,.-27; —
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 214345 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 190
/7 [ days after it has been accepted as complete.
Authorized signature: 1 5QILd'Q t. ` Fee methodology set by Tri-County Building Industry Service Board
Print name: ZACHARY BARBER /// Date: 05/18/2022
I:\Buildiag\Permils1MEC PermitApp_040 113.doc 440-4619T(I 1/02/COM/VVEB)