Permit CITY OF TIGARD MECHANICAL PERMIT
'S COMMUNITY DEVELOPMENT Permit#: MEC2022-00304
Date Issued: 6/14/2022
•g-f C;Ait 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S107AA26300
Jurisdiction: Tigard
Site address: 14450 SW RIVER TERRACE BLVD
Project: Polygon at Roshak Ridge,Swim Center Subdivision: ROSHAK RIDGE Lot U
Project Description: Swim Center-installing(2)furnaces,ducting, (1)bath fan and vent hood ducting only,(2)AC units and gas lines
for pool heater, range and(2)furnaces.
Contractor: PRO HEATING AND COOLING INC. Owner: POLYGON WLH LLC
2095 NW ALOCLEK DR, SUITE 1103 703 BROADWAY ST STE 510
HILLSBORO, OR 97124 VANCOUVER,WA 98660
PHONE: 503-443-5692 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/13/2022 $677.91
yp Plan Review 06/13/2022 $169.48
Class of Work: ALT Type of Const: VB 12%State Surcharge-Mechanical 06/13/2022 $81.35
Occupancy Grp: A-3 Occupancy Load:
Stories: 1 Info Process/Archiving-Lg$2.00(over 06/13/2022 $12.00
11x17)
Project Valuation: $23,000.00 Info Process/Archiving-Sm$0.50(up to 06/13/2022 $52.50
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: 2
Appliances
Vent Fans: 2 Vent Systems: Total $993.24
Hoods: Comm Incinerators: Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 4 Other Desc:
Duct Work: 50
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules ar et forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: �Ei Permittee Signature: �r.1 iJ�a�JJ�'ry� jr
.0,5A4---- Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �i
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
-City of Tigard RECEI\IED Received i (�
Date/By: t (2, VtO) PermitNo.: AG _re...,. .
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re ' w
Phone: 503.718.2439 Fax: 503.598.1960 .c� Other Permit: G.
APR 1 8 2Q: :. Date By: �f11 !'2.2 (�tP a a I c�1 o
T I C A R IA Inspection Line: 503.639.4175 Date Ready/By: 6 A` Avis: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF I ll:rr.,- }•iotified/Method: I . . /L7Y..r Supplemental Information
BUILDING DIVr- '/ .6 ( L.-L7YU I
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
KNew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ a3,000
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ,Commercia1industrial 0 Accessory building For special information use checklist.
❑Multi-family Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
¢ Air conditioning a 46.75
Job site address: 19'i'SU Sub 'R1V,.,1" ACV Y-a", 6\Ve Furnace 100,000 BTU(ducts/vents) a 46.75
City/State/ZIP: '1-1501r t, Q 0 n 2� 4. Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bld ./ t.no.: name:
g aP Project1
Lk d Duct work 23.32
� Roses R\ �--
Cross street/directions to job site: lIh 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
ciAS
'-try0-Qt,ia-b( r). Q.Q '-�3 0-' �U Y netce-- i SYISr1ial\a-i rfn O� fireplace 23.32
' 1 Log lighter(gas) 23.32
j�C+t./1- 5e1/UtGI?Y ' 64hIroow, -Par, Elf 1v.uC4.4 VeAna-tip. PXlltit3 Wood/pellet stove 33.39
111S4zi I\et 4tifp ot( 99AW e) A les- ,"1.rs4-4.it p-'orr 04 • gaS Wood fireplace/insert 23.32
tcAt.S• Chimney/liner/flue/vent _ 23.32
❑ PROPERTY OWNER 0 TEN)NT Other: - - 23.32
Environmental exhaust and ventilation:
z Range hood/other kitchen 1
Name: 1Vr ImpY Y��CS n equipment 1 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) a. 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 1
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: I►/1._ T(YJ / O u��e `_ 4.1 LmIIt't�- $14.15 for first four;$4.03 for each additional
Contact name: FA,I& Do y�I // I J Furnace,etc.
ig
Gas heat pumpAddress: 2\GA - I UCI 1012 `I
Wa►UsuspendaUunit heater
City/State/ZIP: t. 1 ,(Syrvr Cif._ Qi 1 26r Water heater
Phone:(52a 443_5-6; el 02 Fax::( ) Fireplace
p Range
E-mail: \\ P 1,-6l'}eG1�tr 1 f e) 5�Gf I I• G Q 4A Barbecue
CONT1iTOR Clothes dryer(gas)
Other:G ,S Pctot tiff k 1
i Business name:yY O LtfA4ln 4vl A Cof>\t rv, ' -rjr1C-ff�� MECHANICAL PERMIT FEES*
Address: aa3\ mu pA.oc kt or5U\\R14-\2..17-1 Subtotal
City/State/ZIP: tk,k\C\ a 62 cal�� Minimum permit fee fee)
Plan review(25%of permit fee)
Phone:(G1"11) �6'- Fax:(a,a) 94.1 _50-15 State surcharge(12%of permit fee)
CCB lic.: aOg0O` TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted an complete.
•
Authorized signature: ,`N �1 1 (I * Fee methodology set by Tri-County Building Industry Service Board
Print name: /" Date: et 11g 1 Z -
I:tBuildinglPennits\MEC_snnitApp_040113.doc 440-4617T(I 1/01'COM/VEB)
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.
L•\BuildinglPemuts\MEC_PermitApp_040113.doc
pi
City of Tigard
~ COMMUNITY DEVELOPMENT DEPARTMENT
TWGARD Building Permit Review — Commercial - N o Land Use
Building Permit #: AtCZ022 -a)5d Site Address: P Yt-(SD rtMg. T ` PSuite/Bldg#:
Project Name: - ,Q,!«,r6 FOLK Ce-1 AT- 1tPk P-iCGE_.
(Name of commercial business occupying the space. If vacant,enter Spec Space.) Ge 11 k
Planning Review
Proposal: /17 Get f N!CA L. Ut'11 i t
Existing Business Activity: /y�_
Proposed� Business Activity: /�1 I
LR fy site address/suite# exists and active in permit system.
gi3iver Terrace Neighbg hood: .es E7 No
� Zoning. f- ( -
lat n nfitted Use: Yes ❑ No ❑ Spec Space
Confirm no land use required.
Bsiness License: �.
Exists: I: Yes .ice No,applicant was provided a business license application
Notes:
Approved by Planning: --� 1 Date: st/i ZZ'
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved El Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: y st2a.2Z
Site Plans: # 2
Building Plans: #
Building Permit#: Er-Enter budding permit#above.
Workflow Routing: PrPlanning ❑ Permit Coordinator [ Building
Workflow Sign-off: ErS' -off for Planning(include notes from planning review)
Route Application Documents: B' Building original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: /fig4Z
I:1Buil ding\Porms\BI dgPermitRvw_COM_NoLandUse_111819.docx