Permit (3) CITY OF TIGARD MECHANICAL PERMIT
` COMMUNITY DEVELOPMENT Permit#: MEC2023-00287
TIGAF.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/24/2023
Parcel: 2S 101 A D03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 230
Project: Mercer Management Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Re-ducting(3)water source heat pumps with new distribution ductwork, diffusers,and grilles for TI.
Contractor: EXCEL HVAC INC Owner: PACIFIC REALTY ASSOCIATES L P
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 04/24/2023 $601.71
Class of Work: ALT Type of Const: Plan Review 04/24/2023 $150.43
12%State Surcharge-Mechanical 04/24/2023 $7221
Occupancy Grp: Occupancy Load:
Stories: Info Process/Archiving -Lg$2.00(over 04/24/2023 $2.00
Project Valuation: $20,000.00 11x17)
Fuel Air Handlers
Fuel Types: 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: Vent Systems: Total $826.35
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
•
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set
�forth hiin OAR 95 -001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: 4^{.," Permittee Signature: � . °� di �r
r � <j�� " ter/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Apnlicatiio-�n Fox OFFICE USE ONLY
- City of Tigard �R �GEI Y► Received (� _
DateBy. t" 1 aI/% i
11‘ 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review
Phone: 503.718.2439 Fax: 503.59$f1rQb0 If
2 4 2023 Date/By. j' jL�
TIGAR D Inspection Line: 503.(i39.4175 A�fY Date Ready/By: tuns' Fl See Page 2 for
Internet: www.tigard-or.gov
Notified/Method: Supplemental Information
ppl!C1IIIT'YnY�OF TCII;GARD
TYPEEWN+WYIP DI,1ISit,3N COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
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 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTIONS Value $ 20.000.00
- - - - RESIDENTIAL EQUIPMENT1 SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family 0 Master builder ❑Other: Description Qty. Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 12909 SW 68th Pkwy Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP.Tigard/OR/97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:230 Project name:Mercer Global Advisors Duct work 23.32
Cross street/directions to job site: SW Hampton St. and SW 68th Pkwy. 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
Subdivision:
Lot no.: �Oth 2332
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
Re-duct (3) water source heat pumps with new distribution fireplace 23.32
ductwork, diffusers, and grilles for tenant improvement. Log lighter(gas) 23.32
Wood/pellet stove 33.39
_ Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
is PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:PacTrust Range hood/other kitchen
equipment 33.39
Address:15350 SW Sequoia Pkwy. 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 ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Excel HVAC, Inc.
$14.15 for first four;S4.03 for each additional
Contact name:Zachary 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.net Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Excel HVAC, Inc. Odler.
MECHANICAL PERMf1'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)550-6042 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:214345 3// -2--c---- TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
- � ` days after it has been accepted as complete.
Authorized signature: gQ/tp M.- ' Fee methodology set by Tri-County Building Industry Service Board
Print name:Zachary Barber Date:04/24/2023
1:1Building'.Pennits\0 C_PermitApp 040113.doc 440-4617r(1 t/02/COM/WEB)
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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 S69.06
$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.
1:1Buildin 1Permits\MEC PermitA 040113-doc B _ PP_ 2