Permit (8) IN CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Pe COMMUNITY MEC2022-00644
Date Issued: 10/4/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102AA00602
Jurisdiction: Tigard
Site address: 11960 SW PACIFIC HWY
Project: Tigard Tendercare Subdivision: TIGARD HIGHWAY TRACTS Lot: 12
Project Description: Exterior A/C unit replacement. Placement of unit must comply with manufacturer's installation requirements.
Contractor: D & R HEATING&AIR Owner: J MAROSTICA LLC
12220 SW GRANT AVE 11960 SW PACIFIC HWY
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-678-2517 PHONE:
FAX: 503-387-5827
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/28/2022 $235.31
Class of Work: ALT Type of Const: VB Plan Review 07/28/2022 $58.83
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 07/28/2022 $28.24
Stories: Info Process/Archiving-Sm$0.50(up to 07/28/2022 $2.50
11x17)
Project Valuation: $5,932.00
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: 1
Appliances
Vent Fans: Vent Systems: Total $324.88
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set for - 01-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: /-' ittee Signature: s ., / ; t , t .,•
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Fo OFFICE USE ONLY
City of Tigard Received ��. Permit No.. 7 /4d/ _efjeji r
ill . 13125 SW Hall Blvd.,Tigard,OR 9722� yE E I VE D PlanDa Review l t d / ��¢V
B
j
Phone: 503.718.2439 Fax: 503.598.1 60 Date/By: !al • Other Permit:
T I G A R n Inspection Line: 503.639.4175 JUL9 ry ry g Date Ready/By: Ju s: ® See Page 2 for
Internet: www.tigard-or.gov J LOLL eotified/Method: _ 24_,�{,/1 Supplemental Information
:1TY OF.�1GAAHl..3 /.^_� -- -
TYPE OF 'DING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction [Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 6
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 1-and 2-family dwelling commercial/industrial 0 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 I 46.75
Job site address: j i(16/0 3 /a,r�fi il j/ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: / ,` ' A,,.-` 0‹ q.a. J Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name�C..
: Heat pump 61.06
S I f y Gt!-t...- 'r. Duct work _ 23.32
Cross street/directions to job site: / H dronic hot water system 23.32
idential boiler(radiator or
C �y.� � hydronic) 23.32
(,+ / , tal , ,tip eet 71c0 Unit in-wall,in-duct,-s(fuel-type,us not electric),
l � suspended,etc. 46.75
Flue/vent for any of above 23.32
Oth
Subdivision: Lot no.: er' 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
I P , e
1 S �(�/ /' i F` - /y (j/ J fireplace 23.32
1 Log lighter(gas) 23.32
Lk Y_r-L C 6-i 'iz. 1't)/ h o a [//.,. Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name{V i, YJ �//14,i ,�f-/ - Range hood/other kitchen
Address: j �}C + equipment 33.39
`l��(f J ;J ��� �j Clothes dryer exhaust 33.39
City/State/ZIP: ./ ` ,j� 1,.- ,,t/ O Cl .7?-?3 Single-duct exhaust(bathrooms,
'� `�� 1►®�� r toilet compartments,utility rooms) 23.32
Phone:(5* Fax:( ) Attic/crawlspace fans 23.32
(APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: JO i.i2Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:"!"'.`S h.. 6 h k` Z.-
pp, Furnace,etc.
Address: / /)"' f 7 /p Gas heat pump
{ C7 i/ �' ��J2t ry Wall/suspended/unitheater
City/State/ZIP: 'fl/,ei, Ir i V . 47�a-�l Water heater
Phone:( / 6 7 - 5/ 7 Fax: :( ) Fireplace
1 Range
E-mail: • 4 d ri -I•, he , if, / Barbecue
t ttt Clothes dryer(gas) _
[f / Other:
Business name: J�.
1 MECHANICAL PERMIT FEES*
Address:` .2- /1.) �'1 fe/ Subtotal
City/State/ZIP:� it,V,/ 1 7 t 9-y Minimum permit fee($90.00)
J u / Plan review(25%of permit fee)
Phone:5-'d�4 )ff. dc Fax:( ) State surcharge(12%of permit fee)
CCB lic.:cJ '10 `!tt% 1/-7 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
4, days after it has been accepted as complete.
Authorized signature: 1� * Fee methodology set by Tri-County Building Industry Service Board
Print name: "7 clillit L 74 2_ Date: 7 6
I1/02 I:\Building\Permits\MEC_PennitApp_040113.doc -4617T /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
City of Tigard
~IPICOMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: , ?zy24`�oSlil
Site Address: j l et (,p Slit) P4C4(j'C +u9 Suite/Bldg#:
Project Name: AC ((ce.tiv,e,A4-,
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Felt'1D cA- AG 1&t- - ,rof - ,ke
Existing Business Activity: f erso 1101 f V c&f / 77 ca
Proposed Business Activity:
.,Verify site address/suite#exists and active in permit system.
❑ River Terrace Neighborhood: ❑ Yes L7 No
/n.. Zoning: MV— CA759
N Permitted Use: es ❑ No ❑ Spec Space
111 Confirm no land use required.
Business License:
Exists: �D Yes ❑ No,applicant was provided a business license application
Notes: /
Approved by Planning: _ Date: 7111q ��
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 7 ,c
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: anning ❑ Permit Coordinator L_ wldtng
Workflow Sign-off: �1..0Sign-off for Planning(include notes from planning review)
Route Application Documents: ["Trlding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: --7, Date: *KO.
I:\Building\Fonns\BldgPermitRvw_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: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx