Permit (55) n CITY OF TIGARD MECHANICAL PERMIT
'' 2 '. COMMUNITY DEVELOPMENT Permit#: MEC2023-00676
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/17/2023
Parcel: 2S102AC00200
Jurisdiction: Tigard
Site address: 9180 SW BURNHAM ST
Project: Stevens Marine Subdivision: None
Lot: None
Project Description: Replacing 2 ground A/C units and 2 furnaces.
Contractor: WOLD HEATING AND AIR CONDITIONING LLC Owner: STEVENS, PAGE&DEBRA LIVING TRUST
16717 NE 229TH ST 9180 SW BURNHAM ROAD
BATTLE GROUND,WA 98604 TIGARD, OR 97223
PHONE: 503-890-2909 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Info Process/Archiving-Sm$0.50(up to 08/17/2023 $3.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: B Occupancy Load: Permit Fee 08/17/2023 $1,160.51
Stories: 1 Plan Review 08/17/2023 S290.13
12%State Surcharge-Mechanical 08/17/2023 $139.26
Project Valuation: $42,000.00
Fuel Air Handlers
Fuel Types: Natural Gas Units<10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 2 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: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $1,592.90
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ado by the Oregon
Utility Notification Center.
yThose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a rules
Issued By: '�/ ) 11 Permittee Signature:
/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicatioRECEIVE , FOR OFFICE USE ONLY
City of Tigard Received M
AUG 17 2023 Date/By: tri 63, 1 Permit No.: 1 ,1K. 93��/ rib
1111
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ll 1 I ,1 lP I t[J
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Is-.7- 07 3 Other Permit:
l I:;n i,n Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: lu u; ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Nolified/Method' Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*arc based on the value of the work
❑New construction t., Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ < a.f,6) i(1„<S^
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Commercial/industrial ❑ Accessory building For special information use checklist
❑ Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
�� / p Air conditioning 2_ 46.75
Job site address:
I RD 6'LA1 f5(tii^htirt vY- S . Furnace 100,000 BTU(ducts/vents) Z 46.75
City/State/ZIP: 'L. ex,g lq-�,.Z Furnace 100,000+BTU(ducts/vents) 54.91
1- .• Heat pump 61.06
Suite/bldg./apt.no.: Project name: s .,".5 /Jn__ h: a Duct work 23.32
Cross street/directions to job site: 5 AV A SA. S� ��W�/ 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.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
n Flue vent for water heater or gas
iCQDICCJ� Tlye) 4,1^( 16{. �,brQSir-s L'(,y�s'i fireplace 23.32
✓Y ^ Log lighter(gas) 23.32
/ r/1/C• per -"C4S r'n - • 4/C 5 GL✓'� Wood/pellet stove 33.39
Lj:Oe v,'LA 1 tv,C,j h. -it.,..,w sG✓TA -tee. irk/ Wood fireplace/insert 23.32
✓ Chimney/liner/flue/vent 23.32
Other: 23.32
❑ PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: �- �f Fuel piping:
Sy' (IV- Ck - Car L QC $14.15 for first four;$4.03 for each additional
i Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
/ p Range
E-mail: .7311 ( t'1 W C�' ��t4 iel 4 dst'�-r-‘0 LG'+'i�l G1,�:<--t%vvI Barbecue
CONTRACTOR J Clothes dryer(gas)
Business name: '^ / /�jJ 0141,( Other:
Nv 0`fit /� � r1 '��h"J u r MECHANICAL PERMIT FEES*
Address: 1.6 ./. . A)E- LZ_4•6y S"}YCC, / Subtotal //(a41,Sj
City/State/ZIP: i11-A C'ZI,i, _f /1 el 8-6 .G71 Minimum permit fee($90.00)
r^ l Plan review(25%of permit fee) Z 3,/3
Phone:(603)��'Z" /t3 I Fax:( ) State surcharge(12%of permit fee) 09,,z2.
CCB lie.: "Z-24g/ `al TOTAL PERMIT FEE /591,aev
This permit application expires if a permit is not obtained within 180
e/" , ? days after it has been accepted as complete.
Authorized signature: -AI • Fee methodology set by Tri-County Building Industry Service Board
Print name: S(4,,,d,,,� z...,)a Date:s2' /�" 2,3
1:1BuildingTermits1MEC_PermitApp_040113.doc -4617T(I 1/02/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$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Pecmits\MEC_PermitApp_0401 13.doc 2
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Iit
i IN
11(, 1.1 Building Permit Review - Commercial - No Land Use
e _
Building Permit #: (Y)-e,C aG).3— c,G(1 `7 (P
Site Address: Ito St") burg kakn S-j , Suite/Bldg#:/---
Project Name: c-2 A< A4 J$ ' `1 Re pl gce ,,
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: (ze pk40._ -J-wo (1) A Cs u `-,vo t'x ,,,S /nn mS , A-C s wP 6.tognol. ioief woJni/4
fKiSt•n) ''1ci/n.).
Existing Business Activity: /''t64or J€A„,'Cfe_ S4kes /Pasta ,
Proposed Business Activity: tA
Verify site address/suite#exists and active in permit system.
River Terrace Neighborhood: ❑ Yes V No
7 Zoning: /`I U -C 13 b , T�1 cefd bo..)n t8wn Plat tr 5A-Pi ci-
21 Permitted Use: 7 Yes ❑ No • 0 Spec Space
Confirm no land use required.
Business License:
Exists: Yes ❑ No,applicant was provided a business license application
Notes: �14U'5vq./ C;{ (bn 31-o.nin� �^2a� wu''C- L 2-far-i 4 . retiarewu i- ac' el.stln� exkrK.v�
1^^eeJ,w„caI elui� T 1-k�}- ,aP.4( / Scre�ene t'owt Qko'1(n04- to r'rpian ms stw,A,rolS, blr- ;son
only e/-1piwt{- i5 dgne., /n� 15ece.1 u`.11 rvop zcl e 'fo Z d k ). 0
Approved by Planning: Date: '/17/'�ua.-3
Revisions(after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: T-/1 7/a
Site Plans: #
Building Plans: #
Building Permit#: 2rEnter building permit#above.
Workflow Routing: Er"-Planning ❑ Permit Coordinator Building
Workflow Sign-off: I Sign-off for Planning(include notes from planning review)
Route Application Documents: El- Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 14 -_�- n V\ Date: 1177)]
I:1Building\FormsBBldgPerm itRvw_COM_NoLandUse_09072022.docx
Enginee Review
❑ Slope at buildin_, .ad:
❑ PFI Permit#:
❑ Conditions"Met"prior to .suance of permit
❑ Easements (encroachments) p- -ngineering conditions of approval . plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: • Yes ❑ .,o
Assess Water Quantity Fee in-lieu: ■ es ■ No
LIDA Facility on lot: ❑ ❑ No Add Fee: ❑ Yes ❑ No
❑ NOT Approved by Engineerin•• Date
Notes:
Approved by En ering: Date:
Revisions . -r Building Submittal only) Reviewer Date
Rev .n 1: ❑ Approved ❑ Not Approved
'evision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Per oordinator Review
❑ Conditions " - " .rior to issuance of permit
❑ Approved,NOT Rele -d: Date:
❑ ENG Revisions Required: Date:
Notes:
❑ SDC Exemption El Applied for IN Received ❑ Does not apply
❑ Fees Entered: Wash Co Trans Dev T : \ Yes ❑ N/A ❑ Deferred
Tigard Trans SD .. ❑ - ❑ N/A ❑ Deferred
Parks SDC: ❑ Yes El N/A ❑ Deferred
LIDA • -e: ❑ Yes • N/A
El OK to Issue/Approv- : .y Permit Coordinator: Date:
Revisions(after B •ng Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revisio• : ❑ Approved El Not Approved
R- 'sion3: ❑ Approved ❑ Not Approved
1:\Buil d ing\Forms\BldgPermitRvw_COM_NoLandUse_08162022.docx