Permit (2) CITY OF TIGARD MECHANICAL PERMIT
2' COMMUNITY DEVELOPMENT Permit#: MEC2023-00850
T t t. .A1C D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2023
Parcel: 1 S 134AD06202
Jurisdiction: Tigard
Site address: 10500 SW NIMBUS AVE T
Project: Solid Rock Church Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: A
Project Description: Mechanical for TI:Replacing(1)10-ton RTU.
Contractor: REITMEIER MECHANICAL Owner: DIETRICH, NANCY BISHOP
19570 SW 90TH CT ROBINSON, JERRY CHRISTOPHER TRUST
TUALATIN, OR 97062 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE,OR 97222
PHONE: 503-603-0205 PHONE:
FAX: 503-603-0150
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/20/2023 $652.51
Class of Work: ALT Type of Const: VA Plan Review 11/20/2023 $163.13
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 11/20/2023 $78.30
Stories: Info Process/Archiving-Sm$0.50(up to 11/20/2023 $3.00
Project Valuation: $22,000.00 11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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 $896.94
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: 7//411(, Permittee Signature: 5 1 14 //)
/41.
Call 503.639.4175"if;N;;)-7."--e--:by• a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application RECEIVE' Ft)iz OFFICE USE UNI.l'
Cityof Tigard V Receivedty: 'O I16I101s . Nq Mi.MAIA.AO%S--
g e µ Permit No.: /v\
*113125 SW Hall Blvd.,Tigard,OR 97223Plan Review
_ Phone: 503.718.2439 Fax: 503.598.1960 �J 16 2023 Other Permit:
Date/By: j J. J 6-a3
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Jnris:
Internet: www.tigard-or.gov CITY OF TIGARR Notified/Method: See Page 2 for
S
BUILDING DIVlS10 �� 1(p/J"'3 .jr� Supplemental Information
TYPE OF WORK
t- COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction
Agkk.ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 2,2,be.-0
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwellingommercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE.INFORMATION AND LOCATION Heating/cooling:
.. / Air conditioning 46.75
j
Job site address: l750D S W N i Ai b(,{, 5 fkve, Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 4fildrigrok, I t 4dt-r'CJt. , or. q 7 2,23 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:1 Project name: co :id, IZ..0c,I,_ /� Duct work 23.32
Cross street/directions to job site: C 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
Flue vent for water heater or gas
Ke Di t L (® Torl Z-r,� v0,-�'� fireplace 23.32
(t (_„ ��
, I�Nn � Log lighter(gas) 23.32
f� Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER I 0 TENANT Other: 23.32
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
Fuel piping:
Business name: ��f�Q„ )
f� � $14.15 for first four;$4.03 for each additional
Contact name: "1-.0,se h 14.1'IC� Furnace,etc.
Address: I C S I° S vJ U,O'{-�,... L� Gas heat pump
1 Wall/suspended/unit heater
City/State/ZIP:i..a( Cl r Or. q 70 6' 2- Water heater
Phone:(sz3)(_03..d 2 a S Fax::( ) Fireplace
Range
E-mail: Joe*� re I: (-m Li er n.N/ . &owl Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
�p LL'I' a A MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee)
CCB lie.: i 5 3 710 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: * Fee methodology set by Tri-County Building Industry Service Board
Print name: u S 1_1 I v Date: `a-0,- 23
B I:\ uilding\Permits\MEC_P 'tApp_0401I346 44046I7T(1I/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\Permits\MEC_PermitApp_040113.doc 2
City of Tigard
ill " COMMUNITY DEVELOPMENT DEPARTMENT
_ .
T I G A R D Building Permit Review — Commercial - No Land U s e
Building Permit #:
Site Address: 1 0 C- tin) A)6 f 11 i4VE Suite/Bldg#: '1
Project Name: L ( P i2 =C
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: `t.ZT-v
Existing Business Activity: O F C e
Proposed Business Activity: �Le--
ITT rtfy rify site address/suite# exists and active in permit system.
LJ ' er Terrace Neighborhood: Cl1V Yes n o
rmitted Use: Des ❑ No ❑ Spec Space
( firm no land use required.
Business License:
Exists: Yes ❑ No,applicant was provided a business license application
Notes: ti i 1 L (9)t7- ?L.: S 1 r�Gt,' en .�, Rr )'
Approved by Planning: Date: l 0��/
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:
Site Plans: #
Building Plans: #
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date:
I:\Building\Forms\BldgPermitRvw COM_NoLandUse_09072022.docx
Engineering Review
Slope at building pad:
❑ 'FI Permit#:
❑ Co •'bons"Met"prior to issuance of permit
❑ Easel' nts (encroachments)per engineering conditions of approval and plat(not typical on SD' CUP)
❑ Water Q .lity/Quantity Facility:
Assess ater Quality Fee in-lieu: ❑ Yes ❑ No
Assess Wa ; Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility .n lot: ❑ Yes ❑ No Add Fee: ❑ Yes ❑ No
❑ NOT Approved b ngineering: Date
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal o ) Reviewer Date
Revision 1: ❑ Approved ❑ a t Approved
Revision 2: ❑ Approved Cl Not ; proved
Revision 3: ❑ Approved ❑ Not Ap o roved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of permit
❑ Approved,NOT Released: Date:
❑ ENG Revisions Required: Date:
Notes:
❑ SDC Exemption ❑ ' .plied for ❑ Received ❑ Does not apply
❑ Fees Entered: W h Co Trans Dev Tax: ❑ Yes ❑ N/A ❑ Deferred
igard Trans SDC: ❑ Yes • N/A ❑ Deferred
Parks SDC: ❑ Yes • N/A ❑ Deferred
LIDA Fee: ❑ Yes ❑ /A
❑ OK to Issue/ .proved by Permit Coordinator: Date:
Revisions (aft: Building Submittal only) Reviewer Date
Revision . ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw COM NoLandUse_08162022.docx