Permit (15) CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT MECHANICAL
MEC2021-00875
Date Issued: 11/16/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 500
Project: Lifestance Subdivision: ASHBROOK FARM Lot: 5
Project Description: Install new duct system and replace supply and return grills.
Contractor: PCI CONSTRUCTION Owner: KING CAPITAL INVESTMENTS LLC
I 24627 SE HOFFMEISTER RD ATTN KING,THOM
DAMASCUS, OR 97089 19250 NE PORTAL WAY
PORTLAND, OR 97230
PHONE: 503-262-8600 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/15/2021 $743.95
Class of Work: ALT Type of Const: VB Plan Review 11/15/2021 $185.99
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 11/15/2021 $89.27
Stories: Info Process/Archiving-Lg$2.00(over 11/15/2021 $12.00
11x17)
Project Valuation: $25,600.00
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 $1.031.21
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
IClothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 100
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: /..j j Vim,pe,VJQ-ge, Permittee Signature: Ovw Ap-p ,a4-u-'.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
115
Mechanical Permit Applica.„ film:), FOR OFFICE USE ONLY
City of Tigard Received pp /� �77,,..��'` Permit No.: �QQ��.��. qq ^^�� �y�Q
g T 7, 1 Date/By: f/ d 2(244 4// IV6GC,LQG� `i�UZ�
13125 SW Hall Blvd.,Tigard,OR 97223 T 2 t' Plan Review
t6 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 1 1 / J O -
a j 4 Other Permit:
T I C A R D Inspection Line: 503.639.4175 L;ITY OF T' Date Ready/By: / t is: ® See Page 2 for
Internet: www.tigard-or.gov 3'f 1 ` "'I No'led/Method. / ' ,. Supplemental Information
TYPE OF WORK CO IAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction yi Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$e5 1,0O. St.o
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling xi 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:
Job site address: to O es Air conditioning 46.75
titsswOa3a JUL ITc rJ 00 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -[79ard i O 9 72z3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: L i-re 51,a At_ Duct work 23.32
Cross street/directions to job site: R 17 4. &re eri bar Rd . Hydronic hot water system 23.32
9 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: 1 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
I rnsi•at I new duc±Sysi-ey-n and replace 5 ip P1t.i1 fireplace 23.32
Log lighter(gas) 23.32
and re4-thr>1 air grills. 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
1 City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name. pGI Cbns+ruc4 10n L L C.
$14.15 for first four;$4.03 for each additional
Contact name: jcrry Marlin Furnace,etc.
Address: Gas heat pump
(C 8?Q SE SO Pl 1G1 Wall/suspended/unit heater
City/State/ZIP: 1'c,l1 and t OR ¶i Z`7 Water heater
Phone:(503) 7z+E• 4,343 Fax: :( ) Fireplace
Range
E-mail: I a h j er y 54 a 9 rr1a11• corn Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
FOCI Lic.4 0r LLC MECHANICAL PERMIT FEES*
Address: ZA1.6 t-1 5E. N o f f rn e I SE'Cr Rd • Subtotal zc Grn
City/State/ZIP: 'DaVria a Lt1 S Ui, `t70&CI Minimum permit fee($90.00) �"""
C Plan review(25%of permit fee)
Phone:(543 )7.4-63413 Fax:(503) 2 4.z•9(.4$ State surcharge(12%of permit fee)
CCB lic.: 1 Cr 4,501 / Washi n3bh PCI C OCL 807 0 N 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: 46 e y�_. �`,��_- * Fee methodology set by Tri-County Building Industry Service Board
(
Print name: a r4 i cc) C "la�r-/-;ct _ Date:/0 ,1 l -a i
I:\Building\Permits\MEC_PermitApp_040113.doc 440-461 TT(11/02/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.
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