Permit (108) CITY OF TIGARD MECHANICAL PERMIT
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� 2. . COMMUNITY DEVELOPMENT
Permit#: MEC2017-00520
4
TrGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/27/2017
Parcel: 2S113AA00500
Site address: 16100 SW 72ND AVE B18 Jurisdiction: Tigard
Project: Jevo Subdivision: ROSEWOOD ACRE TRACTS Lot: PT A&F
Project Description: Replace(9)RTU's with new ductwork,(4)rooftop exhaust,(3)ceiling fans for restrooms,(1)unit heater. Install(1)
ductless heat pump split.
Contractor: EXCEL HVAC INC Owner:
PO BOX 1188 PACIFIC REALTY ASSOCIATES
CANBY, OR 97013 ATTN: N PIVEN
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 07/27/2017 $2,608.71
Class of Work: ALT Type of Const: VB Plan Review 07/27/2017 $652.18
12%State Surcharge-Mechanical 07/27/2017 $313.05
Occupancy Grp: B Occupancy Load:
Stories: Info Process/Archiving-Lg$2.00(over 07/27/2017 $2.00
Project Valuation: $100,000.00 11x17)
Info Process/Archiving-Sm$0.50(up to 07/27/2017 $32.50
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: 1 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump: 1
Appliances
Vent Fans: 7 Vent Systems:
Hoods: Total $3,608.44
Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ated by the Oregon
Utility • ' - • enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00904 You m-
or dir ct questions to i. C , calling 503.232.1987 or 1.800.332.2344. f ob in copy of the rules
Iss ed By:y / / .........1,_. Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectFon date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Api,t� FOR OFFICE CSE()NL)
City of Tigard , VED Received y/�
Date/By: ! ,/ Permit No.: pi G A^M 17.E ex; at
13125 SW Hall Blvd.,Tigard,OR 97223.111
L�'dL/ tom/
C Phone: 503.718.2439 Fax: 503j1910 7 2017 Plan Revie a Q-
Date/By: ) / •1 7 Other Permit: &All r'7,„00.16/
TI G A R D Inspection Line: 503.639.4175 Date Read/B Jur s:
Internet: www.tigard-or.goC fly OFTIGARD Ready/By: /7/ /�^j 5• H See Page 2 for
Notified Method: t Supplemental Information
TYPE OF WORK OMl►1ERCLAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
o New construction XAddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
o Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CA EGORY OF CONSTRUCTION Value:$ i ` (o
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
121-and 2-family dwelling Commercial/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
Job site address: /,':2) /Q 0 S-Gt., 707 N 7J /(1/27,- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: / / A7z D / /� Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./ t re-Cr I Project name: .,)!..v VO Heat pump 61.06
Duct work 23.32
Cross street/dtrections to job site: 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WQR '."` Gas fireplace/insert 33.39
Flue vent for water heater or gas
>�c ()LA'el C (I J<To j S "'//{),�1"i oJ�7-4-•012.1<_. fireplace 23.32
`7 G�CFfr'F !_`,.�,C,(�U5% Log lighter(gas) 23.32
�
/3 C C I Z./� F. hJ 5 T"�i Z. IPG$'7p Wood/pellet stove 33.39
iert.PL- t r't„C/, C/M 1 T71G. r/ fl�
A45-Ar
� Wood fireplace/insert 23.32
� -.V5LL Cr) Oi/�'TL `<r ,Lf 1-PU/VI P Spy.i j , Chimney/liner/flue/vent 23.32
PROPERTY OWNERh Other: 23.32
1 ENANT;
Environmental exhaust and ventilation:
Name: 17DAy C J j-( 7 Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(5 63 )Gc9 k' -‘3'a C Fax ( ) Attic/crawlspace fans 23.32
0 APPLICANT c 0 CONTACT ttI'ERSON Other:
23.32
Business name: _ /j� Fuel piping:
C- - v`� $14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: CSC cL 7 Other.
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MECHANICAL PERMIT FEES*
Address: j/3-$ /... O 6,0k
Subtotal
City/State/ZIP: �__ r3 ,� i Q Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(9 71) 623 0.- 7/9 r./ Fax:( ) State surcharge(12%of permit fee)
CCB lie.: a,y q 5-
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: SE/z en,‘
Date: 7.- /7 _ eO/7
I:\Building\Permits\MEC_PermitApp_ 113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation:T 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