Permit (119) CITY OF TIGARD MECHANICAL PERMIT
2 . COMMUNITY DEVELOPMENT Permit#: MEC2017-00751
T r GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/11/2017
Parcel: 2S 101 AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 290
Project: Thenell Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25, PT
Project Description: Modifying duct work for TI.
Contractor: EXCEL HVAC INC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 1188 ATTN: N PIVEN
CANBY, OR 97013 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 10/11/2017 $207.21
Class of Work: ALT Type of Const: Plan Review 10/11/2017 $51.80
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/11/2017 $24.87
Stories:
Project Valuation: $5,000.00
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 $283.88
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
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 adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009 You ma obt- a copy of the rules
or direct questions to OUNC by calling 5 . . 7 or .::..
Issued By:,../ 62,
e Signature:
t
Call 503.639.4175 by 7:00 a.m.for the next available insp>tion dat'
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 l O R ()Fri( II I ' 1.O M M.1
City of Tigard Received
-t i r' Date/By: (( rt .lawN Permit No.: :�.k "--/'
13125 SW Hall Blvd.,Tigard,OR 97 r 4 0wa. 4Plan //d� j 7
■ Date/By:Review ;1. / 00(.2 C
Phone: 503.718.2439 Fax: 503.598.060 Other Permit:
Inspection Line: 503.639.4175
T 1 G\R t) np f Note Reade o: See Pent 2 for
Internet: www.tigard-or.gov I�1� � G �l�1 tf Notified/Method: Supplemental Information
IliaN
. ` .` CommatCIAL 1 1 T IS1B :KUS'T.;
, 4 ii:O.; 71,- ,' Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/a tlt�l erltent performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
RY OP i ONSTRUCO Value:$$5,000 00
❑ 1-and 2-family dwelling ►4 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
**-�1tmAtiOIV: !Lpoli'MQhi.
Heating/cooling:
Air conditioning 46.75
Job site address:12909 SW 68.Pkwy Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Portland,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:290 Project name:Thenell Law Group Duct work 23.32
Cross stteet/directions 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
.Ifireplace/insert 33.39
iifESC"iLPTtt Ql�. �Al�:.= Gas
Flue vent for water heater or gas
Modify existing duct work for new rooms fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
>. P>l<Q 'ERTX.QWl ',TO , 1-,„,,,,,C1,0"410._:,
Environmental exhaust and ventilation:
Name:PacTrust Range hood/other kitchen
Address:15350 SW Sequoia Parkway,Suite 300 equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Portland,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)624-6300 Fax:( ) Attic/crawlspace fans 23.32
1 f £ ' Other: 23.32,- .Gam P
Business name:Excel VAC,Inc Fuel piping:
HVAC,
$14.15 for first four;$4.03 for each additional
Contact name:Jennifer Fulsher Furnace,etc.
Address:PO Box 1188
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Canby,OR 97013 Water heater
Phone:(503)504-3627 Fax::( ) Fireplace
Range
E-mail:Jennifer@excelhvac.net Barbecue
CO1NTRACIOR . Clothes dryer(gas)
Business name:Excel HVAC,Inc Other:
ME.CH�►NICrs�. f ��� .� �*
Address:PO Box 1188
Subtotal
City/State/ZIP:Canby,OR 97013 Minimum permit fee($90.00)
Phone:(503)504-3627 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:214345 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within I
/ days after it has been accepted as complete.
Authorized signature: if * Fee methodology set by Tri-County Building Industry Service Board
Print name:Jennifer Fulsher Date:10-2-2017
I:\Building\Permits\MEC PermitApp_040113.doc 440-46I7T(11/02/COM/WEB)