Permit (16) CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit#: MEC2019-00213
T 1(_1;`k,f.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18/2019
Parcel: 2S112DD00701
Jurisdiction: Tigard
Site address: 15858 SW UPPER BOONES FERRY RD
Project: Ideation Subdivision: None Lot: None
Project Description: Relocating(2)supply air diffusers,adding(2)return air grills,replacing all ceiling grills with new,and replacing(2)
bath fans.
Contractor: EXCEL HVAC INC Owner: PACIFIC REALTY TRUST
PO BOX 1188 ATTN: N PIVEN
CANBY, OR 97013 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 971-930-7194 PHONE: 503-624-6300
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/18/2019 $145.81
Class of Work: ALT Type of Const: VB
Plan Review 04/18/2019 $36.45
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 04/18/2019 $17.50
Stories: Info Process/Archiving-Lg$2.00(over 04/18/2019 $2.00
11x17)
Project Valuation: $3,000.00 Info Process/Archiving-Sm$0.50(up to 04/18/2019 $1.00
11x17)
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: 2 Vent Systems: Total $202.76
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those'rules are set forth in OAR 952-001-0010 through OAR 952-001-00 . You may.i a opy of the rules
or direct questions to OUNC by calling 50 32.198 or 1.8 .332.2344.
Issued By: Permittee Signature:
"C‘
Call 503.639.4175 by 7:00 a.m.for the next available inspectio ate.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatio9 F c 7,,,v , . FOR OFFICE 1.SE ONEN
City of Tigard --- --.' Received 4../ ' ii of I /ptett?..)sd,_coal/
3
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960
lig APR - 2 2019 Plan Revievt 1 1 -,.1
Date/By: -7 - ,,,J2- ) --- 1 i Other Permit:
D Inspection Line: 503.639.4175 r'-'' r-' --1- -') Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Bc_i
TI GA R No. d/Method:L.; I I 7 d Supplemental Information
i
TYPEOFWORK
1741MER,81 / FEE* SCHEDULE-- USE CHECKLIST-
-i4,-.,„. ,, , . , -, ' - • ,--=-: - - ' ''''-'' - ''"' ' '" -- ' Mechanical permit fees*are based on the value of the work
0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ al Ott,Q
y TE KY OF CONSTRUCTION ...,... , . RRSIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 1-and 2-family dwellmg Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION '
_ i " Air conditioning 46.75
Job site address: /6--.4-5-1' ,sta oppa-z govAt F..r:key Trairk Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 7--, ...(s--k p 10),-,,...., 9 7o c--v Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 2"-Z GA-n CA/
Duct work 23.32
Cross street/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
ON OF WOR14.7;.,;,,,,k:111S.,_$:: ) q Gas fireplace/insert 33.39
Flue vent for water heater or gas
,C&-OC.00-7/6'C.Rj.5 UPPZ.y A le DirrusEs fireplace 23.32
Log lighter(gas) 23.32
At i:(7., .)eErure,tu Ari x., e-rk t-L4Av / eiFPLA e-E Wood/pellet stove 33.39
6'C-i N C,n I C-4e-ff ktilot/41-11-1 Wood fireplace/insert 23.32
REPCif C (14q). P51-417.,E74J:41,,,--, . ,, -.0 .-r;,I.. 4.1- ,t,, -.,,, - m- - -: Other:7.
Chimney/liner/flue/vent 23.32
23.32
'ffl'l '-->En"161Kelifi OWNER 7-,,,,,,:;:17 1 14- - ''k4r - Environmental exhaust and ventilation:
Name: 'ic m ds'/ 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
a --Apptic-Aiif:z: '------:7: -;j:j---eo#N--r-ici,--ik:Rsiii4 --'''' -- Other: 23.32
, .
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
/.
Contact name:
Furnace,lil Furnace,etc.
Address:
57V - t 5,ty Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: T--,011.61r)yto .&*.e.:4;44,/i/A ez. A,),6-7- ,, , Barbecue
CONTRACTORClothes dryer(gas)
Other:
Business name: Eier EL A4,4 G_L.,,c
, MECHANICAL PERMIT FEES*
Address: i?..00, 13 d n rg Subtotal
Minimum permit fee($90.00)
City/State/ZIP: CA A/)3y i 0-A. 970i 3
Plan review(25%of permit fee)
Phone:(9 7/) 95 0 - 7).24/ Fax:( ) State surcharge(12%of permit fee)
CCB lic.: /(/34i5/' TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it bas been accepted as complete.
Authorized signature: 're * Fee methodology set by Tri-County Building Industry Service Board
Print name: -3-tc-IL,e)ePt° /741,-"r" Date:
I:\Building\Permits\MEC_PermitApp_040113...c 440-4617T(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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
15858 SW UPPER BOONES FERRY RD, LAKE April 30, 2019 at 9:48:53 AM
OSWEGO, OR, 97035
Record Type: Record ID:
Commercial - Mechanical MEC2019-00213
Inspection Type: Inspector:
699 Mechanical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor