Permit (107) CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00388
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/29/2019
T t c_;A It.C) 9 Parcel: 1S136DD02300
Jurisdiction: TIG
Site address: 11799 SW 69TH AVE
Project: HAMPTON INN&SUITES Subdivision: Lot:
Project Description: Gas&Condensate drains for New 87,872 sq.ft.five-story,152 room hotel with parking structure.
Contractor: YORK CUSTOM MECHANICAL Owner: DVKOCR TIGARD, LLC
PO BOX 21474 1419 W MAIN STREET, SUITE 110
KEIZER, OR 97307 BATTLEGROUND,WA 98604
PHONE: 503-554-1771 PHONE: 360-723-0024
FAX: 971-273-0647
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/20/2019 $1,236.71
Class of Work: ALT Type of Const: IIB Plan Review 06/20/2019 $309.18
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 06/20/2019 $148.41
Stories: Info Process/Archiving-Lg$2.00(over 06/20/2019 $6.00
Project Valuation: $45,000.00 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: Vent Systems: Total $1,700.30
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 10 Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions = a NC by calling 503.232.1987 or 1.800.332.2344.
i
Issued By: ��� _ _ Permittee Signature:
C--(X._)4` ''':--
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
5000
Mechanical Permit Application FOR Oil i( l I SE Oyl,l
Received
Cityof TigardDate '/ ' E Permit No.: G ,_ - �,3.
1315 SW Hall Blvd.,Tigard,OR 97223 Plan Re: ( d / tom G-.�`f°1 f Ct''S58
g Plan Review p
Phone: 503.718.2439 Fax: 503.598.1960 �'� 6-r t3 ., d C-I � Other Permit � � j - 5'
Date/By: 4BB@lfff
I 1 G A R p Inspection Line: 503.639.4175 gry.(E,CDate Ready/By: . /' Juris: See Page 2 for
Internet: www.tigard-or.gov 9 x ,otified/Metho-: �I 7;�'y/ Supplemental Information
� .12019 �'' ,lir ` ` -
TYPE OF WORKO t t IAL FEE*SCHEDULE- LSE CHECKLIST
(�(or TIGARLiMechanical permit fees*are based on the value of the work
j2ELNew construction ❑Addition/alteratL
�QE e meip/ISION performed.Indicate the value(rounded to the nearest dollar)of all
ElDemolition 0 Other: kimechanical materials,equipment,labor, verhead,and rotit.
- Value:$ Si(..70CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYTEMS FEES*
❑ 1-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: ,! i 'Ill am'S Lt, `' Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: �T T e 1 Nap I Q a_."` (1.---77_7-'3 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Pro ect name: nii �� 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
Subdivision: l 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
G-As (( l C. -D t fireplace 23.32
Ale") ( � Log lighter(gas) 23.32
('� Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER ' 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
0 APPLICANT til CONTACT PERSON Other: 23.32
/ I Fuel piping:
Business name: \101 ._. �> 4,,01.3e
���{��0�'��� y� $14.15 for first four;$4.03 for each additional
Contact name: 1 Yap./t� Furnace,etc.
Address: .�1) e-.) '7,I 1.-r/LI Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: i ,� Water heater
-- -
Phone:( ) Fax::( ) Fireplace -
Range
E-mail j AVri'� \10(4--9_ \i ( 41-041.( � Barbecue
l CONTRACTOR Clothes dryer(gas)
Business name: / ' � _Other:
r(t, ! (_1✓�j�JVVa!I NnC ((�1 l(C� , ('lL MECHANICAL PERMIT FEES*
Address: 1..)4) c*. Z 101 q Subtotal
City/State/ZIP: !chi t Q_ 4-7 509 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(9/5 0.3- c?---7(p' Fax:( ) State surcharge(12%of permit fee)
CCB lic.: '2,05,31.--:, 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: "T2 I jj \ogy Date: 42//7 Ar
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