Permit (262) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00581
T-1(;Aft 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2019
Parcel: 2S101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE#10
Project: Oregon Academy of General Dentistry Subdivision: VARNS ACRES Lot: 9
Project Description: Mechanical for TI: Installing a VAV box,exhaust fans,and kitchen hood installations;relocating ducts and grills.
Contractor: ARJAE SHEET METAL CO, INC. Owner: TRIANGLE POINTE TWO LLC
8545 SE MCLOUGHLIN BLVD. 901 NE GLISAN ST, STE 100
PORTLAND, OR 97222 PORTLAND, OR 97232
PHONE: 503-231-7717 PHONE:
FAX: 503-230-4888
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/20/2019 $728.71
Class of Work: ALT Type of Const: VB Plan Review 08/20/2019 $182.18
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 08/20/2019 $87.45
Stories: Info Process/Archiving-Lg$2.00(over 08/20/2019 $2.00
11x17)
Project Valuation: $25,000.00 Info Process/Archiving-Sm$0.50(up to 08/20/2019 $6.00
11x17)
Fuel Air Handlers
Fuel Types: Electricity 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: 3 Vent Systems: Total $1,006.34
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
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/ay obtain a copy of the rules
or direct questions to OUNC by calling 03.232.1 :7 or 1.800 32.2344.
Issued By: //�I��
- - Permittee Signature: �
. 0/A .
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.
Mechanical Permit Application FOR OFFICE LSE ONLY
City of Tigard Roteit tut
• 13125 SW Hall l3lvd Tigard,OR 97 r rj' llra`t34: �tJ c� ✓, Perit /'.ficy� Ui `11-'C.r.� 0(
11111
�, ! flan Ite`[eu'
Phone: 503 14 439 Tax 503 395- , s d a t.,- .. Other Pcrrtut:
t�ties -1�.. 9 � �rt a
TIGARD
Inspection 5(b6494C'S j t �/f 4(-
Internet: www.tlgard or.goti ( ,.r Date R ulv ny. uru: See Parc 2 for
20113 �ati#ied S..tho<� ��
���l.d L/' eJ/e �e app(Amaral Int irrmadon
TYPE OF .03,�+' I I CQN31ERcIA1.FF* SCI [?ISE USSE(3lE CLS '
0 ` � tnki Mechanical permit Zees*are based on the tialue oldie work
New construction ,•f Addition 1a at IxilfsnF:tic�riiirnf
perCornaeetl.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:S 2 �j/C?>79
RESIDENTIAL EQUIPMENT I SYSTEMS FELS*
0 I-and 2-family dwelling j121 Commercial/industrial 0 Accessory building For.specialinjhrnuuion use eheeklitt.
❑Multi-family 0 Master builder
0 Other: Description I Qty. Ea. 1 Total
JOB
QQSITE
2INFORMATION AND pLOCATIO Heating/cooling:
Job site address: /'
/cJ3✓�J j Ij Air conditioning 4E 75
�_ 1-7Q,A,--k way Furnace 100,001)B I t%(dainrsarnty) 40.75
CityrState"ZIP; -fi , 9g Il Furnace 100,000-133 U(dunis',.ents) 54.91
Suite bldg apt.no.: Cii Project name: c ,/6'1/F/g� 7 I feat pump (L46
f(! Duct work 23.32
Cross streetdirections to job site: l lydronic hot water system 23.32
Residential boiler(radiator or
Itydronic) 23.32
unit heaters Olicl-type.not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue-vent for any of above 23.32
Subdivision: 1.01 no,: Other: 23.32
Other fuel appliances:
"Tax map/parcel no.:
Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
T P 0 �// / 1/ I
;De vent for water heater or gas
4-pi" MOVe r(6Is OIV(A r� V fireplace 23.32
r J // log lighter(gas) 23.32
k
4`o 2c12Lt AAS „et,S r e8Jz146.
_ // / J� �p Wood pellet stove 33.39
IlcLe./l. 4ntrP 04 WI �,i?e 4v1. ,2- gicig WoodFireplaceiinsert 23.32
®R K, Chimneyiliner;flue"vent 23.32
0 PROPERTY OWNER TENANT Other: 23.32
E�� Range h od taloili exhaust and ventilation:
Name: A 'aA
/ priVit // Ranee hood/other kitchen
Address:
J equipment 33.39
Clothes(hover exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathr(xms.
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic erawlspaee fans 23.32
tgi APPLICANT 0 CONTACT' PERSON Other: 23.32
Business name: 4c cke. i 1' � Fuel piping:
514.15 for first four,S4.03 for each additional
Contact name: pa, r
{� (� Furnace,etc.
Address: Qr5S/'5 rSE KIP d4 S/Vc( Gas heat pump
t/ 1 / pi .9
V all suspended-'tinit heater
City."State/ZIP: /0 l`/wvei /� `977Q‘ Water heater
_ - 'Phone:( }--Z ti-----7.?/.7 Fax::( ) Fireplace
Range
E-mail: tQP_VLtIlis j Q-t e,(A 1
! Barbecue
CO RACTOR Clothes dryer(gas)
Business name: Other:
MFC:tIANR'AL PERMIT FEES*
Address: -
Subtotal
City/State/ZIP: 81inintutn permit fee(890.01))
Phone:( ) Plan review(254;0 of permit fee)
Fax:( j
State surcharge(12`%,ofpemait fez)
CCB lie.: C aS35 7 l G 7.T TOTAL PERMIT'FEE
�`�V This permit application expires if a permit is not obtained within 180
da)s after it has been accepted as complete.
Authorized signature: ,64 * Pee methodology set 0,Tri-C`aunt} tiiiilding Iridostrs Series:Board
Print name: 72a Ut d ierrn4,242 Date: 023 711/f
I mudding Penne..511G_Perm itApp_0401 li.doc 440-46 7r 1)1:02(Ott W Di)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
T -Valuation: __Permit Fte: -
S0.00 to S500.00 Minimum fee S69.06
S500.01 to$5,000.00 $69.06 for the first S500.00 and
S3.07 for each additional $100.00 or
fraction thereof,to and including
$5,000.00.
S5,000.01 to$10.000.00 S207.21 for the first S5.000.00 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
traction thereof,to and including
550,000,00.
$50,000.01 to$100,000.00 S 1,363.71 IOr the first$50,000.00 and
$2.49 for each additional 5 100.00 or
fraction thereof, to and including
$100,000.00.
SI 00,000.01 and up $2,608.71 for the first S 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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