Permit CITY OF TIGARD MECHANICAL PERMIT
111 ' ' COMMUNITY DEVELOPMENT Permit#: MEC2019-00552
T-I i;A Iz.(-) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2019
Parcel: 2S115BA00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY N
Project: Planet Fitness Subdivision: None Lot: None
Project Description: TI:Installing duct system for new tenant.
Contractor: DIRECT MECHANCIAL CONTRACTORS Owner: TECOLOTE RESOURCES INC
PO BOX 872472 KELLY'S LEGACY LLC, ET AL
VANCOUVER,WA 98687 BY HESSLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE: 360-901-6063
PHONE: 503-764-7595
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/30/2019 $3,484.71
Class of Work: ALT Type of Const: VB Plan Review 09/30/2019 $871.18
Occupancy Grp: A-3 Occupancy Load: 12%State Surcharge-Mechanical 09/30/2019 $418.17
Stories: Info Process/Archiving-Lg$2.00(over 09/30/2019 $16.00
11x17)
Project Valuation: $130,000.00 Info Process/Archiving-Sm$0.50(up to 09/30/2019 $44.50
11x17)
Fuel Air Handlers
Fuel Types: Electricity Units<10000 cfm: 4
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Fumaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 4 Vent Systems: Total $4,834.56
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 100
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 to OUNC by calling 503.232.1 87 or 1.800.332.2344.
Issued By: /214..
Permittee Signature: art,C,
?. '
Call 503.639.4175 by 7:00 a.m.for the next available inspection te.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application„., ,, ..., ,, , . -,-- FOR OFFICE USE ONLY
City of Tigard
1, 1 ,,, ,-, -,;1.,,,, ''14-pii:::iceiv-1-....A4i Ilk
Date.By: y ,)„(4 ,\I--.1)
Other Pertni7?:::kA?DtAC ' 5
111 • 13125 SW Hall Blvd.,Tigard,OR 97223
6 Phone: 503.718.7439 Fax: 503.598.1960 ,)u L. 6 ,, L.''''' Hateliv: V .1.-3- / ' 'Qt a
Inspection Line: 503.639.4175 . , 21 See Page 2 for
TIGARD Date Ready.13:) ,
Internet: www.tigard-orgox .. Not '. Method-
' Not • Men-md/ i Supplemental Information
'''' k•/1/1illt".-
___,
- -
TYPE OF WORK ------1COMM •CIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction I AdditionJalterationreplacement pertimmed.Indicate the value(rounded to the nearest dollar)of all
LI Demolition LI Other: mechanical materials,equipment,labor,overhead,and profit.
- - Value:S$130,000.00
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 I-and 2-family dwelling El Commerciallindustrial 1:11 Accessory building For special infonnation use checklim.
0 Multi-family D Master builder 0 Other: piion
S-2-escri Qty,. Ea. Total
Heatinl/couli
JOB SITE INFORMATI AN LOCATION/I -
Job site address7M4.2AC __
-
c. :i/ t ''_ Air conditioning
Furnace 100.000 BTU 4ducts'venls) 46.75
46.75
City/State/ZIP:Tigard/Oregon/97223 Furnace 100.000-i-BTU tducts'ventst 54.91
Heat pump 61.06 i
Suite/bldg./apt.no.: Project name:Planet Fitness
Duct work 23.32
Cross street/directions to job site:Corner of SW Pacific Hwy and Durham Rd Hydronic hot water system 23.32
Residential boiler(radiator or
hsidronic) 23.32
Unit heaters(fitel-type,not electric.
'n-.all,in-duct.suspended,etc.
46.75
Fluelvent for any of above 23.32
Other: 23.32
Subdivision: Lot no.:
, Other fuel appliances:
.
Tax map,parcel no.: _Vater heater 2/.32
DESCRIPTION OF WORK (IM;fireplace.insert 33.39
Flue rent for water heater or gas
New mechanical duct system for gym fireplace 23.32
.._.
Log lighter(gas) .7.'3.32
Wood:pellet stove 33.39
1 Wood fireplaceinsen 23.32
_ ---- - -1
Chimney.liner flue'yent 23.32
Other: 23.32
0 PROPERTY OWNER 1 TO TENANT
- -- _____
„i _ Environmental exhaust and ventilation:
Name:Town Square Fit LLC Range hood,other kitchen
equipment 33.39
Address:15171 Ban a Rdts33.39
Clothes dryer exhat
City/State/ZIP:Lake Oswego/Oregon/97035 gi -duct exhausti(bati ir001 ns,
toilet compartments,utility rooms) __23.32
Phone:(503)764-7595 I Fax:( ) ; Anic.'enovispace fans 23.32 ,
----- ,
0 APPLICANT 1CONTACT PERSON 1 Other: 23.32
Fuel
.32 l
1
J Feel piping:
Business name:Town Square Fit LLC
---i i $14.15 for first four;$4.03 for each additional
Contact name:Gary Van Drew I Furnace.etc.
t--
Address: 15171 Ban Rd Rd Gas heat pump
l Wall'suspended'unit heater -4-
City/State/ZIP:Lake Oswego/Oregon/97035 - --1 t-Wilter heater
Phone:(503)764-7595 Fax::( I Fire'lace ----j
Range
E-mail:gvandrew5(donsn.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name:Not yet determined (-I.(--) - - .04 t,---, „I , . , ,
ti 0-,vc A :--(--14 ti,/-4- 1 C- 4_C--- MECHANICAL PERMIT FEES-
Addn.
Address: -0 box. s 72 q 7z._ Subtotal
CityiState'ZIP: Vi4-mCou. :.: ^ .. ,. .4
iS. Ilik-,,-,, 9'5'68'7 Minimum permit fee(S90.00)
Plan review(25'0ot-1-len- it-tee)
m
Pho .
-(30
. 9oi -- - •63
_ _ - x: ) State surcharge(IT".of permit fee)
-
----
• -
CCB lie.: i ip , i , •,. d 1 TOTAL PERMIT FEE 3,484.
This pernit application expires if a permit is not obtained u itbin 180
g days after it has been accepted as complete.
Authorized signature: - ... -
' Fee methodology set by-Uri-County Building Industry Service Board
1-- 1---
[Print name: --vs L 0 A ell_ 1)ate: . CI) dev9
/
. .
L Buildlag Permits,MLC_Pernit App 040!Il 44 .1"T'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 S500.00 Minimum fee$69.06
$500.01 to$5,000.00 S69.06 for the first 5500.00 and
$3.07 for each additional S100.00 or
fraction thereof to and including
S5,000.00.
S5,000.01 to 510,000.00 S207.21 for the first 55,000.00 and
S2.81 for each additional S 100.00 or
fraction thereof,to and including
S 10,000.00.
$10,000.01 to S50,000.00 $347.71 for the first S10,000.00 and
$2.54 for each additional S100.00 or
fraction thereof, to and including
S50.000.00.
550.000.01 to$100,000.00 S1,363.71 for the first 550,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
S 100.000.00.
S100,000.01 and up $2,608.71 for the first S 100,000.00 and
S2.92 for each additional 5100.00 or
fraction thereof__
Note: All new commercial buildings require 2 sets of plans.
[_•':,Building Permits'.,MEC_PcrmitApp_140I I 3.doc 2
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
!PI = Transmittal Letter
r i c n i n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: fv\ DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
SEP 3 2019
FROM: IQ v c !, I Al-C-e--) CITY OF TIGARD
BUILDING DIVISION
COMPANY: Piz-0 c me v9 .ISO C 14-re_f
y�--.
PHONE: CO3 —Sl `� —C/99 B :
RE: /' 2 06 5 c./ t/c,/y /'7c-c_alo I y-7L$5?
(Site Address) / (Permit Number)
Pt Pf F ' f
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain): C v r c‘
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Techni ian: ate: 9 - Z� f Initials: j
Fees Due: El 1 Fee Description: Amount Due.
Special
Instructions:
Reprint Permit(per PE): ❑ Yes / No ❑ Do
Applicant Notified: Date: ' ! 1� Initia :
I:IBuilding'Forms\Transmittal Letter-Revisions_061316.doc