Permit (6) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00712
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2019
T l t''�R g Parcel: 2S113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 200
Project: RMLS Subdivision: None Lot: None
Project Description: TI to include drywall,suspended ceilings,doors/frames,and paint for new tenant.
Contractor: EXCEL HVAC INC Owner: PACIFIC REALTY ASSOCIATES LP
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 10/07/2019 $347.71
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/07/2019 $41.73
Occupancy Grp: Occupancy Load: Additional Plan Review 10/07/2019 $1.00
Stories: Info Process/Archiving-Lg$2.00(over 10/07/2019 $2.00
11x17)
Project Valuation: $10,000.00
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 $392.44
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Ceiling Grills
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are et forth in OAR 952-001-0010 through OAR 952-001-00•i. ou may in a copy of the rules
or directq uestions to OUNC b ailing 503.232. 987 or 1.::.1.33 344.
Issued By: lc A/ / i I Permittee Signature: _
/
,s_
Call 503.639.4175 by 7:00 a.m.for the next available inspection -ate.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ��� 1VE Dae/B a i>fy��C � i�' `i'-, 9--pI
. ' 13125 SW Hall Blvd.,Tigard,OR 97223 r� Pl `
Phone: 503.718.2439 Fax: 503.598.1960 OCT A 2019 Date/By:
t/By Review Irk=riZelilli
TIGARD Inspection Line: 503.639.4175 DateReady/By: Juris Fi See Page` for
Internet: www.tigard-or.gov CITY OF Tr ARD Notified/Method: Supplemental Information
BUILDII`
TYPE OF WORK 1,;-::-;-, / COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ la A Creat'
CATEGORY OF CONSTRUCTION w �' RESIDENTIAL EQUIPMENT/SfSTEMS FEES*
❑ I-and 2-family dwelling commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION -. Heating/cooling:
" Air conditioning 46.75
_Job site address: /c.../C/ 51," u xis Furnace 100,000 BTU(ducts vents) 46.75
City/State/ZIP: t e0 ( 9 7 (4 Furnace 100,000+BTU(ducts/vents) 54.91
T Heat pump 61.06
Suite/bldg./apt.no.: 0 Project name:
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: 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
,e.P_ c E et' _i/✓, . cep rz-r L4.C;S fireplace 23.32
41 S • - AI -'Ii zIP adisi
Log lighter(gas) 23.32
A',/,0 / Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
.1 'ROPERTY OWNERF y . ❑ TENANT Environmental exhaust and ventilation:
Name: )(cf.71-Z,OS'/ 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
..s `. ❑ APPLICANT 0 CONTACT PERSON Other: 23.32 _
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: ,d Furnace,etc. _
la't✓ Gas heat pump
Address:
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range _
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: ?, � Al �4 � MECHANICAL PERMIT FEES*
r�rrr rr�1F,>
Address: p dy j ii V g Subtotal
City/State/ZIP: �-__�� Va.. "701 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( v y)1 e S C* 5 i9 C1 Fax:( ) State surcharge(12%of permit fee)
CCB lic.: a/,,q S----- 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: srt,_e9 1, Date: E`a' fi 9
I:\Building\Pern its\MEC_PermitApp_040113.doc 440-4617TT(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
K7"//,/./"' '!ri'�f�C�/r'�/�'f/i`jsf`%l ///,, , ,,'�u� ,r�r ,+;Y!+�; r.',% ..�/lid
u` e %'f� Permit Free ff '�',,;/;orr !.
$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:A Building\Permits\MEC PermitApp_0401 13.doc 2