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Permit
CITY OF TIGARD MECHANICAL PERMIT •. COMMUNITY DEVELOPMENT Permit#: MEC2019-00533 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/23/2019 TIC,±1 R D 9 Parcel: 1 S135DD01800 Jurisdiction: Tigard Site address: 11565 SW HALL BLVD 160 Project: Dr.John Chung Subdivision: None Lot: None Project Description: RTU replacement. Contractor: EVERGREEN GAS Owner: TV5 LLC 16385 SW LANGER DR 10855 SW CASCADE BLVD SHERWOOD, OR 97140 TIGARD, OR 97223 PHONE: 503-407-9542 PHONE: FAX: 503-344-6345 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 07/29/2019 $434.07 Class of Work: ALT Type of Const: VB Plan Review 07/29/2019 $108.52 Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 07/29/2019 $52.09 Stories: Info Process/Archiving-Sm$0.50(up to 07/29/2019 $17.00 11x17) Project Valuation: $13,375.00 Fuel Air Handlers Fuel Types: Natural Gas 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 $611.68 Hoods: Comm Incinerators: Required Items and Reports(Conditions) Woodstoves: Gas Fireplaces: Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: 1 Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those ru-s are set .rth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to 0 y (ling .0 . 32.17 or .800.332.2344. Issued By: / ,r," i _=—.__ Permittee Signature: V1•/4 . Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY a. Received Cityof Tigard r Permit No.: 111‘ g � ^ ' Date/By: !Q "- 1 i-GAJ t 3 13125 SW Hall Blvd.,Tigard,OR 972 "'"" . 1 � Plan Review �- Phone: 503.718.2439 Fax: 503.598.19 0 q 2-01 Date/By: `7—13_I 9 Other Permit: 4/ oil_ev/ T 16 A R I) Inspection Line: 503.639.4175 1 UL 2 "' Date Ready/By: J •Fa See Page 2 for Internet: www.tigard-or.gov J hc'�f Notified/Method. ( �.. ,. ,....=0.• Supplemental Information e " f Oib' 'CIAL FEE* SCHEDULE USE CHECKLIST TYPE OF W `t Mechanical permit fees*are based on the value of the work ❑New construction -*ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,land profit. Value:$ le;f 51 % ©0 — CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwellingommercial/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 t 46.75 Job site address:1k gto-G- Sys► ikak. 13` is Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIPli/,�o ' 0 2.2 3 n Furnace 100,000+BTU(ducts/vents) 54.91 Y/Jt/"• ( 't'. Heat pump 61.06 Suite/bldg./apt.no.: Project name: q Duct work 23.32 Cross street/directions to job site: J Hydronic hot water system 23.32 Residential boiler(radiator or AI• f '—I • .__-71,. a — .w• 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 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flk o-r .�-(` ( / fireeplace vent for water heater or gas v-e-oka___ 1. �,[J^�C�/} . �=/.� / ` ' v`n i� fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 0 PROPERTY OWNER TENANT Environmental exhaust and ventilation: Name: b atiaa ../,, ,-„e,� p S Range hood/other kitchen \” equipment 33.39 Address: pd Z Clothes dryer exhaust 33.39 City/State/ZIP:(Va ri ti► Ill V ' Single-duct exhaust(bathrooms, vV' / toilet compartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 It APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name: l Y p '�aS $14.15 for first four;$4.03 for each additional Contact name: `` r'� Furnace,etc. Address: \‘,0SV\1 1 l 1/- 1 Y e Gas heat pump /r Wall/suspended/unit heater City/State/ZIP: %(Veylitil C LtJ Water heater fPhone: -401ti.�-�' /2__ Fax::( ) Fireplace Range E-mail:OM LLQ..., O inrejz�c\� ,n e21—' Barbecue COM�RACTOR Clothes dryer(gas) Business name: ` Other: MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: 4 U3\ 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:�\` Date:i2,211 (I I:\Building\Permits\MEC_PermitApp_040113.doc 440-46171(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\Pennits\MEC_PermitApp_040113.doc 2 City of Tigard M_ ilII COMMUNITY DEVELOPMENT DEPARTMENT , Building Permit Review — Commercial - No Land Use Building Permit #: / t I CAD/q `'UD S-33 Site Address: IA'5(oS SW -Hall aVG( . Suite/Bldg#: Project Name: Grant Aye/ Vrope1(-h-Ps (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: ` ((1i �v-Afi Existing Business Activity: N I A- Proposed Business Activity: N I P .®; Verify site address/suite#exists and active in permit system. N River Terrace Neighborhood: ❑ Yes 'R' No F1 Zoning: (12) Wermitted Use: ❑ Yes ❑ No ❑ Spec Space X Confirm no land use required. usiness License: Exists: ❑ Yes ❑ No,applicant notified to obtain business license Notes: U Y - lS hcrr Vtstke +, Sfi e&. ' ctue io mit ix . Approved by Planning: V,v) ( , Date: 1 '22119 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: y2-1-45 Site Plans: # Building Plans: # Building Permit#: N"-Enter building permit#above. Workflow Routing: anning ❑ P oor ator ,uilding Workflow Sign-off: 0 Sign-off for Planning(include notes from planning review) Route Application.Documents: ❑ Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: fher4-Se1,4 Date: _77_,a1 7..._ I:\Building\Fonns\BldgPermitRvw_COM_NoLandUse_0601 16.docx Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sen o Applicant: Revision Notice 2: Date nt to Applicant: Revision Notice 3: D. Sent to Applicant: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A ❑ OK to Issue P- it Approved by 'ermit Coordinator: Date: I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 070915.docx