Permit (2) CITY OF TIGARD MECHANICAL PERMIT
t ,q COMMUNITY DEVELOPMENT Permit#: MEC2019-00868
Date Issued: 12/31/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S101AA07700
Jurisdiction: Tigard
Site address: 12520 SW 68TH AVE B
Project: Allstate Subdivision: WEST PORTLAND HEIGHTS Lot: 9-13
Project Description: Remove and replace existing RTU.
Contractor: RITE WAY HEATING &NC INC Owner: CHORUBY, PAUL N
PO BOX 1815 12520 SW 68TH AVE #A
HILLSBORO, OR 97123 TIGARD, OR 97223
PHONE: 503-693-3161 PHONE:
FAX: 503-647-9999
FEES
Specifics: Description Date Amount
Type of Use: COM Building Misc Fund(copies/prints) 12/31/2019 $8.50
Class of Work: ALT Type of Const: VB Permit Fee 12/31/2019 $385.81
Occupancy Grp: B Occupancy Load: Plan Review 12/31/2019 $96.45
Stories: 12%State Surcharge-Mechanical 12/31/2019 $46.30
Info Process/Archiving-Sm$0.50(up to 12/31/2019 $25.50
Project Valuation: $11,425.00 11x17)
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 $562.56
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 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 o to follow the rule- -dopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010through OAR 95 101-00•'. You m obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Parinittee Signature:
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.
Building Permit Application
Commercial RECEIVED
Cl of Tigard Received /, / o
lig 13125rSW Hall Blvd,Tigard OR 97223 DEC 16 2019 I trB r /! !tp I`7 � PenntNyl�� /7 00P6G
Phone: 503-718-2439 Fax: so3-59s-ICY OF TIGARD pater yv: )a—)g' 19 Related Permit:
T 1 G:1 A 17 Inspection Line: 503-639-4175 Date ReadylBy: ARV. S See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notifie ud:r /7.5///yyy//_�(((p///���� SappletoeatalIntormatiea
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling Commercial/industrial
Valuation: $
AccessorybuildingNumber of bedrooms:
❑ ❑Multi-family
❑Master builder El Other: Number of bathrooms:
JOB/^SITE INFORMATION/ , AND LOCATION Total number of floors:
Job site address: 12,5 2( J s LJ t-k�t chit i s New dwelling area: square feet
City/State/ZIP: -"(/,Ift ra C Q. co 2 Z j Garage/carport area: square feet
luite Idg./apt.#: 3 Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: Indicate the value(rounded to the nearest dollar)of all
. equipment,materials,labor,overhead,and the profit for the
`�n � ff /{p DESCRIP
-T
I
^ON O�Fp WORK'n / /., ^ work indicated on this application. (�
r rnoV� �\t,(Z'I t `i I �I u Cn-' F1` l' t-�LG�/l: lY I + " ' Valuation: $ I I - 1 7
n' t 1 (- ( 1 J Existing building area: square� feet
' K1t�/ trot v New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories: I
Name: 04.AA I CYLD0U,I0. Type of construction:
Address: 15 26 w La 1 1/-e- SLte. 6 Occupancy groups:
City/State/ZIP: - 4\a jr ' 6 4 (j 1 u 3 Existing:
Phone:5(.3) Lp2_ _ 5gg9 Fax:( )
New:
yj APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: r �� � � pease referm fee it):
at' Structural plan review tee(or deposit):
Contact name: " j,rou
Address: �Q. �E d x (&ICJ FLS plan review fee(if applicable):
L( e t C\ 2 o O .
cli t7� Total fees due upon application:
City/State/ZIP: 6 t(,Iil. VV ll>L
Phone:(.3)IA 54 I( I Faxt:-F-1-- Amount received:
E-mail: � 6 1 (�I() I'1 to h Iryn �YN PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR "J Commercial and residential prescriptive installation of
�`) roof-top mounted Photovoltaic Solar Panel System.
Business name: IV i--D ,{ `/ �- {"1(/1/A Submit two(2)sets of roof plan with connection details
II.. �L `1C/', • and tire department access,along with the 2010 Oregon
Address: aO box I Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review
IS�2bV 0 D "!1I 23 $180.00
Phone:E63 )(Q1i3- ,JI(2 l Faxt(� and administrative fees):
I � State surcharge(12%of permit fee): $21.60
CCA Lic.: I�JI 12//� Total fee due upon application: $201.60
Authorized signature:!- This permit application expires If a permit is not obtained
within ISO days after it has been accepted as complete.
Print name: I)►U,L 4.I r L S Date:IZ- I(p—101 * Fee methodology set by Tir-County Building Industry
Service Board.
1:1Building\Peumits\BUP_COM_PermitApp.doe Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: /L1 J-C o2p/g —(9O d 6 d '
Site Address: /a$00 Sw 6$4'4 /lve Suite/Bldg#:
Project Name:
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: of Let RT Meci . v n i'i"
Existing Business Activity:
Proposed Business Activity:
Er Verify site address/suite#exists and active in permit system.
6"River Terrace Neighborhood: ❑ Yes LNo
Zoning: T MU
_yermitted Use: 0 Yes ❑ No ❑ Spec Space
Confirm no land use required.
�iness License:
Exists: ❑ Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: / Date: /
/09
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: /2-A 6 A 7/
Site Plans: # e2
Building Plans: # �- p
Building Permit#: 'Enter building permit# above. I1 I
Workflow Routing: c2Planning ❑ Permit Coordinator E'Tiuilding
Workflow Sign-off: 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: Date: /.2-A7,,b9
I:\BuildinglForms\B1dgPeni itRvw_COM_NoIandUse_1 I I 819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes: 111W
MIv
Revisions (after Building Submitt., only)
Revision Notice 1: Date `-nt to ' pplicant:
Revision Notice 2: Date Sent t%Applicant:
Revision Notice 3: Date Sen o Applicant:
❑ SDC Fees Entered: Wash • Trans Dev Tax: ❑ Yes ❑ N/A
Tigar., Trans SDC: ❑ Yes ❑ N/A
Par.s SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coor i nator: Date:
`.
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_1 1 1 819.docx