Permit (2) N �� CITY OF TIGARD MECHANICAL PERMIT
` ' COMMUNITY DEVELOPMENT Permit#: MEC2019-00867
T f GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/31/2019
Parcel: 2S101AA07700
Jurisdiction: Tigard
Site address: 12520 SW 68TH AVE A
Project: Allstate Subdivision: WEST PORTLAND HEIGHTS Lot: 9-13
Project Description: Remove and replace existing RTU.
Contractor: RITE WAY HEATING &A/C 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 Permit Fee 12/19/2019 $385.81
Class of Work: ALT Type of Const: VP Plan Review 12/19/2019 $96.45
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 12/19/2019 $46.30
Stories: Info Process/Archiving-Sm$0.50(up to 12/19/2019 $7.50
11x17)
Project Valuation: $11,425.00
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 $536.06
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 you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010through OAR 952-001- You m o tain a copy of the rules
or direct questions to OUNC by calling 503.232.198 or .:Ir..- .2344.
Issued By: e�irir 1ttae 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 FOR OFF It: I< I sF.ONI.\
City of Tigard H EL,EIVED Received / /i /, 9
,ntNye/ECa0n_00,47
13125 SW Hall Blvd.,Tigard,OR 97223(�C Plan R view
i ° Phone: 503-718-2439 Fax: 503-598-19K1I-C 16 2019 Date/By: Jam' -2 ` Iq
Related Permit:
TIGARD Inspection Line: 503-639-4175 Date Ready/By: i twig. ® See Page 2 for
lntemet: www.tigard-or.gov CITY OF TIGARD twaiNk :f". ( 1 Supplemental Information
BUILDING DIVISION
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
[YAddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling IKCommercial/industrial
Number of bedrooms:
❑Accessory building ❑Multi-family
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: (2 57 L0 s jlive, New dwelling area: square feet
City/State/ZIP: fl fi j 1`( g 1 Zz,3 Garage/carport area: square feet
0 ldg./apt.#: Project name: 5 .e 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
/ p�I� `/ DESCRIPTION OF WORKO t�� C work indicated on this application.
Vi'► '6Y� ( (6tl v ltil t'-'1 ) LL.I Gl ( n >S Valuation: $ l 1 Li Z
new �- J Existing building area: 11 square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: \i W fa �/j�^�1 '^�' (/,l, ) Type of construction:
Address: 1 Z5A (1J�i , � Occupancy groups: •
City/State/ZiP:-" f1 d,L Ci--1 Z1-3 Existing:
Phone:(SO) (Q LU _Selotq Fax:( ) New:
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: j t) (��� � ( (Qat-1�//) vie refer deposit):
`�-� `^ lt��(�(+''Y_1 ' J Structural plan review fee(or deposit):
Contact name: t OV
F LS plan review fee(if applicable):
Address: 7o Q 1g'1�
Total tees due upon application:
City/State/ZIP: � s�ro (`?� �� I Z3
Phone:(5D ) lD j 3- 51 Y/ ( Fazes{--�� Amount received:
E-mail: ✓✓ i(lf (r,l rt�',e yON WTR gyp`A'/ VI(Atilfiq , W PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
C ' Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: e,[.t ( 001(I Submit two(2)sets of roof plan with connection details
1 vvv�� J and tire department access,along with the 2010 Oregon
Address: -. ")O� ,� I Solar Installation Specially Code checklist.
City/State/ZiP: ll ( �{ 7 Permit fee(includes plan review
{v v' °� v and administrative fees): $L80.00
Phone:6r3 )��31(p Fax State surcharge(12%of permit fee): $21.60
CCB Lie.:`1 I l/4_ LKIL
Total fee due upon application: $201.60
Authorized signal This permit application expires if a permit is not obtained
�t ` within 180 days after It has been accepted as complete.
Print name o n P ;t_,'\ti. Date:I Z-4& —g * Fee methodology set by Tii-County Building Industry
Cvl Service Board.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
1
T I G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: /''/EZ 'j/ 9 -0a P6 7
Site Address: IaS�6 fto 6 ,4ife Suite/Bldg#:
Project Name:
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: eid)pce 2T MBcIA, vn;4
Existing Business Activity:
Proposed Business Activity:
Verify site address/suite#exists and active in permit sys�te n
River Terrace Neighborhood: ❑ Yes lir No No
gr Zoning: f
-Q—Permitted Use:' �� ❑ Yes 0 No 0 Spec Space
tErConfirm no land use required.
_2 Business License:
Exists: 0 Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: .6�c,,_. Date: l 14(P 6
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: /Z//G,/2
Site Plans: # Z
Building Plans: # �.
Building Permit#: tenter building permit#ab
Workflow Routing: Planning 0 Permit Cfr . ator +ID-Building
Workflow Sign-off: Q�ign-off for Planning(include notes from planning review)
Route Application Documents: ID--Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: .e.<6r Date: ,'�/ 7 y
I:\Building\Forms\BldgPemutRvw_COM_NoLandUse 111819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of buil ' g permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only
Revision Notice 1: Date Sent to .. 'cant:
Revision Notice 2: Date Sent to ' pplicant:
Revision Notice 3: Date Se o Applicant:
❑ SDC Fees Entered: Wa Co Trans Dev Tax: 0 Yes ❑ N/A
:, d Trans SDC: 0 Yes ❑ N/A
Parks SDC: 0 Yes ❑ N/A
• OK to Issue Permit
Approved by Pe it Coordinator: Date:
_
I:\Building\Forms\BldgPennitRvw_COM_NoLandUse_1118I9.docx