Permit _r , CITY OF TIGARD MECHANICAL PERMIT
IIIIIr COMMUNITY DEVELOPMENT Permit#: MEC2020-00212
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2020
Parcel: 1 S136DC03300
Jurisdiction: Tigard
Site address: 11714 SW 72ND AVE
Project: Dirt By Design Subdivision: 72ND AVE APARTMENTS Lot:
Project Description: Interior mechanical work for new tenant.
Contractor: JACOBS HEATING&AIR CONDITIONING Owner: 72ND AVENUE PROPERTY LLC
4474 SE MILWAUKIE BY RICHARD CASSINELLI
PORTLAND, OR 97202 4804 NW BETHANY BLVD#I-2
PORTLAND, OR 97229
PHONE: 503-234-7331 PHONE:
FAX: 503-296-5351
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/28/2020 $266.22
Class of Work: ALT Type of Const: VB Plan Review 04/28/2020 $66.56
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 04/28/2020 $31.95
Stories: Info Process/Archiving-Lg$2.00(over 04/28/2020 $4.00
11x17)
Project Valuation: $7,090.00 Info Process/Archiving-Sm$0.50(up to 04/28/2020 $12.50
11x17)
Fuel Air Handlers
Fuel Types: Electricity 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: 1
Appliances
Vent Fans: 2 Vent Systems: Total $381.23
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 20
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 03.232.1987 or 1.800.332.2344.
Issued By: ' � A / Ay,,,,44:7 Permittee Signature: r OP//-ce�\/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. /„/`
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
30ECEIVE "
Mechanical Permit Applica i n FOR ori.Icl: I sl:ONLY
APR 09 l0 Received
City of Tigard Date/By: i/ /7/7-4 A) Pemut V7rE V-. 2e) e
• 13125 SW Hall Blvd.,Tigard,OR 9722
Phone: 503.718.2439 Fax: 503.598.14h TY OF TIGARD Plan Reei 1 Other Permit:
► Date/By:4'Ol�+
i i r,,`it f) Inspection Line: 503.639.4175 81J I LQING DIVISION Date Rea /B 1 ru s
dy y: f ® See Page 2 for
Internet: www.ligard-oLgOV No' d/Met .L/ //rl /i Supplemental lnformanon
TYPE OF WORK " ' E": SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
Nit New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 7090.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling 'Commercialindustrial 0 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: 11714 SW 72nd Ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/Z1P: Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Duct work 23.32
Cross street/directions to job site: .b/2.T- -iy , �3 f j1 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: Tigard -Tualatin I Lot no.: Other. 23.32
Other fuel appliances:
Tax map/parcel no.: 1 S 136DC03 300 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
(1)2.0 ton ductless split heat pump with(1)indoor cassette unit.Oudoor heat fireplace 23.32 _
pump garage O supply ( p ) Log lighter(gas) 23.32
um located in ara a on wall bracket. 1 outside air su l fan untem ed to Wood/pellet stove 33.39
single supply diffuser.(1)ceiling exhaust fans ducted to existing exterior wall louve- Wood fireplace/insert 23.32
Comm- Building Permit#BUP2020-00035 Chimney/liner/flue/vent 23.32
Other: 23.32
OWNER I El TENANT Environmental exhaust and ventilation:
Name: 72nd ave property LLC Range hood/other kitchen
equipment 33.39 Address: —
Clothes dryer exhaust 33.39
City/State/Z1P: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32 _
Phone: ( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Jacobs Heating&Air Conditioning $14.15 for first four;$4.03 for each additional ---
Contact name: Andrea Bowlds Furnace,etc.
Address: 4474 SE Milwaukie Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Portland,OR 97202 Water heater
Phone:(503)234-7331 Fax::( ) Fireplace
Range
E-mail: andreab@jacobsheating.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Jacobs Heating&Air Conditioning other:
MECHANICAL PERMIT FEES*
Address: 4474 SE Milwaukie Ave Subtotal
City/State/ZIP: Portland, OR 97202 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503 )234-7331 pax:( )
State surcharge(12/u of permit fee)
CCB lic.: 1441 TOTAL PERMIT FEE
C This permit application expires if a permit is not obtained Within 180
4,41.A10....N days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: ANDREA BOWLDS Date: 4/9/2020
rlBuilding\Permits1MEC_PemitApp_040113.doe 440-4617r(ii i02/coM/WEn)
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 Permits\MEC_PermitApp_040I I 3.doc 2
City of Tigard
14 III
v COMMUNITY DEVELOPMENT DEPARTMENT
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #: /"lFC ao LO OC?07/2--
Site Address: ill 1 Li SW 12140( Pc\rc Suite/Bldg#:
Project Name: ,b,2T- 6),, - f6Ai
(Name of commercial usiness occupying the space. If vacant,enter Spec Space.)
Planning Review
•
Proposal: 1\11•CCA w1 IC&! perri L+'- all l *flo'
Existing Business Activity: I v I Pr
Proposed Business Activity: YJ l A-
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: 0 Yes NN No
Zoning: Tu,Li
rtfy Permitted Use: ❑ Yes ❑ No 0 Spec Space
Confirm no land use required.
IVA'Business License:
Exists: 0 Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: An-NA (Q4_ Date: 41f) 120
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: y///?0
Site Plans: # L
Building Plans: # A--
Building Permit#: ` 1 Enter building permit#above.
Workflow Routing: 'Manning 0 Permit Coordinator Er�uilding
Workflow Sign-off: ri-g-ign-off for Planning(include notes from planning review)
Route Application Documents: iulding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: ��
By Permit Technician: G-� V p -'"(e ��-4---- Date: �//7/2-0
I:1 Building\FormslBldgPennitRvw_COM_NoLandUse_111819.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 Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applica. :
❑ SDC Fees Entered: Wash Co Trans to ev Tax: ❑ Yes ❑ N/A
Tigard Trans : C: ❑ Yes ❑ N/A
Parks SD ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordi' tor: Date:
I:\Building\Fonns\BldgPermitRvw_COiv1_No LandUse_111819.docx