Permit (12) CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT71
Permit#: MEC2019 00761
T[GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/30/2019
7
Parcel: 2S112DD00200
Jurisdiction: Tigard
Site address: 15862 SW 72ND AVE 150
Project: Wood Enviornmental Subdivision: None Lot: None
Project Description: Mechanical for TI: (3)new RTU's, replacing(2)split systems, new duct work for existing split system,(2)exhaust
fans, and gas piping.
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 10/30/2019 $1,612.71
Class of Work: ALT Type of Const: VB Plan Review 10/30/2019 $403.18
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 10/30/2019 $193.53
Stories: 1 Info Process/Archiving-Lg$2.00(over 10/30/2019 $4.00
11x17)
Project Valuation: $60,000.00 Info Process/Archiving-Sm$0.50(up to 10/30/2019 $5.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 cfm: 2
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: 2 Vent Systems: Total $2,218.42
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
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 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1,800.332.2344.
Issued By: �,/s- -,..--- ." Permittee Signature: I'
'
Call 503.639.4175 by 7:00 a.m.for the next available inspection d. e. 4
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 Receivedlig `^�
`J g \r DateBy: i ,v'if,y i-7^1'_ Permit No.: � �AT' f�L to
'� 13125 SW Hall Blvd.,Tigard,OR 97223 �E' V E Plan Review / n 4 �J
v q Other }} G
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: )0-20... / Permit/it� �,�://—C%l,�
TIGARD Inspection Line: 503.639.4175 OCT 3 U 2019 Date Ready/By: auris: 'El $ee Page 2 for
Internet: www.tigard-or.gov Notified/Method: / it,
/�7, "`-'.r Supplemental Information
TYPE OF WORKJILDlNG DIVISI°1\1 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
E New construction .ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ (CO. 404,'
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
E 1-and 2-family dwelling NCommercial/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: /5"- J-`, 71 A4) AL/5 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:
/C, / 121 00)7.- 9 7a2,4 Furnace 100,000+BTU(ducts/vents) 54.91
l Heat pump 61.06
Suite/bldg./apt.no.: /5C Project name:woo° L'rt/1/1 Qc+;J m I_Ftwx i
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
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
Flue vent for water heater or gas
r o <� r fireplace 23.32
�� /(��;w l�TU 5 tv�IJ i✓C7'!ri tJ l�(L�/�l`�'.i<.L Cc�3 t/L j�u�s'3�+'�.$' p
_ _ Log lighter(gas) 23.32
W/A/ Lt/ �d'c'0 IDC./CrDu }j7 K. CI) I S /11jcZ- 51'"l T WI/e454 ) P
Wood/ ellet stove 33.39
6.X,.7L+✓Of.IC./ C ,1 /srz.):5--r f/PA/ , 5 jam!PI J� '19. Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
,PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: j:(.771J C T.. 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:(L5-63)6 41-b-g.`lr`•6 Fax:( ) Attic/crawispace fans 23.32
)APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: .7%.1,-c,, i Fuel piping:
r: ��l�l �_ ��• '� $14.15 for first four;$4.03 for each additional
Contact name: ��1-i Sri,/ /4,--F-• Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( 9.),' ) 9 30 _ 7/ 91/ Fax: :( ) Fireplace
Range
E-mail: L yz l) 4E----, (�r�•L L t',4(L ,AiET" Barbecue
J CONTRACTOR Clothes dryer(gas)
Business name: Other:
^ �-- ' (_, MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: P,,G.. t5 DV // ��t17v(3� c 7�•)) Minimum permit fee($90.00)
Y Plan review(25%of permit fee)
Phone:(5'7/) 9 3 O u 7i 9 v Fax:( ) .tet/%,Q" State surcharge(12%of permit fee)
CCB lie.: al V a 41,r 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. C.* Fee methodology set by Tri-County Building Industry Service Board
¶f,
Print name: 5!,y„ly /�r,,„i -" Date: /04o/X/0.C'1
C\Building 1 Permits\MEC_PermitApp_040113.doc 440-4617T(1 /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\Permits\MEC_PermitApp_040113.doc 2
Julie Drinkwater
From: Jeremy Hunt <jeremy@excelhvac.net>
Sent: Thursday, October 24, 2019 11:30 AM
To: #Building Permit Technicians
Subject: OTC app.
Caution! This message was sent from outside your organization.
Hello,
I would like an OTC for a mechanical permit doing a tenant improvement. Installing rooftop units and heat pump split
systems with ductwork and structural engineering.
Time: Wednesday 10/30/19
Address: 15862 SW 72nd Ave. #150
Tenant: Wood Environmental
Jeremy Hunt
971-930-7194
r el
HVAC, INC
CCB#214345,
WA# EXCELHI835MU
P.O. Box 1188
Canby, OR 97013
1
City of Tigard
Iii.
� COMMUNITY DEVELOPMENT DEPARTMENT
C
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #: jY1, Gdet 9-00 ,C i
Site Address: lSOL _ cid' 7Zj ), Suite/Bldg#: (SO
Project Name: A•is i Err\vi,rEA -,-),i
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review ii l
— Proposal: houvtil,4 °lc, : G�1 f ^+b a� Li- 1,,,,,,fspldi- Srs Mi ,v0 AA-LA(14 sl.ficjvrai eAiAtir
Existing Business Activity: IJ r�-c.,
Proposed Business Activity: 0 qtt
41/yerify site address/suite# exists and active in permit syst m.
IV/River Terrace Neighborhood: CI Yes No
2 Zoning: J--f)
y ermitted Use: Yes ❑ No ❑ Spec Space
[ Confirm no land use required.
lid Business License:
Exists: ❑ Yes �No,applicant notified to obtain business license
Notes: LIS' ai- SP- Sku-S i GI 1 tt rug "livil"1 i I itti4c,
Approved by Planning: Cii///' Date: [G-36-i q
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: /0/)/4011 y
Site Plans: # I
Building Plans: # ,
Building Permit#: r building permit# above.
Workflow Routing: QP}arrning ❑ Permit Coordinator —BL'fding
Workflow Sign-off: Com]--sign-off for Planning(include notes from planning review)
Route Application Documents: Lding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: 1071,•
By Permit Technician: ___,.. '"'e_' 5) Date: /C)A/rr�
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_060116.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 Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes 0 N/A
Tigard Trans SDC: 0 Yes 0 N/A
Parks SDC: 0 Yes 0 N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvwCOM NoLandUse 070915.docx
Front1 DSTS
Subject: Jeremy with Excel HVAC:Wood Environmental; 15862 SW 72nd Ave. #150;
971-930-7194
Location: CR 3 Permit Center
Start: Wed 10/30/2019 10:00 AM
End: Wed 10/30/2019 11:00 AM
Recurrence: Weekly
Recurrence Pattern: every Tuesday,Wednesday, and Thursday from 10:00 AM to 11:00 AM
Meeting Status: Meeting organizer
Organizer: -Building_OTC
Mechanical OTC: Rooftop units and heat pump split systems with ductwork and structural engineering.
1
City of Tigard • BUILDING DIVISION
,111111 .
Over-The-Counter (OTC) Mechanical Permit
T l C AR n Appointment Checklist
Permit Record#: /-17k6-6,20 00-2(.4 f
Contact Name: i'j 1Y/4"3''-- Phone #: ,77/- �j c)- 7/9
Business Name: � Appointment Date: 'AO 0/t
Site Address: /577) Sc.J 71"4 , 0&15-0 Bldg/Suite #: /5-z)
Project Name: /A fes ,/ —74/a y
Project Description: Z7z.., f j 5,/1
Related Record #: ;ad r -
APPLICATION SPECIFICNFORMATION'
GENERAL INFORMATION
*Class of Work: Occupancy Group: 4 Type of Construction:
*Type of Use: Oregon Specialty Code: p) Cr
Number of Stories:
FUEL FURNACES
Type: 36••s Furnace< 100K BTU Furnaces>= 100K BTU
Gas Pressure: Roof Top Unit(RTU) 3 Tons S"
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm 2 Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler(BTUs) Vent Fans Gas Line )O v
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work Gas Fireplace
Fire/Smoke Dampers Other Mechanical Units—Describe:
Total Project Valuation: $ 6 O j 000 FEES DUE
$ Gia . 7) Mechanical Permit Fee
$ �g Plan Review
$ f 4�3 • S'3 12% State Surcharge
$ t-] Info Proc/Arch,Lg(over 11x17 $2.00)
$ Info Proc/Arch,Sm(up to 11x17 $0.50)
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other:
Building Staff:
Date/Time: $aa) g ,c.91,TOTAL FEES DUE
I:\Building\Forms\OTC_MEC_021116.docx