Permit (9) CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2019-00780
TLGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/05/2019
Parcel: 1 S 134 B C00200
Jurisdiction: Tigard
Site address: 12180 SW SCHOLLS FERRY RD
Project: One Medical Group Subdivision: None Lot: None
Project Description: Mechanical for TI: New exhaust fans,duct work,and grilles.
Contractor: ARROW MECHANICAL Owner: ATLAS GREENWAY LLC
10330 SW TUALATIN RD 333 NW NINTH AVE, STE 1009
TUALATIN, OR 97062 PORTLAND, OR 97209
PHONE: 503-692-1565 PHONE:
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/05/2019 $1,737.21
Class of Work: ALT Type of Const: VB Plan Review 12/05/2019 $434.30
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 12/05/2019 $208.47
Stories: Info Process/Archiving-Lg$2.00(over 12/05/2019 $10.00
11x17)
Project Valuation: $65,000.00
Fuel Air Handlers
Fuel Types: Electricity Units< 10000 cfm: 3
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: 4 Vent Systems: Total $2,389.98
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 100
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,. l�ii Permittee Signature: O/(/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,
0
Mechanical Permit Application FOR OFFICE USE ONLY
c r,- Received
Cityof Tigard /r (D.(‘1 57.. Permit No.:, , C 7o
g Date/By: I J/J fl �
" 13125 SW Hall Blvd.,Tigard,Ont; Plan Revie
1 I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 'J )- 7 . 1 Other Permit:Agit./J,;1rr,0-�^q Gill
T i G.�R[) Inspection Line: 503.639.4175 OCT 3 1 2019
Date Ready/By: / / Juris: See Page 2 for Cl _I
Internet: www.tigard-or.gov ��,, �yy��ggrr��p Notified/Method:Il (� ! j Supplementa6lnformatlon
..., J 4%.?'ifi�1 7. ,
TYPE OF \`'0 i }I , 1 ., .,," w I t r g.� I} ,r-s�',
Mechanical permit fees*are based on the value of the work
❑New construction 12 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
/
Value:$ .",.- 11:,;
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling [ Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION
Air conditioning 3 46.75
Job site address: t aL, q ,kao c) �c_\,.., `v, t S \r Y`0 VV) Furnace 100,000 BTU(ducts/vents) 2 46.75
City/State/ZIP: 'I\cyU`Y ) 0' . CA fiJ Furnace 100,000+BTU(ducts/vents) 1 54.91
� -1 Heat pump 61.06
l�J
Suite/bldg./apt.no.: Project name: l.c V\.c., co.\ Duct work 3 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
AIM
Residential boiler(radiator or
11/4/f 41• /QQL t1 c4Gd U"LLQ r.Airl) Ci./ hydronic) 23.32
Unit heaters(fuel-type,not electric),
,i"�-t ,,-L-,1 y in-wall,in-duct,suspended,etc. 46.75
Cfj1fLGG7el�? /4I 4 Uv w eaI�Y Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot no..
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32
DESCRIPTION OF ViORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
ok
1 e-'11- .Nt,\i c,c �-.� �',1�' fireplace 23.32
t't-� 1 1 �- 23.32
Log lighter(gas)
T-P\f" VA. \Y\- '2 \-e����' 1!i ' ' ' Wood/pellet stove 33.39
Y dl Vl _'S r v-,, i \ 6� ►�t^� Wood fireplace/insert 23.32
J Chimney/liner/flue/vent 23.32
Other: 23.32
17.(1312OPERTY OWNER I [TENANT
Environmental exhaust and ventilation:
Name: ()v.-)(....: , C i rC-1 ,, c ;.j Range hood/other kitchen
G' equipment 33.39
Address: \ eYylL�_V v-d �'j -1� Clothes dryer exhaust 33.39
City/State/ZIP: `�L 5�'\ / v _ >�^ 4 j Single-ducpt exhaust(bathrooms, )
Y \�1 U c._t toilet corn arxhaust,btili rooms 5 23.32
Phone:( 4 i(4. a�� , �tar-72 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT' ❑ CONTACT PERSON
Other: . 23.32
n
Fuel i
PP g:
Business name: "t GT___ :: f $14.15 for first four;$4.03 for each additional
Contact name: C V--\O\_Y e'U "-e--.C, Furnace,etc.
a (� r1 Gas heat pump
Address: 93� ��\ I S LZ I Y-2. ��Y C 3 V
( Wall/suspended/unit heater
City/State/ZIP: 'C?xv e..../-v v-t-t \ , S ) G/r A qb2\ I Water heater
(�I )
Phone: (.. (:).2, 30Fax::( ) Fireplace
` et Range
E-mail: '1 t7-�lC1C � �
\V-c.A U � � �LLT sv .( +n'\ Barbecue
Clothes dryer(gas)
Other:
Business name: j �r0(N � -,.-I ,` r c, MECI[ANICAL PERMIT FEES*
Address: 10 33c. Sim 14 i 144 Subtotal
�Q L Minimum permit fee($90.00)
City/State/ZIP: -7-
! Usti iQ- )1 ® Plan review(25%of permit fee)
Phone:()--63) 6 qL -. 15 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: 5193 1//f 20 Z0 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
daysafter it has been accepted as complete.
Authorized signature: � -�` Fee methodology
y set by Tri-County Building Industry Service Board
Print name: tCtra 24
2z, Date: `1 " 0 I - tot
I:i13uildingiPermits\MEC_PermitApp_0401 I3.doc 440-4617T(I I/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 PeimitApp_040113.doc 2
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•
Permit Advisors TRANSMITTAL
OCT 31 2019
CFI OF " °.
November 1, 2019 : �� " ` ) '
FROM: TO:
Richard Rizo City of Tigard BUILDING DIVISION
Permit Advisors ATTN: BUILDING DIVISION
8370 Wilshire Blvd Suite 330 13125 SW Hall Blvd.
Beverly Hills, CA 90212 Tigard, OR 97223
(310) 275-7774 (503)639-4175
RE: One Medical - Tenant Improvement
Project Address: 12180 SW Scholls Ferry Rd.
Please find the following in the attached package:
• (3) Mechanical plans
• (3) Electrical plans
• (3) Plumbing plans
• (1) Completed Mechanical Application
• (1) Completed Electrical Application
• (1) Completed Plumbing Application
pieie. 6e--E.5 i.,'(" Covey SI..��
Should you have any questions or concerns, please feel free to contact me at (818)
602-3620 or email me at richard@permitadvisors.com.
Regards,
Richard Rizo
Permit Advisors 18370 Wilshire Blvd Suite 330 I Beverly Hills, CA 90212 1310.275.7774