Permit (2) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2019-00892
Date Issued: 12/31/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S134BC00200
Jurisdiction: Tigard
Site address: 12180 SW SCHOLLS FERRY RD
Project: One Medical Group Subdivision: None Lot: None
Project Description: New ductwork,grill,and ceilings exhaust fans for TI.
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 12/31/2019 $919.21
Class of Work: ALT Type of Const: Plan Review 12/31/2019 $229.80
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 12/31/2019 $110.31
Stories: Info Process/Archiving-Lg$2.00(over 12/31/2019 $6.00
11x17)
Project Valuation: $32,498.00 Info Process/Archiving-Sm$0.50(up to 12/31/2019 $2.50
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:
Appliances
Vent Fans: 4 Vent Systems: Total $1,267.82
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1000
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: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio e.
This permit card shall be kept in a conspicuous place on the job site until completion the project.
Approved plans are required on the Job site at the time of each inspection.
Mechanical Permit Application i -( %t -, , i, FOR OFFICE USE ONLY
City of Tigard t " Date/B t f l t Pj r,l ,?al9'ry��2)
;14- • 13125 SW Hall Blvd.,Tigard,OR 97223 r'-' w /� / " "+"' `V
I Phone: 503.718.2439 Fax: 503.598.1960 - .0 �' - plan evieq ..." C- I l /C _,_'`�
Inspection Line: 503.639.4175
1iq I Date Ready/By: lads:
H See Page 2 for
Internet: www.tigard-or.gov E Notified/M thory i? Supplemental Information
TYPE 17P VVOttk. f,. ! :�^ . , -,,: *SCHEDU :-f�{; C tIftT .
.. . ... .. . Mechanical permit fees"are based on the value of the work
❑New construction .1 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other mechanical materials,equipment,labor,overhe and. .fit
CATEG+ Y OF�JLTIO\ Value $ 7i
❑ 1-and 2-family dwelling IC Commercial/industrial ❑ Accessory building For special information use checklist
❑Multi-family ❑ Master builder D Other: Description Qty. Ea. Total
.IOt3 Sl11 iNFORAIATIOA .VNI) IXK1ATMS Heating/cooling:
Air conditioning 46.75
Job site address: `2/ 5 - ,j 445 i'6 Z/ jot) Furnace 100,000 BTU(ducts./vents) 46.75
City/State/ZIP: l , 6 g- y'7A-Z 3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bld /a t.no.: Project name: r Heat pump 61.06
g P J �NqZ �/�I/L Duct work 23.32
Cross street/directions to job site: /2/ V- d- S...041aS F.£R.zS' 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
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
r : { z N OF.WORK. Gas fireplace/insert 33.39
- . ..?,; `� »! _Y_! ?. .. .�_ . . ;. .. Flue vent for water heater or gas
/Jrih) 17t)Gri... i. / f'rol7._f u5/.A.._i eE/4/,04" .61-,a.I£i/9- FAN5, fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER 3 0.,T10tA k`T`; -- Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
j APPLICANT. ❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
�i7.1pv� Mf'=P. i#4,p . t_dC_ ��s�,1.'37ft./l �j�'.S� /a)C' $14.15 for first four;$4.03 for each additional
Contact name: ,10640 CI{.1410,1 pjER-1 4/M) Furnace,etc.
Address: /O b () Si.> ed Sri ge)A-t7 Gas heat pump .
Wall/suspended/unit heater
City/State/ZIP: .ry i.-_;/,ora 97OG L Water heater
Phone:(,,jJ) 6,2_/5-6,- Fax: :(52)3) 4:1/- /g 7, Fireplace
Range
E-mail: Az?.cti_l:/..1 fi 1F Cv rr r,2c.,.J't,Z.. , e„,."� Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: ,Q.ec. , plre/4-4Ajlej4e_. &s Tk.4c?'rd5/ /,)e-
Address: /0 33.30 $t..) -roi# 017,-) EJ$) Subtotal
City/State/ZIP: .. 4. '/� 6,C. 9204.2
Minimum permit fee($90.00)
/ q Plan review(25%of permit fee)
Phone:( zs3) 4:42_/c-c Fax:( s'v, L// _/cf 77 State 12/e surcharge
g ( ° of permit fee)
CCB lic.: 563 TOTAL PERMIT FEE
This permit application expires Ira permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: (:),--/..'"."--2----" * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,779H 9d24,,
A-Aj Date: /2.20--nil
11BeildingPermitsU4EC_PemttApp_040113.do° 444-0617T(11/02/COh1/WEB)