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Permit,. W4EEEEtAkiEi14N3ilMU ittuiWEtitEUii4Ei...iitetiii4StIn4ii441-MiUM Ettiiii4W ttiMUEu.1144. . a.0i1si .f (I til i oa , f.. i r : : l ti ..si l ii.I ,,, ;: r :,:'Pi . CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Pe COMMUNITY M EC2021-00548 Date Issued: 8/5/2021 T 16 A p.f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2 S 102AC00900 Jurisdiction: Tigard Site address: 12571 SW MAIN ST Project: Table 11 Pizza Kitchen Subdivision: None Lot: None Project Description: Gas line to pizza oven. Contractor: J&M CONTRACTOR SERVICES Owner: TABLE 11 LLC 35601 NE 251ST AVE 11336 SW CAPITOL HWY YACOLT, WA 98675 PORTLAND,OR 97219 PHONE: 503-680-0195 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 08/04/2021 $112.04 Class of Work: ALT Type of Const: VB Plan Review 08/04/2021 $28.01 Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 08/04/2021 $13.44 Stories: Info Process/Archiving-Sm$0.50(up to 08/04/2021 $1.50 11x17) Project Valuation: $1,900.00 Fuel Air Handlers Fuel Types: Natural Gas 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 $154.99 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 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules Issued By: Holly Va4w(De7Wege Permittee Signature: OrliAppUcatt,o-vt Call 503.639.4175 by 7:00 a.m.for the next available inspection date.t / 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 Applicationmimunwziguuiiiiiiimi it City of Tigard EGEIVE tRz:By -1`2c`2\ w Permit No m L.Zoz.k_c si5`i?. 13125 SW Hall Blvd Tigard.OR Plan Revie+s Phone' 503.718.2439 Fax. 503598.1960 i J Other Permit . r,- Inspection Fine JUL503 639.4175 �U DatelHv 9 ��2� Date Reads I3s' 1u14 0 Sec Page 2 for Internet wssu Tigard-or.gov Notified\tclhal �� Supplcntental Information CITY OF TIGARL A/Pa ,f TYPE OF itilitiNG DIVISION ° `"-',1-'4 commERimAL FEE* SCHEDULE- USE CHECKLIST ‘7,,p,jrAtotIolvlechanical permit lees+are based on the value of the stork ❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition Olhei: mechanical materials,equipment,labor overhead,and profit - Value $ / 00 CATEGORY OF CONSTRUCTION ❑ I-and 2-liunilydwelling VIColnmcriid:industrial ❑ Acec.soiy building For special information use checklist. ❑ Mulli-tamil) ❑ \'1 i ter builder ❑Other: Description Qty Fa Total FOB SITE INFORMATION AND LOCATION , Ileating/cooling: — - Air conditioning 46 75 Job site addre s {" Furnace 1(10,000 BTU ohms says) 46.75 City/State/ZIP: T' _^ Furnace I00.000+BTU(ducts/tents) 54.91 TT? C3r� �`7 33 Suite/bldg./apt.no.: �J1 Project name:T )) '` f J Heat pump 61 06 a�I� 11 �1 ZZ� Ki 1'c_-1'tt'i1 Duet work :3 32 Cross street/directions to job site: Hydronic hot water system 23 32 Residential holler(radiator or hydronic) 23 32 Unit heaters(fuel-type,not electric). in-stall,in-duct.suspended,etc 46 75 Flue/vent for any of above 23 32 Subdivision: Lot no.' Other 23 32 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 Ga`- ( tyif.rr-O t` -z-a ('Stff?n. fireplace 23.32 Log lighter(gas) 23 32 Wood/pellet stove 33.39 Wood tireplace/insen _3 32 Chimney/liner/flue/vent 23.32 Other: 23 32 ❑ PROPERTY' OWNER 0 TENANT -------- - Environmental exhaust and sentilation: Name No0P r k f : - ree i I�frk Range hood/other kitchen equipment 33 39 Address: (?`a?1 J1A ' ) 5f Clothes dryer exhaust 33 39 City/State/ZIP: 1(t a.(-c.) OR, ci 7 2-33 Single-duct exhaust(bathrooms_ toilet compartments.utility rooms) 23.32 Phone'( ) Fax:( ) Atticierawlspace fans 23 32 0 APPLICANT 0 CONTACT PERSON Other 23 32 Business name: (� Fuel piping: Ta 1 t °t.�1�+ ('t� ,s $14.15 for first four:$4.03 for each additional ('ontact name: "T-k., l s5,.,�i�,�, 5 Furnace,etc. l Gas heat pump Address. r� j St ��-'� �- d 5� Ave-/^ Wall/suspended/unit heater City/State/ZIP: rio 5 Water heater Fireplace - Range F.-mail ,-os- J ill-d">',>4311. 4,� (.� r^I a t(. C1:10 ) Barbecue CON't$ACTOR Clothes drier(gas) -,--_— Business name Other d Sex v t C P S MECHANICAL PE FEES" Address: `"a Subtotal City/State/71l': m111111111111 permit tic($90 0O) Plan res'ess(25°e of permit feel Phone:(. ) ` - - Fax'( I State surcharge(1 2%of permit feel CC I3 lie.: I 59 5 TOTAI,PERMIT FEE i 57.t ell This permit application expires if a permit is not obtained within 180 j� 1 days after it has been accepted as complete. Authorized signature' A��t.•'-(�ti' • t-ec methodology set by Tri-County[Sodding Industry Senicc Hoard Print name. il e�_e/e+c_2, Lam s-f. Date: 7/((„`/ I ,suPub i t3uddrmns+MEC Penni.App_oatil II dx j 440-I61Tr1111,2'CQM'WtiB) .aixaa+i is HHaNHHlu Hidxaatu s tie.NN iw.vui+" Yt;.. - ais.. iHuao is yH.•ifYYAiIHAwlltciYulldffidfit6li&ilfiaYidNifa law.+a x +.f aduduuluaia 1xAusatuteu HiMY.axis . alHaautF+ HN aaifixiM uuttHwai ue3eAtaa Haef!»i-rrti.+triidx. Branden Taggart From: Branden Taggart Sent: Wednesday, August 4, 2021 4:33 PM To: jandmassistant@gmail.com Subject: Table 11 Pizza Kitchen: MEC2021-00548 - 12571 SW Main St. Attachments: Invoice.pdf Hello Rebecca, The Mechanical permit for Table 11 Pizza Kitchen is ready to issue now. The balance due is$154.99, and I have attached an invoice above for you to reference. These fees can be paid online now at https://aca- prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number MEC2021-00548 under the Building tab. There is a 3% service fee for credit cards, but e-checks do not have a service fee. Once paid, please email the Permit Technicians at TigardBuildingPermits@tigard-or.gov so that we may issue this permit and make the site copy set of plans available for pick up. Thank you, Branden Taggart City of Tigard "I 9 y Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent©tigard-or,gov 1