Permit CITY OF TIGARD MECHANICAL PERMIT
■ COMMUNITY DEVELOPMENT Permit#: MEC2022-00258
T t f A I<',I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/4/2022
Parcel: 1 S134AA01900
Jurisdiction: Tigard
Site address: 10115 SW NIMBUS AVE 150
Project: Mugen Noodle Bar Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Remove and replace RTU
Contractor: JNB MECHANICAL INC Owner: ROBINSON,JERRY CHRISTOPHER TRUST
3315 NE 112TH AVE A40-41 DIETRICH, NANCY BISHOP
VANCOUVER,WA 98684 9701 SE MCLOUGHLIN BLVD
MILWAUKIE,OR 97222
PHONE: 360-433-9439 PHONE:
FAX: 360-433-9439
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/22/2022 $383.27
Class of Work: ALT Type of Const: VB Plan Review 04/22/2022 $95.82
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 04/22/2022 $45.99
Stories: 1 Info Process/Archiving-Sm$0.50(up to 04/22/2022 $26.00
11x17)
Project Valuation: $11,357.00
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 $551.08
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you t• folio' the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y. .\\,obtain . copy of the rut
l ,Issued By: ,4r Permittee Signature: vide& , .E
i.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of th project.
Approved plans are required on the job site at the time of each inspection.
S-3/2S122.
Mechanical Permit Applicatio ioiz("icy,Ilse.ONLY
City of Tigard 'R EC E��/�E Da« y 03 / lvl2 �•� � o�-ram 25-8
111 Permit No.:
't 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Revie
�. Phone: 503.718.2439 Fax: 503.598.1960 MAR 2022 t-) - 6- Other Permit:
Date.R7
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: tfi luris: ®Sec Page 2 far
Internet: www.tigard-or.gov CITY/ OF 1 I Ultra) Notified Method: / /u/) �/'_ Supplemental Information
BUILDING DIVISIO kaa �„ (�
TYPE OF WORK COMMERCI :' FEE* SCHEDULE-USE CHECKLIST
— — Mechanical permit fees*are based on the value of the work
0 New construction 1st Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$,th�ijS'
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
1 Air conditioning 46.75
b
Job site address: IQ 'S SW 0\m loos hQed. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:-VN(a(1 d OR 01`62-9, / Furnace 100,000+BTU(ducts vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:S `G�I Project name:M ell �� `� p ct 2 Duct work 23.32
Cross street/directions to job site: ,epl otc e,meh* 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: Lot no.: Other:ibC tQ e o i 4- \ 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
v)e)ylbve, eit .3 V ) alai replace, u,,.\1- \new . 2,1v. fire lace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0PROPERTY OWNER I 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: 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:( ) Fax:( ) Attic/crawispace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:�N'Q, k an'\�1 "��G Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: (,,ov,(ne, G.--i Furnace,etc.
Gas heat pump
Address:J3\5 UG ,i?"'i^ twe, ._,At., S-1n LAO..,41___-_______ WalUsuspended/unitheater
City/State/ZIP:\}UYl�,pltver- wpi ct v{o.� Water heater
2( ) 133_GIp ti ( ) Fireplace
Phone: ✓ <✓ 19' C. Fax:
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: �V..) Med\U\n,en\. � i Other:
MECHANICALPERMTf FEES*
Address:' \CJ �G (t0-- me,. alb-U1t Subtotal
City/State/ZIP:v�tfic o - 1 .3� Gy ga. Minimum permit fee($90.00)
W Plan review(25%of permit fee)
Phone:(4060 L43-5.-Ci06;I ,- Fax:( ) State surcharge(12%of permit fee)
CCB lic.: % L TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
6/1/1/
days after it has been accepted as complete.
Authorized signature:(1_,04/ • Fee methodology set by Tri-County Building industry Service Board
Print name:ecky kne ( fa A Date:SI 2-a.-1�Q c}.?—
1:10uitding\Purmits\MEC_PcrmitApp 0401t7'doc 440-4617r(I1/02/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:\suilding\Permits\MEC PermitApp_040113.doc 2
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
111
Tl Building Permit Review — Commercial - N o Land Use
Building Permit #: ME(',202.2.-Q0258
Site Address: 0((C S.) k) Itia(A AVr Suite/Bldg#:
Project Name: M ij i r1/41Coi
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: P,T"V (2-. e cAC icft
Existing Business Activity: K fi4
Proposed Business Activity: N
12 Verify site address/suite# exists and active in permit system.
E River Terrace Neighborhood: ❑ Yes II No
.toning. tAi/V.
y1 P mitted Use: , -Yes ❑ No ❑ Spec Space
Confirm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: _.. Date: 3/3r.)/2
Revisions (after Building Submi al only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 00 949 2.
Site Plans: # -
Building Plans: # ?—
Building Permit#: tenter building permit#above.
Workflow Routing: Er-Planning ❑ Permit Coordinator wilding
Workflow Sign-off: Cl-Sign-off for Planning(include notes from planning review)
Route Application Documents: R..-Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: DO V2O2
I:\Building\Forms\BldgPermitRvw_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 Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx