Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2022-00290
Date Issued: 5/9/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S136DB02502
Jurisdiction: Tigard
Site address: 11634 SW PACIFIC HWY
Project: Mike's Drive in Subdivision: None Lot: None
Project Description: Gas piping for cooking line.
Contractor: DP PLUMBING INC Owner: JORORET LLC
15825 NE SPRINGBROOK 888 SW 5TH AVE STE 1600
NEWBERG, OR 97132 PORTLAND, OR 97204
PHONE: 503-537-9492 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/08/2022 $161.16
Class of Work: ALT Type of Const: Plan Review 05/08/2022 $40.29
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 05/08/2022 $19.34
Stories: Info Process/Archiving-Sm$0.50(up to 05/08/2022 $0.50
11x17)
Project Valuation: $3,500.00
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 $221.29
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 2 Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
•
go4kApe".
Issued By: Permittee Signature: /, ?5
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard Detc/ny: l�/ji/J,�- �.r� PetmitNo.: olit., •10_.ey39,6
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review w1 / t vim` „'v 1L
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Qate/By: y -a 6- -i. p �—vo, ,? t
T I G A R D Inspection Line: 503.639.4175 R E C { yBy 1w;: St a Page 2 for
Internet: www.tigard-or.gov * ,tilt cthod: 13 22, Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST 1
(A yOF 1.1 .aANu Mecha ical permit fees`are based on the value of the work
❑New construction �,Addition;altcrationhcpl(catte .t perfonned.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other:
NG P VISION mechanical materials,equipment,labor,overhead,and profit.
Value.$ I//,$U
CATEGORY'OF CONSTRIJ'CTION _ RESIDENTIAL EQUIPMENT/SYS'PEMS FEES*
❑ I-and 2-family dwelling [Commercial/industrial ❑Accessory building 1 For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Beating/cooling:
' Air conditioning 46.75
Job site address: 1 1 16 3 q ,5 UJ Pat 142fc 1, et Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ! 1- Furnace 100,000+BTU(duets/vents) 54.91
/a t.no.: Project name: r Heat pump 61.06
Stake/bl
p I I /��� ��r/G�`!1 Ductwprk 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/vest for any of above 23.32
Subdivision: 1 Lot no.: Other: 23.32
Other lust appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WiUUC 1 Gas fir place/insert 33.39
(
/, Flue vent for water heater or gas
Iv)s.-&(( / tp1! 41, conk I)nC[ fireplace I 23.32
Log lighter(lax) i 2 I._32
_---i
Wood/pellet stove 33.39-_
Wood 1 replace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0'PROPERTY OWNER I ❑ TENANT Envh ojuneotat exhaust and ventilation:
Name: Range hood/other kitchen
cquipm nt 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single- uct exhaust(bathrooms,
toilet c mpamnents,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/erywlspace fans 23.32
APPLICANT j❑ CONTACT PERSON Other: l 23.32
❑
—... Fuel pi ping:
Business name:
$14.15 fur first four;$4.03 fur each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: �p Other:
it,rl n(,/IdL C MECHANICAL PERMIT FEES*
Address: f �� JAJ `} Subtotal
� r� x1 ($90(,",7
City/State/ZIP: pi�G(kl 1�k [ -7( Plan review permit tee nmit e)
review(25%al'pelmit fee)
Phone:( Sl3) tSlq- (�Q Fax:( ) State surcharge(12°/ of permit fee)
CCB lie.: 22(1/bt u TOTAL PERMIT FF.F.
vv This pyrntit application expires i1'a permit is mat obtained within 180
days after it has been accepted as complete.
Authorized signature: 1,J0J l!l Xlt tJ'+_' * Fee r}tethodology vet by Tri-County Building Induahy Set-vice Board
1 Print name: 0� p_i Date: .I (I j Zz
I:1DuildininPemits\MEC_PermitAep_WUi 13.doc a>n l/02/COM/WPn)
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