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Permit (3) 714 1 CITY OF TIGARD MECHANICAL PERMIT 11, COMMUNITY DEVELOPMENT Permit#: MEC2022-00892 Date Issued: 10/10/2022 TIGARD D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134AA01900 Jurisdiction: Tigard Site address: 10115 SW NIMBUS AVE 600 Project: Donburi Factory Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B Project Description: Type I Hood Contractor: CAESARS CONSTRUCTION Owner: ROBINSON, JERRY CHRISTOPHER TRUST PO BOX 1231 DIETRICH, NANCY BISHOP CLACKAMAS, OR 97015 9701 SE MCLOUGHLIN BLVD MILWAUKIE, OR 97222 PHONE: 503-734-4490 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 10/10/2022 $383.27 Class of Work: ALT Type of Const: VB Plan Review 10/10/2022 $95.82 Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 10/10/2022 $45.99 Stories: Info Process/Archiving-Sm$0.50(up to 10/10/2022 $18.00 11x17) Project Valuation: $11,400.00 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 $543.08 Hoods: Comm Incinerators: Required Items and Reports(Conditions) Woodstoves: Gas Fireplaces: Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: exhaust fan Duct Work: Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. r Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard RECEIVED Date/B: 1 f01 J<Ad— PermitNo.: 11��Q�a0�d_ (s Ia •II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i y �Q•4 Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 �E P 2 8 2022 Date/By: .�oZ TIGARD Inspection Line: 503.639.4175 Date Ready/By: uris: 0 See Page 2 for Internet: www.tigard-or.gov vI CY OF TIGARD ) eth7 Supplemental Information 3UILDING DIVISION TYPE OF WORK RCIAL FEE* SCHEDULE— USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction F)Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ J) i r CATEGORY OF CONSTRUCTION ' ' Y S-'' , RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address: /O//.5- `7 G i pi Wl L S L, t 60 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 7% l9/. 97 z Z 3 Furnace 100,000+BTU(ducts/vents) 54.91 1 / Heat pump 61.06 Suite/bldg./apt.no.: Project name: To 0)Dc W I fa c�)y Y (1/ Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or MS-4§6' Gt-L OY v?ec.v k(L"L/ le hydronic) 23.32 ' Unit heaters(fuel-type,not electric), 447`/S 7Ll ti C ,Q ( //kie live— 1MCt iC 1-7/0o i d a c /I vv_ in-wall,in-duct,suspended,etc. 46.75 ( t7)V ./6 Fr 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 /Ksh,ll�G„�.. gi( Y/GLv 114.4 /y(2 : fireplace 23.32 Log lighter(gas) 23.32 axl5$i/�t5 gai 6 vte ( WIO(kK Q" nvl Cr 0 PT Wood/pellet stove 33.39 Cy--✓ Woe,a Wood fireplace/insert 23.32 • Chimney/liner/flue/vent 23.32 0 PROPERTY OWNER 0 TENANT Other: 23.32 Environmental exhaust and ventilation: Name: , Range hood/other kitchen / �, / equipment 33.39 / Address: j/ f-1 H4 Las Q� ,&1 Clothes dryer exhaust 33.39 City/State/ZIP: 77 pay a 1. e? ZZ-j Single-duct exhaust(bathrooms, 6 toilet compartments,utility rooms) 23.32 Phone:( ) ',// //`'/ // Fax:( ) Attic/crawlspace fans 23.32 ❑ APPLICANT 0 CONTACT PERSON Other: 23.32 / Fuel piping: j"Business name: a Y,S �n � G rR i /tl L �L� $14.15 for first four;$4.03 for each additional Contact name: ( sa V /d pC z— Furnace,etc. Gas heat pump Address: ©k 1Z3/ Wall/suspended/unit heater City/State/ZIP: 4( G-! �1l', /.__ q 7 Q/ Water heater Fireplace Phone:(!'�_ [[�� (/���) �3y���� Fax: :( ) '° Range E-mail: bi/"l (f ;,0.i4„,,c.i/;�Y.5. 6' fr,, /_6 1,4i' Barbecue CONTRACTOR Clothes dryer(gas) Business name: Other: Cr YcolY SYIi �G t2S (f !l C MECHANICAL PERMIT FEES* Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lic.: / g 2 / 7g 70.1 J,Z y TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board Print name: L Sa,/ /0(0C2- Date: ©%_ 2 e_Z Z I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/02/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. 1:\Building\Pemuts\MEC_PermitApp_040113.doc 2 City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT 'PtI T 1 G A R D Building Permit Review — Commercial - No Land U s e Building Permit #: Lac);— ac; Q,4---. Site Address: VMS SW N‘Wibk)S 1 Suite/Bldg#: (PC2° Project Name: 001\00 6 Or1 (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: ` (C4k m?.Fil• 1CGlrncaA Existing Business Activity: 5rfnCe Proposed Business Activity: 'vl c Prw w.1 Ss-1 (911`S�l r'PMt Verify site address/suite# exists and active in permit systttee . •JJ ❑ River Terrace Neighborhood: ❑ Yes !LJ No Er Zoning: MVt -Z ..2 Permitted Use: ,(Yes ❑ No ❑ Spec Space NA-Confirm no land use required. 10.4144e0( 10AAAAD2Ain.ODOZ(p , IOvfi ;SnOf re lli'i e( '61Ms Business License: U scope of we✓k. Exists: ❑ Yes Z—No, applicant was provided a business license application Notes: t4 Sl`15 'rot irOVfel (/(1GA foe /10(p.3 C'PWfr Screerr✓l . Approved by Planning: ,9Date: 1 'Z 2 '2 Z Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: 7/ A Site Plans: # Building Plans: # oZ Building Permit#: CJ Enter building permit#above. Workflow Routing: ❑ Planning ❑ Permit Coordinator Er-Building Workflow Sign-off: 1 `111❑ Sign-off for Planning(include notes from planning review) Route Application Documents: ❑ Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: .'<ot 1\Q" VoAAI Date: 43- I:\Building\Fonns\BldgPermitRvw_COM NoLandUse_09072022.docx Permit Coordinator Review ❑ Conditions "Met"prior to issuance of permit ❑ Approved, NOT Released: Date: ❑ ENG Revisions Required: Date: Notes: ❑ SDC Exemption ❑ Applied for I❑ Received ❑ Does not apply ❑ Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A ❑ Deferred Tigard Trans SIX: ❑ Yes ❑ N/A ❑ Deferred Parks SD 7 ❑ Yes ❑ N/A ❑ Deferred LIDA Fee: ❑ Yes ❑ N/A ❑ OK to Issue/Appr vea by Permit Coordinator: Date: Revisions (after B,ailding Submittal only) Reviewer Date Revision 1:,7 ❑ Approved ❑ Not Approved Revisi 2: ❑ Approved ❑ Not Approved R sion 3: ❑ Approved ❑ Not Approved I:\Building\Forms\BldgPermitRvw_COM NoLandUse_08162022.docx