Permit !� ' a CITY OF TIGARD MECHANICAL PERMIT
: �' _ ' COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00200
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/21/2008
PARCEL: 2S102CC -00500
SITE ADDRESS: 13600 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: TIGARD MARKETPLACE LOT: JURISDICTION: TIG
PROJECT: H MART
Project Description: Install return air ducts to frozen food case with misc. stainless steel flashing. NO PLAN REVIEW REQ
Project Value: $17,800
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
13500 PACIFIC CORP Description Date Amount
BY CAP ADVISORS
38345 W TEN MILE RD, STE 170 CITY OF TIGARD MET 4/21/200E $336.80
FARMINGTON HILLS, MI 48335 [HRTAX] Hourly 12% S 4/21/200E $40.42
Total $377.22
Phone:
Contractor:
ARTIC SHEET METAL
2310 NE COLUMBIA BLVD
PORTLAND, OR 97211 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 288 -5844
FAX 503- 288 -5849
Reg #: LIC 17095
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued y: Permittee S'• atu =. ,- �� y��
Call 503.639.4175 by 7:00 a.m. for inspections that bu: ness day.
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 Application FOR OFFICE USE ONLY
A N Received /� O r/ Mechan 1&J p. ,,
DateiB : A D Permit No.: , I O ' 010
City of Tl and Planning Ap. oval Building
y g Date /B Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /B : Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
Internet: www.ci.tigard.or.us jiii,
Contact : Case No.:
__� Contact ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Su lemental Information.
# 8 -0330
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
[i] Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
Value: $ 17,800.00
800.00
❑ 1 & 2- Family dwelling a Commercial /Industrial S ee Page 2 for Fee Schedule
111 Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description Qty 1 Fee(ea.) Total
❑ Master Builder ❑ Other: Heating/Cooting
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: 13500 SW Pacific Hwy Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 1 14.00
Project Name: H — MART Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: _ Lot #: Repair units • 12.15
#: Other Fuel Appliances
Tax map/parcel
Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
HVAC - Furnish and install new Flue vent (water heater /gas fireplace) 10.00
return air duct to (2x) , Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Frozen Food cases, with Wood fireplace /insert 10.00
misc SS Flashing Chimney/liner /flue /vent 10.00
® PROPERTY OWNER 1 0 TENANT Other: 10.00
Name: H -MART Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 10.00
Address: 13600 SW Pacific Hwy
Clothes dryer exhaust 10.00
City /State /Zip: Tigard, OR 97223
Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
0 APPLICANT lil CONTACT PERSON utility rooms) 6.80
Name: Carl Tasa Attic /crawl space fans 10.00
Address: 2310 NE Columbia Blvd. Other: 10.00
Fuel Piping
City /State /Zip: Portland, OR 97211 * *($5.40 for first 4. $1.00 each additional)
Phone{ 503) 288-5844 Fax( 503) 288-5849 Furnace, etc. **
Gas heat pump **
EgnaiLctasa@arcticsheetmetal.com Wall/suspended/unit heater **
CONTRACTOR Water heater **
Business Name: Arctic Sheet Metal Fireplace **
Address: 2310 NE Columbia Blvd. Range **
City/State/Zip: Portland, OR 97211
BBQ **
y p� � Clothes dryer (gas) **
Phone{ 503) 288-5844 Fax: ( 503) 2/1R-5849 Other: **
CCB Lic. #: yl yl j p Total:
1 7 [) 9 5 Mechanical Permit Fees*
Authorized S ubtotal: $
t g rtature: . 1 •.:: 04/21/08 ?0
Minimum Permit Fee $72.50 $
G - ry L. • cQuown Plan Review Fee (25% of Permit Fee) $ t ----
(Please print name) State Surcharge (8% of Permit Fee) $ 44 ' .
TOTAL PERMIT FEE $ , 77, � , 9----,
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
TOTAL VALUATION: PERMIT FEE:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each
additional $100.00 or fraction thereof, to and
including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for
each additional $100.00 or fraction thereof, to
and including $10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for
each additional $100.00 or fraction thereof, to
and including $50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for
each additional $100.00 or fraction thereof, to
and including $100,000.00.
$100,001.00 and up $1,396.50 for the first $100,000.000 and
$1.10 for each additional $100.00 or fraction
thereof.
All New Commercial Buildings require 2 sets of plans.
is \Building \Permit Forms \MecPermitAppPg2 09- 01- 03.doc
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MEC2000-00200
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/21/2000
Phone: (503) 639-4171 11111'
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/9/2008 TIME: TOOAM PAGE: 17
SITE ADDRESS: 13600 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: TIGARD MARKETPLACE LOT #: TYPE OF USE:
PROJECT NAME: H MART
DESCRIPTION: Install return air ducts to frozen food case with misc. stainless steel flashinc.j. NO PLAN REVIEW
REQUIRED. Project Value: $17,800
OWNER: 13600 PACIFIC CORP, PHONE #:
CONTRACTOR: ARTIC SHEET METAL PHONE #: 503-288-5844
Inspection Request Scheduled For: Date: 519/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
626 Duct work 069666-01 503-341-5533
Corrections/Comments/Instructions:
■F41 P MP' I PARTIAL APPROVAL CANCEL fl NO ACCESS
111 FAIL r CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: Sh 6e5 Phone #: (503) 718-