Permit - CITY OF T MECHAN I CAL
e,,,,, , A DEVELOPMENT SERVICES PERMIT
X f i PERMIT # • MEC97 -0114
�'j- -'� �.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-0171 DATE ISSUED: 07 / 30 / 97
PARCEL: 1S136DB -02600
SITE ADDRESS...: 11201 SW 72ND AVE
SUBDIVISION • ZONING: C—G
BLOCK • LOT • JURISDICTION: TIG
CLASS OF WORK..:NEW FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 3
OCCUPANCY GRP.. :A3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 1 BOILERS /COMPRESSORS HOODS • 6
FUEL TYPES 0 -3 HP....: 2 DOMES. INCIN: 0
:GAS 3 -15 HP • 3 COMML. INCIN: 0
MAX INPUT: 4500000 BTU 15 -30 HP : 0 REPAIR UNITS: 0
FIRE DAMPERS'..: Y 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: M 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS. :10
FURN < 100K BTU: 5 <= 10000 cfm: 3 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : A quick serve restaurant with a drive - through service lane.
Owner: -- FEES ---------
MCDONALDS CORPORATION type amount by date recpt
5000 SW MEADOWS ROAD, SUITE 230 PRMT $ 189.00 B 07/30/97 97- 297744
LAKE OSWEGO OR 07035 PLCK $ 47.25 B 07/30/97 97- 297744
5PCT $ 9.25 B 07/30/97 97- 297744
Phone #:
Contractor:
GARONAIRE INC
2515 KAUFFMAN AVE
$ 245.50 TOTAL
VANCOUVER WA 98660
Phone #: 360 -696 -1604
Reg #..: 000695
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Heat in g Unt Ins p
approved plans. This permit will expire if work is not started Cooling Unt Insp
within 180 days of issuance, or if work is suspended for more Hood Inspect ion
than 180 days. ATTENTION: Oregon law requires you to follow rules Fire Suppr Insp
adopted by the Oregon Utility Notification Center. Those rules are Duct Inspect i o n
set forth in OAR 952- 001-0010 through OAR 952-',q-0080. You may Fire Damper Insp
obtain copies of these rules or direct questions to OUNC by calling Final Inspection
(503)246 -9187.
Issue By: ; Vim-' Permittee Signature: (S; t1
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + ++
Plan C eck #
CITY OF TIGARD Mechanical Permit Application Recd By
13125. SW. .HALL BLVD. Commercial and Residential Date Recd
TIGAt D, OR 97223 Date to DST '? // /Q7
(503) 639 -4171, x304 Permit# Nf ELR7 DI 14-
Print or Type • called
Incomplete or illegible applications will not be accepted
Name of Develo menUP Description
i i 1C_ 'vat. Table 1A Mechanical Code aTM PRICE AMT
Job Street Address 1110 1 1 J ' Suite# A) Permit Fee -0 - -0 - 10.00
Address `�,, it)
Bag# City/State 1.) Fumace to 100,000 BTU 6.00
including ducts & vents
Name (or name of business) 2.) Fumace 100,000 BTU+ 7.50
Owner }� G Lam,.�.. -1,0 S including duds & vents 1 j i• 5
Mailing Address - 3.) Floor Fumace 6.00
including vent
City /State Zip Phone 4.) Suspended heater, wall heater 6.00'
or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP: absorb unit to 100K BUT
City /State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP: absorb unit to 500K BTU" V.
Contractor N8f1e l Io ' �l1_� XB(�Gi ib 8.) Boiler or comp, heat pump, air cond. 15.00 '
(Prior to //
j °0 15.30 HP; absorb unit5-1 mil BTU" AU
issuance Marling Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all City /State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor > 50 HP; absorb unit 1.75 mil BTU"
license Oregon Const. Cont. Board Licit Exp. Date 11.) Air handling unit to 10,000 CFM , 4.50 •
information J
rm j 5 '
for COT COT Busness Tax or Metro # Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database).
Architect N8fe 13.) Non-portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single dud 3 3.00 �
- 1
Engineer City /State Zip Phone 15.) Ventilation system not induded in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
/
to be done Residential 0 Non - residential 0 (D
Additional Description of work 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of C 21.) Clothes dryer, etc. 4.50
S
building or property TS? Tet/3
22.) Other units / ° 4.50 Sd
'
Type of fuel - oil 0 natural gas` LPG 0 electric 0 23.) Gas piping one to four outlets r 2.00
I hereby acknowledge that 1 have read this application, that the 24.) More than 4-per outlets (each) .50
information given is correct, that I am the owner or authorized agent of 2/ l N.
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of OwnerlAgent Date 'SUBTOTAL i "" 1 l
5% SURCHARGE
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL y->S_ ; '
TOTAL / ���' � /1
i:\dstlrmech�mtdoc (rev 9 'Minimum permit fee is $25 + 5% surcharge !�
**Residential NC requires site plan showing placement of unit ��