Permit CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: MEC2009 -00150
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/08/2009
Parcel: 2S114AA00200
Jurisdiction: Tigard
Site address: 16285 SW 85TH AVE 403
Subdivision: DURHAM HALL BUSINESS PARK Lot: 0
Project: Souper Natural Pepper Heads
Project Description: Install Type II steam hood.
Owner: FEES
SHIPMAN, W H LIMITED Description Date Amount
BY NORRIS & STEVENS INC, 621 SW Permit Fee 04/08/2009 $181.10
MORRISON STE #800 Plan Review 04/08/2009 $45.28
PHONE: 12% State Surcharge 04/08/2009 $21.73
Contractor:
L S MANUFACTURING INC
5924 SE 42 AVE
PORTLAND, OR
PHONE: 503 - 262 -0348
FAX: 503- 262 -0498
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue 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 $248.11
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
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 to follow the rules adopted by the Oregon
Utility No ' - • '. ; . er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of th les
Issued y: ` ' / 7 u Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business 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.
Apr 01 09 11:16a Brittle Kittle 503 684 5262 p.1
A Mechanical Permit Applicatio - FOR O1•hlt h_ USE OILY
City of Tigard Received `'
`J g � � Permit No : M� I �� -.•/6
13125 SW Hall Blvd., Tigard, OR 97223 Q plan Re ■
Phone: 503.639.4171 Fax: 503.548.1960 APR - g 200' Q Da paid; 7 :Bc itttWri � Other Permit:
TI G A D inspection Line: 503.639.4175 Dist Rer'i :4ris•
w.tigard- or.gov S See menta for
Internet: ww
CTTy OF TIGARD NatifiedfAle +hoG: Supplemental Information
niVISIO
TYPE OF W Rti. COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
[] New construction ❑ A ditionlalterationireplacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead,;p� profit.
CATEGORY OF CONSTRUCTION I Vahte: 7 1f / 66''
C 1 i-- RESIDENTIAL EQUIPMENT SYSTEMS FEES*
® 1- and 2- family dwelling 4ommercialtindustrial ❑ Accessory building
For special r information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty I Ea. I Teal
JOB SITE INFOILVIATION AND LOCATION Heating/cooling
�v Air conditioning or heat pump
Job site address: ,
� 5�1 5 A � S� (requires site plan showing placement) 14.00
City/State/ZIP: • • 1 "\ UgQ 5(.(\ i Furnace 100,000 BTU (ducis!vers) 14,00
Furnace 100,000+ BTU (ducnlveote) 17.90
name:
Sui g.iapt. no.; ; J Prote
@[IJ/7 ct < f
rr/ J�� t ___� Gas heat !nag 14.00
Cross street /directions to job site: \� LL .\ 6. vi . ` Duct work 10.00
� \ - \ n � S () R Residential i hot ile r system 14.(Kl
„\ t `� ` Resident�l boilec (radiator or
V'7\ .(:1 �1 U S � �U - 7- �uk3 2'dronic)
'Unit heaters (fuel-type, 14.00
` , 1 ype, not eiectric>, ;
in gall. in duct suspended. etc. 14,00
r. ! Flue /vent for any of above 6.80
Subdivision: I Lot no.: Other: I 10.00
r
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Other:
heater 10.00
a --- Gas fireplace 10.00
C Cl. 3 L
5 ( )O V mLi A Q oh Flue vent for water heater or gas +}
fireplace i i 10.00
Log lighter (gas) 10.00
Wood /pellet stove __ 10.00
Wood fireplace/insert I 10.00
Chimneyiliner /fluevent 10.00
❑ PROPERTY OWNER I TENANT
Other: 10.00
Name: 5 k N . \ �� Environmental exhaust and ventilation __ _
w n � ' 1 Range tsoodiother kitchen i
Address: 1 S W ``'� f� �e 'p ` VU _ equipment 10.00
City /State/ZIP: .k.-1 ` ` 00 C OR- f 0 V Si Clothes dryer exhaust. 10.00
_ Single -duct exhaust (bathrooms,
Phone: ( —)C.: .'v Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT `KJ CONTACT PERSON I Attic crawlspacc fans 10,00 _I
C tit '' ( Other: 10.00 _
Business name: )I"r -
j c--(N) �s i Fuel piping;
Contact name: \ l , ` � \,;\'Z $5.40 for first four, $1.00 for each additional
,`
Address: 9 V u 'i `i■I(P kA.A.SC. Furnace, etc. i
as ham pump +
City/State/ZIP: t,_ \:e�� �,1�1 �.�. 3„r �J ��' ` '1 � C �L y � G �/ Wall ;utpendedlunil heater {
Phone: ( 5 J (�7�' - � b ' 3 I Fax: ( N! I 3 —0‘8----7 ( Ware heater
�� r- /� /� / � f /;) cei � u +rj Fir .ace
E -mail:
a( "1 *kit, l tJl (. \ C Ranee
CONTRACTOR Barbecue
r � Clothes dryer ( eas}
business name: LS �' - t� . � I
,3q2.,-/a Other: I
Address.
Z � � flu PERMIT FEES*
City /StateiZIP: 1 `-d tr lr� it l v 1 , ( _ V Subtotal l /g /.
�- (0
Phone: ( } t _/° F ( �) Minimum permit fee ($72.50)
CC '� 7 `� �7 -L y9R � Plan review (25% of permit fee) y,S'
CCB lie.: S"j 9 7 /� State surcharge (12% of permit fee) al , 5
I 1 F TOTAL PERMIT FEE ji.if /1
Authorized si • e: This permit apptintiou expires if a permit is not obtained witltiu 180
p � , set days s e k has beta accepted as to amiete.
t int n ame: , ,• ��° Date: 3 0 — Fee methodology set b} Tri- County Building industry Service Bawd
I. cuildir .aermits`- ,.4fEC- PeneitApp.doc !19/57 446.461Tr 01:02 /COM wEB1
• Building Division
Over- The - Counter (OTC) Mechanical Permit
TIGARD
Check List
r/1 it i
Description of Project: {-' V. ) (C ( T
GENERAL INFORMATION
Class of Work:* Floor Furnace: Evap. Coolers:
Type of Use:* r f A Unit Heaters: Vent Fans:
Occupancy Group: Vents w/o Appl.: Vent Systems:
Stories: Boilers, Comp, Heat Pump, A /C: Hoods:
Fuel Types: 0 - 3 HP: Domestic Incinerator
ELC / GAS / NG / OIL / OTHER 3 - 15 HP: Com. /Ind. Incinerator
Max Input BTU: 15 - 30 HP: Repair Units:
Fire Dampers: 30 - 50 HP: Wood Stoves:
Gas Pressure: H / M / L >50 HP: Clothes Dryer.
No. of Units: Air Handling Units: Other Units:
Furnace <100k BTU: <_10,000 CFM: 2- Gas Outlets:
Furnace .100k BTU: , >10,000 CFM:
/
Notes: K IL 7 147 .
INSPECTIONS I I FEES DUE
Post /beam mechanical $ ' ,l , to Permit Fee
Gas line $ 2(, 73 State Surcharge
Mechanical rough -in $ 4' , 33 Plan Review Fee
Fire damper $ Additional Permit Fee
Duct work $ Additional Plan Review Fee
Smoke detector $ Investigation Fee
Investigation inspection $ Misc. Fee
Misc. inspection $ Hourly Rate Fee
Final inspection $ Hourly Rate State Surcharge
$ 24,e, (( Total Fees Due
OTHER PERMITS REQUIRED I
Building Electrical
Plumbing Site Work
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I:\Building\Forms \OTC - MEC.doc 09/22/06