Permit CITY OF TIGARD MECHANICAL PERMIT
1 4 * COMMUNITY DEVELOPMENT Permit #: MEC2011 -00056
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/23/2011
Parcel: 2S104BB08100
Jurisdiction: Tigard
Site address: 14200 SW BARROWS RD
Project: GODFATHER'S PIZZA Subdivision: RUSSELL'S SCHOLLS FERRY Lot: 4
Project Description: Replacing existing evaporative cooler.
Contractor: AMERICAN HEATING INC Owner: ALULI REAL ESTATE HOLDINGS LLC
1339 SE GIDEON ST 415 -C ULUNIU ST
PORTLAND, OR 97202 KAILUA
OAHU, HI 96734
PHONE: 503 - 239 -4600 PHONE:
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/23/2011 $215.64
Class of Work: ALT Type of Const: Plan Review 02/23/2011 $53.91
Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Mechanical 02/23/2011 $25.88
Stories:
Project Valuation: $5,267.00
Fuel Air Handlers
Fuel Types: 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 $295.43
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 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
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By`- i Permittee Signature:
•
C. 6 . • 39.4175 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.
rB. 7. 2011 10 , ?2AM 503239, 14 O. 5622 P. 2
M et:uitauivaa s a l aaaaa r.ap � ^ I iii: c)1 f 1(t i
City of Tigard t � Received • P« ffitNa:
III 131 SW Hall Blvd., Tigard 13125 D areair �f/ . Sol ( c.x.OSy
Plan Review
S. Phone: 503.639.4171 Fax: 50 1860 1 � z. Auem `t Permit:
I t e; n r. D Inspection Line: 503.639.4175 C_t`� .` \__ ` \e 1 Date R,� lids; • l l See Page 2 for
Internet www.tigard N � , Notified/Method; Supplemental Informiitiun
` T "E OF WORle � � • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
C) New construction it Addition/alteration/replaoetnent 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 maleriel equipment, labor, overhead, and profit.
CATEGORY OF CONSTRt1CTION . Value: $ n, ( 7 4 ® O
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- frunily dwelling .4 COMmercialindustrial ❑ Accessory building
For special information use checldist
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty, I Ea_ 1 Total
JOB SIT1E INFORMATION AND LOCATION Heating/cooling _
ob site atldres8 � Air conditioning
J
'_ J i�ti s Lu) Q q ta,tl arac i ui.es site plan showing &cement) 46.75
City / State/ZIP: - r14aq „ y p . do_ G1114-3 Furnace 100.000 BTU (ducts/venal _ 46.75
-- Furnace 100,000+ BTU ducts/vents 54.91
Suite/bldg./apt no.: _ ` P name; 61M PA i _ al P' z .4 Heat pump 61.06
Cross street/directions to job site: Duct work 2132
Hydronic hot water system 2332
Residential boiler (radiator or
hydronic 2332
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no Flue/vent for any of above 23.32
Other: 23.32
Tax map/percel no.: Other fuel appliances
. DESCRIPTION OF WOE Water heater 23.32
Gas fireplace ■ 33.39
ICE P 4 r.... Orisreh) C ' VGA Pt (tier t ig d I� 'LC h _ Flue vent for water heater er gas
L,.)I7 a LIkE POP LJIS• A e A P (212.4.710s fireplace 23.32
Log lighter) 23.32
0-45 e Lax. Wood/pellet stove 33.39
—
Wood fireplace/insert _ 23.32
, Chimney/liner /flue/vent 23.32
❑ PROPERTY °W AR %TENA T Other: 23.32
Name: a6 Q Atli Pizza It 3211 0 Environmental exhaust and ventilation
Range hood/other kitchen
Address: / (j 2!]61 S bU 114aR UUl[S . fit . equipment 33.39
City /State/ZIP: ?/o1f 2d Q 2 cr7 123 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet corn I artmonts, utili rooms) 23.32
ivi APPLICANT g CONTACT PERSON — Attic/crawlspace fans 23.32
Other: 2.3.32
Business name: ' i W! , rr � - - r a . L o — Fuel piping
Contact acute: Lief a ILA ,Sod f., L4+UK. / y S14.15 for first four, $4.03 for each additional _
- ^7� , ^,� Furnace, etc.
Address: j J 61i (I�Y� i ` S� Gas heat pump
City / State/ZIP: ' / 4 / ( f l J l ) ¶ 2 ( Wall/su ded/unit heater
Phasic: ( '5 �j) 23 Fa x: ;'( a 03 0 Water heater
Fireplace
E-mail: cart u
� tnnarz►cn,n w9. R l'1.cr�
CONTRACTOR . Barbecue .
�(� ^A Clothes dryer (gas)
Business name: _ _
�" 'r p (1 r (� A'1 ���2>:� Other.
Address: MECHANICAL PERMIT FEES"
City/Store/ZIP 41 a{}a- . — Subtotal
p _
Minimum permit fee ($90.00)
Phone: ( .• L W P 0 0 Fax: ( ) 'a,3 —103 O Plan review (25% of permit fee)
CCB tic (3 State surcharge (12% of penult fcc)
TOTAL PERMIT FEE
,` /I' This permit application expires We permit is not obtained within 180
Authorized signature: 1 1 . days after it has been accepted as complete.
Print name: (� 3 . Git� g /t 1 Date: • Fee methodology set by Tri- County Building Industry Serving Beard
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