Permit U CITY OF TIGARD MECHANICAL PERMIT
1* COMMUNITY DEVELOPMENT Permit #: MEC2011 -00094
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2011
Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 16655 SW 72ND AVE 300
Project: Food Sales West Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Install new Type 1 hood, relocate (1) walk -in freezer and install (1) new walk -in freezer. Fire suppression for hood
done by others.
Contractor: BULLDOG MECHANICAL & REMODELING INC Owner: PACIFIC REALTY ASSOCIATES
3307 NE 39TH ST 15350 SW SEQUOIA PKWY #300
VANCOUVER, WA 98661 PORTLAND, OR 97224
PHONE: 360- 901 -2610 PHONE: 503 - 624 -6300
FAX: 360 - 693 -1505
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/18/2011 $629.65
Class of Work: ALT Type of Const: IIIB Plan Review 03/18/2011 $157.41
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/18/2011 $75.56
Stories: Info Process /Archiving - Sm Sheet (up to 03/18/2011 $12.50
11x17)
Project Valuation: $21,080.00
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $875.12
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
issuan , or if work"* suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit Notification Center*. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0s • •. •u may obtain a copy of the rules
or rect questions to OUNc a int 03.232.1987 or 1.800.332.2344. '
Is ued By: A / Permittee Signature: ■
%� / i-
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Call 503.639.4175 by 7:00 a.m. for the next available inspection • • e.
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.
0
— ______-Asiirk.fR' .:` fir .xee 1 `Y.
Mechanical Permit Application CENED Received hOlz 0141 c L 1 tit. ()NIA
g
City of Tigard Q Q DateB 02 1 // / P No.: u e � l il `/
111111 I • 13125 SW Hall Blvd., Tigard, OR 97223 y' (/'""
Phone: 503.718.2439 Fax: 503.598.196t1 ^ n} 1 Plan Review
TAR 9 O Date/By: 3 J I L, 1 i t (� Other Permit:
T l .. A it I) Inspection Line: 503.639.4175
Internet: www.tigard-or.gov Date Ready/By: Juris: BI See Page 2 for
CITY Y OF TIGARD Notified/Methoc", `/ Supplemental Information
iJ 91NU DIVISION Ago
TYPE O W ORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
— Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all F
❑ Demolition ❑ Other: mechanical materials, equipment, labor, over -7., and profit.
CATEGORY OF CONSTRUCTION Value: $ I jj ;�
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1- and 2- family dwelling commercial /industrial 0 Accessory building For special information use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description i Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling: O
t a 0e Air conditioning
Job site address: V t 5I c IAJ j j I � "�1 21� d 3 (requires site plan showing placement) 46.75 G
City/State /ZIP: , Z (f I Furnace 100,000 BTU ( ducts/vents) 46.75
�\ J Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name:F(J (era l �� 1. Heat pump
/ `'r f (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23,32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: l Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
0 �n l C S �1 �.. r l r Gas fireplace 33.39
1 .J � .cJIJ 1 Yj 1 ^ Flue vent for water heater or gas
ze Lo t K1 1.9..3 e/2— fireplace 23.32
� f '/ Log lighter (gas) 23.32
3 5 $ (Q vJ��ri tf..3 F2P, _– Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Name:
Other: 23.32
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
,�,�,� toilet compartments, utility rooms) 23.32
FE/APPLICANT LIl1rCONTACT PERSON Attic /crawlspace fans l 23.32
Business name: 13 LL UM � / � 4 , ,, c Other: 23.32
��''�i Fuel piping:
i v}
Contact name : n� 2 £ . . l p�s r $14.15 for first four; $4.03 for each additional_
Address: 7 01 to E O /V /1 t 3 p`7F ] S ' / Furnace, etc.
JJ ! Gas heat pump
City/State/ZIP: . J 'TO' la ( Wall/suspended/unit heater
Phone: Li Q) 9 � _ Z /1 O Fax: : ( �) �� ! ` _ Water heater
v c, I /� 1 J t r Fireplace
E- mail :. y j� -' e c, w �-
,Ait, 0 G,Ty Range
CONtfRACTOR Barbecue
Business name: Clothes dryer (gas)
Other:
Address: e/ MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Phone: Minimum permit fee ($90.00)
( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.:
Rl �1 t 1 State surcharge (12% of permit fee)
.._ TOTAL PERMIT FEE
Authorized signature: � / / � O This permit application expires if a permit is not obtained within 180
J / days after it has been accepted as complete.
Print name: uQ ( • � , _ 1 �_� 1 yl. t Date: 3_ j * Fee methodology set by Tri-County Building Industry Service Board
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