Permit CITY OF TIGARD MECHANICAL PERMIT
r'
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00345
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/19/2011
T 1 G ARD Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9627 SW WASHINGTON SQUARE RD FCO2
Project: Sonic Subdivision: WASHINGTON SQUARE MALL Lot:
Project Description: Install new gas line for (3) fryers & (1) griddle.
Contractor: AL'S PLUMBING Owner: PPR WASHINGTON SQUARE LLC
5655 CROSSLER CT. S. BY THOMSON PROPERTY TAX SERVICES
SALEM, OR 97306 ATTN HILARY RAYMOND
CARLSBAD, CA 92008
PHONE: 503 - 508 -0041 PHONE:
FAX: 503 - 375 -3444
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 07/19/2011 $84.41
Class of Work: ALT Type of Const: Plan Review 07/19/2011 $21.10
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 07/19/2011 $10.13
Stories:
Project Valuation: $1,000.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $115.64
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 4 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 ' w . is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility i cation Cente . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or di ct questions to OUNC b alli g :03.232.1987 or 1.800.332.2344.
Is ed By: t / 0 /LE Permittee Signature: x
Call 503.639.4175 by 7:00 a.m. for the next available inspection da .
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 ....7
FOR OFFICE USE ONLY
City of Tigard Date/B d / l r AT . , Permit No.: .J / e' /� j �{/9
3 5
y / ` v�
1111
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 DatcBy: Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready/By: Juris: lid See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 1000 . 4:4 CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: qL2 S . ` Q$1a\ , i SQ cC O2.. (requires site plan showing placement) 46.75
City /State /ZIP: Furnace 100,000 BTU (ducts/vents) 46.75
��� t 0---, `, �� Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: �N t Heat pump 61.06
Cross street/directions to job site: I..) as1111-- „'/.0.0 S Duct work 23.32
((`� Hydronic hot water system 23.32
�� �`�
�-OOCO C-410 Q-1 Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
tit] 4- tsS S QL! S Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER El TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
•
126PLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
LS \ ■r- : \4_1(,.- ..-7 1.-.1C- • Fuel piping
Contact name: d� �� O L . - rr- ----- $14.15 for first four; $4.03 for each additional
Address: S Furnace, etc.
'S�� C Sk.L _ Cx _ Gas heat pump
City /State /ZIP: S i ,,�` s t % Wall /suspended/unit heater
t Water heater
Phone: (.515) # 5 - eS5, - OU e. \ Fax: : (. 5t , " ) ' 51 r _ -7 j 4 1,44._
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: &LS Ca-..) Clothes dryer (gas)
Wi\3\J -)6, �a-ic. Other: - FR`tGli- C"u1A 4- 1A.%"; 51..6
Address: •$$ C .sSk...jz_ C v , S , MECHANICAL PERMIT FEES*
City /State /ZIP: S.c �r �,,,_ t C. S' Subtotal
Phone: (563) - 1)5s- CIO 4. tS3 )
\ Fax: (5 - 3- . 7 s 3 444-
Plan permit fee ($90.00)
review (25% of permit fee)
)
CCB lic.: C 4 6 State surcharge (12% of permit fee) �, / /
TOTAL PERMIT FEE ii ` "J N*' 1
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 0.7 9 _.r Date: ") .....'t S._ \ \ * Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (I 1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
(:\Building \Permits \MEC- PermitApp.doc 10/01/09 2 •