Permit MECHANICAL PERMIT
CITY OF �r
• COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00562
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12!20/2007
PARCEL: 1 S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 104 ZONING: C -G
SUBDIVISION: TIGARD PLAZA LOT: 002 JURISDICTION: TIG
PROJECT: TAQUERIA 7 ESTRELLAS
Project Description: Installation of customer supplied exhaust hood. Project Value: $6,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: A3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS: 1
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WO
GAS PRESSURE: 50 + HP: CL DSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS O DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 3
Owner: FEES
TIGARD PROPERTIES INC Description Date Amount
2106 SE OCHOCO ST
MILWAUKIE, OR 97222 [MECH] Permit Fee 12/20/20C $159.50
[MECPLN] Plan Rev 12/20/20C $39.88
[TAX] 8% State Surcha 12/20/20( $12.76
Phone: Total $212.14
Contractor:
PENNCO REFRIGERATION LLC
294 W. SECOND PLACE CIRCLE
LAFAYETTE, OR 97127 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 349 -5807
Reg #: LIC 174822
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued :y: t iLL i■ , Permittee Signature: _ ;
Call 503.639.4175 by 7:00 a.m. for inspections th�y,0ess . ay.
This permit card shall be kept in a conspicuous place on the job e until completion of the project.
Approved plans are required on the job site at the time of each inspection.
� [ 7 ?'i L (1 it ? 4S'" - ■
e an al Permit Application FOR OFFICE USE ONLY •
City of Tigard P eceived 4,, y,� j�
* " �ateBy pf C D 7 : / Permit No.: H�.��1 :AV7 -" / .Z.50
71 • 13125 SW Hall Blvd Tigard, OR B- CE1
r/w
C •
. Phone: 503.639.4171 Fax: 503.598.1960 Plan Revie ) IG
DateB t 07 Other Permit:
T,I A R D Inspection Line: 503.639.4175 SEP 27 1007 Date Rea y y: hri 61 See Page 2 for
Internet: www.tigard or.gov /� Notified/Method: 10 � ( SupplementalInformation
y, i 1, i ARD �/ S Lii / J
TYP � 1 ��
T DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
` 1 V 1J l� Mechanical permit fees* are based on the value of the work
❑ New construction �f Ad 1 c l ra to rep acement IVIS performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labo , overhead, andprofit.
CATEGORY OF CONSTRUCTION Value: $ 0 , erDO !
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: (� ` is- L' . Air conditioning or heat pump
11 ✓ ( CA ( IL L � �� 14 to
'J (requires site plan showing placement) 14.00
City /State /ZIP: tl c6.4-61/ o it I Z z 3 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name :� u Fumace 100,000+ BTU (ducts/vents) 17.90
Q (A' t 7 5r1 /- j Gas heat pump 14.00
Cross street/directions to job site: S W 531 44.1 Duct work 10.00
Hydronic hot water system 14.00
r- ?Gt 14. t— /L IN I tt`/4 Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
I
DESCRIPTION OF WORK Water heater 10.00
I $ �'r,L(.e't,L 0 h a € W 5 6 l ^'� � 5 v� Gas fireplace 10.00
� l �1 � � Flue vent for water heater or gas
(3 t �/ Ss E(' 1 _ u 5+ 1 � n fireplace 10.00
_ L JC C tGt '1 !X Log lighter (gas) 10.00
Wood/pellet stove 10.00
\ - Wood fireplace /insert 10.00
❑ PROPERTY OWNER `�Q TENANT Chimney /liner /flue /vent 10.00
Other: _ 10.00
Name: .-3(-)aln, IM- u_ Environmental exhaust and ventilation
r ti.eZ
Address: ` 1 a L/ 5' 5 /„.) / /i l � /� / D' Range hood /other kitchen
/ ti equipment 10.00
City/State /ZIP: 712 re.'/ Q L '7 ZZ 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT CONTACT PERSON Attic /crawlspace fans 10.00
Business name: PC'&.Lco p_, 01 e'k h +/d Other: 10.00
Fuel piping
Contact name: 19Z $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( 3 ) 76# --e y 3 Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
.1 l _ Clothes dryer (gas)
Business name: L° Yt p Zed (73 e�4 7 /b , LI .�
Other:
Address: 9—C14/ S ei Pig. L.,f rTZL MECHANICAL PERMIT FEES*
City /State /ZIP: L Tc,i f c- G n_. 9 12 7 Subtotal
q l Minimum permit fee ($72.50)
Phone: (S-63 3 4 [ 5-ger) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: pp.i $"a S - D 9 State surcharge (8% of permit fee)
%� � TOTAL PERMIT FEE =./c2, /4
) /
Authorized signature: ( i ._ / - � 1 This permit application expires if a permit is not obtained within 180
�} days after it has been accepted as complete.
Print name: D e , / K /6 h Date: 7P --2 / "" '7 • Fee methodology set by Tri -County Building Industry Service Board
1:\ Building \Permits 'NEC- PermitApp.doc 01/19/07 4404617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
• $1.00 to $2,000.00 , Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00. •
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and •
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or'
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396:50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I
•
1:1Building\Permits\MEC- PermitApp.doc 01/19/07 2
CITY OF TIGARD
I BUILDING DIVISION PERMIT #: MEC2007 -00562
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1:2012007
Phone: (503) 639 -4171 1111
Inspection Requests (24 Hrs.): (503) 639 -4175 - gar r:_ I
INSPECTION WORKSHEET FOR DATE: 5/13/2008 ' TIME: 7:02AM PAGE: 10
SITE ADDRESS: 11945 SW PACIFIC HWY 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION: Installation of customer supplied type 1 hood. Project Value: $6,000 Includes Type I hood,
extension of existing gas line to 3 outlets.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: PENNCO REFRIGERATION LLC PHONE #: 5033415007
Inspection Request Scheduled For: Date: 5/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Me = : • • Kr A
G95 Micc. inspection 069811 -01 503-547 -5273 , n
orrections /Comm nts /Ins ctions:
0-(CA (5q(-1 0
i3Db (vvva. Oxv&S-z_le) 5 Cm
� Y
❑ PASS ❑ PARTIAL APPROVAL XANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I Z
Inspector: Dater/ 1 �I o Phone #: (503) 718 - T
' CITY OF TIGARD . - -
A
BUILDING DIVISION PERMIT #: MEC2007 - 00562
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ' !l' 1 L!
INSPECTION WORKSHEET FOR DATE: 5/2/2008 TIME: 7:00AM PAGE: 28
SITE ADDRESS: 11945 SW PACIFIC HM 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION: Installation of customer supplied type 1 hood. Project Value: $6,000 Includes Type I hood,
extension of existing gas line to 3 outlets.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: PENNCO REFRIGERATION LLC PHONE #: 503
Inspection Request Scheduled For: Date: 5/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact ' Messa•e , ri d■—/
640 Exhaust hood 069250 -01 503 -4 -1051
Corrections /Comments /Instructions: , / c A
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1-/-A - KI 6 a..t/l U13-e...__. $
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• PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Tie FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (/ 4 V Date. Phone #: (503) 718-742-1
CITY OF TIGARD - . - .
BUILDING DIVISION PERMIT #: MEC2007 -00562
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12120/2007
Phone: (503) 639 -4171 ". i - 7
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ' `'I i
INSPECTION WORKSHEET FOR DATE: 6/5/2000 TIME: 7:00AM PAGE: 9
SITE ADDRESS: 11945 SW PACIFIC HWY 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION: Installation of customer supplied type 1 hood. Project Value: $6,000 Includos Type I hood,
extension of existing gas line to 3 outlets.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: PENNCO REFRIGERATION LLC PHONE #: 503 - 349 -5807
Inspection Request Scheduled For: Date: 6/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message 4
640 Exhaust hood 070943-01 503-516.7793 N ;
Corrections/Comments/Instructions:
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10
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!►: -. SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
IliC/ l� Inspector: /� ( f___ , Date: Z" / Phone #: (503) 718 - 24
k
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00562
13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 12I70J2007
Phone: (503) 639 -4171 l
In Requests (24 Hrs.): (503) 639 -4175 `:_.. / /1/t2 c f(e'
INSPECTION WORKSHEET FOR DATE: 5/28/2008 TIME: 7:00AM PAGE: 14
SITE ADDRESS: 11945 SW PACIFIC HWY 104 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: TAQUERIA 7 ESTRELLAS
DESCRIPTION: Installation of customer supplied type 1 hood. Project Value: $6,000 Includes Type I hood,
extension of existing gas line to 3 outlets.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: PENNCO REFRIGERATION LLC PHONE #: 503 - 349 -
Inspection Request Scheduled For: Date: 5/20/2008 1 6 Pour Time:
Code # Inspection Description Confirm # Contact # Mes- ge t i
640 Exhaust hood 070448 -01 503.516 -7793 Y 71/a I '
Corrections /Comm�ts /Ins ns: d ' , d -
S
)____ / (2 -ft — O V 4 j 7c a Ate 1\ X ILeSc .
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kise.1-d P'd.-1-4- d Pr, ( -C - V\ tAA-k •
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, n/eate - , ' _ �t C i e / S IA S -
1
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
V6 1 ; Inspector: Date: 5 7 i 0 1 Phone #: (503) 71 8 - /