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Permit C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2005 -00842 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE E 12/28/2005 I 35 PAA RCCELL : 1 S135DD -03301 SITE ADDRESS: 11945 SW PACIFIC HWY 228 ZONING: C -G SUBDIVISION: HOFFARBER TRACTS NO.1 LOT: 002 JURISDICTION: TIG Project Description: Install 1 class 2 hood. Valuation: $2000.00 CLASS OF WORK: ALT FLOOR FURN: - EVAP COOLERS: — TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: 'VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: 1 FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: • GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS FURN > =100K BTU: < =10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES TIGARD PROPERTIES INC Description Date Amount 2106 SE OCHOCO ST [MECH] Permit Fee 12/28/20C $72.50 MILWAUKIE, OR 97222 [TAX] 8% State Surcharl 12/28/20C $5.80 Phone: Total $78.30 Contractor: G & J CONSTRUCTION 1806 SE 12TH AVE. REQUIRED ITEMS AND REPORTS PORTLAND, OR 97214 Contact #: FAX 503 235 - 5501 PRI 503- 805 -3050 Reg #: LIC 166242 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 By: �/ l : �� Permittee Signature: Call 503 - 639 -4175 by 7:00 a.m. for inspections at 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. • Mechanical Permit A ,.;, ,7, t IC ED FO It OFFICE I'SE ONLY City of Tigard Received Date/By. a , ' 1 � i 1) Permit No.: 1 1 A l _ 1(, 7,- 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 20 Plan Review Date/By. Oth• Permit: Inspection Line: 503.639.4175 ��`(+ ' �, / / p _r 1 • � � Date Ready/By: � ® See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIG . -` Notified/Method: r41111 Su pplemental Information RUILDIRG DIVISION • TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction Qf Addition/alteration/replacement 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, and profit. CATEGORY OF CONSTRUCTION Value: $ 0.0/0 RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling RrCommercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family 0 Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling J� t Air conditioning or heat pump Job site address: //g9 y c S 41 O c,, i / (requires site plan showing placement) 14.00 City /State/ZIP: j ,, (�'/� Furnace 100,000 BTU (ducts/vents) 14.00 �� ' r Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: ZZ 7 Project name:1;� „ /P I /I /7h1 Gas heat pump 14.00 1 _ Cross street/directions to job site: Ca.. i � Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 10.00 Subdivision: Lot no.: Other: 10.00 _ Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 �,[� Q�/ / Gas fireplace 10.00 --A- r .c-�du�d C�G.ec.AA /lad C/' Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: Environmental exhaust and ventilation • Address: Range hood/other kitchen equipment ' 10.00 City /State/ZIP: • Clothes dryer exhaust 10.00 Phone: Single -duct exhaust (bathrooms, ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT )2i CONTACT PERSON _Attic/crawlspace fans 10.00 Other: 10.00 Business name: - _ Fuel piping Contact name: J P2 r �j 1 4'9 ,, f e $5.40 for first four; $1.00 for each additional / O ( � / Furnace, etc. Address: 1 G /. p, Gas heat pump City /State/ZIP: gbh 1 / i , J/ G h / Wall/suspended/unit heater Phone: (,fog) b ijJ G,f O I Fax: : 6a3) 2.,Q - SV f 4 Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Business name: CT y ' 7 �n ,o �G h _ Clothes dryer (gas) Other: Address: / 4 0 [0 Sr / 2 59:04y MECHANICAL PERMIT FEES* City /State/ZIP: A. "7 x �f Q r' Subtotal Phone: (S Qf ) O J , e7 69 Fax: ( ) Minimum permit fee ($72.50) Q Plan review (25% of permit fee) CCB lic.: /(p 6 2 f 2 —AS- t i State surcharge (8% of permit fee) a4.144.4. TOTAL PERMIT FEE ‘—. 50 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 6 D ^ / C l f Date: /Z -- 2,P O.f I • Fee methodology set by Tri- County Building Industry Service Board is\ Building \ Perm itsAMEC- PermitApp.doc 12/03 4404617T(11 /02/COM/WEB) o q 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:\ Building \Permits\MEC- PenmitApp.doc 12/03 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2110500842 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/280006 Phone: (503) 639 -4171 1 111 1(11 Inspection Requests (24 Hrs.): (503) 639 -4175 _..' INSPECTION WORKSHEET FOR DATE: 2/7/2006 TIME: 7 :02AM PAGE: 17 SITE ADDRESS: 11345 SW PACIFIC HVVY 228 CLASS OF WORK: SUBDIVISION: F10FF ARFJER TRACTS NO.1 LOT #: UO2 TYPE OF USE: PROJECT NAME: TIGARD PIZZA KITCHEN DESCRIPTION: Install 1 class 2 hood. Valuation: $7000.00 OWNER: TIGARD PROPERTIES INC, PHONE #: CONTRACTOR: G & J CONSTRUCTION PHONE #: 503-805. 3060 Inspection Request Scheduled For: Date: 2/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 026414 -01 603806.3050 Y l Corrections /Comments /Instructions: i 15— r 1‘) ( ( lki _A .C ........, rt PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI A EES ASSESSED ....,, Inspector: Ir ` / Date: 7 ©� Phone #: (503) 718 - 7