Permit CI TY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00136
.+ c � I � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/28/2005
l
PARCEL: 1S135DD-03301
SITE ADDRESS: 11945 SW PACIFIC HWY 248 ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT: 002 JURISDICTION: TIG
Project Description: Installation of refigeration for walk -in freezer & frig.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: UNK VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
<= cfm: OTHER UNITS:
FURN > =100K BTU: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
TIGARD PROPERTIES INC Description Date Amount
2106 SE OCHOCO ST [MECH] Permit Fee 3/28/200E $72.50
MILWAUKIE, OR 97222 [TAX] 8% State Surchar€ 3/28/200f. $5.80
Phone: Total $78.30
Contractor:
LIEM TRAN
415 NE 58TH REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97213
Phone: 503 238 - 0638
Reg #: LIC 80640
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: 22 f j, Permittee Signature: : 1
Call 503 - 639 -4175 by 7:00 a.m. for inspections that 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 1 1 l ,.,�1 i. �7 FOR OFFICE USE ONLY
City of 1 igard s Da p
y:Z� yv -96 . 2 Permit No.: h1/45, Lotas a a I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 344II1 Date/By: Other Permit:
Inspection Line: 503.639.4175 e i 11
www.ci.tigard.or.us . . Date ed /Met Ready/By: turn: r Supplemental See Page 2 for
Internet: www.ci.ti
g CITY OF T1 p t . Notified/Method: 1 ki Supplemental Information
r I,IIr nIN( DIVISION
. • TYPE OF WORK „ COMMERCIAL FEE *; SCHEDULE .11SE,CHECIS,IST
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.
' CATEGORY OF CONSTRUCTION - - Value: $
:.y " RESIDENTI EQUIPMENT /SYSTEMS 'FEES*
❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building .
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION - . - Heating/cooling
' Air conditioning or heat pump
Job site address: J Q /� �- �/
S tt V C_� 4 �/9. , z f (requires site plan showing placement) 14.00
City/State/ZIP: ^� J /�/ Furnace 100,000 BTU (ducts/vents) 14.00
r
; k i> 0 � `? 7Z? f
Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: 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
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
. DESCRIPTION OF WORK . Water heater 10.00
Gas fireplace 10.00
� ZL 7-4.61 4 _ s. (,..- 41 / 1 1lN /e_ yv l Flue vent for water heater or gas
t _ i , / fireplace 10.00
; \9e i t P-Q �t'-- ,6-7 / of,./ Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY -OWNER Chimney/liner /flue/vent 10.00
❑ TENANT Other: _ 10.00
Name: Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State/ZIP: 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
– Other: 10.00
A
Business name: 1 P / _ ' 71-7(4),_. — Fuel piping
/� r -1 r Ube P 'i /y P p
Contact name: 61&../E0/1 / s 0cA J $5.40 for first four; $1.00 for each additional
Address: �-6 S-- 1( Furnace, etc.
/ �l Gas heat pump •
City/State/ZIP: P 622 ikitip / o 9j 7 7 , /C Wall /suspended /unit heater
Phone: ( c 23 r 0 6 . g Fax: : ( / ) / Water heater
Fireplace
E -mail:
Range
:, - 'CONTRACTOR. - . ' Barbecue
�. Clothes dryer (gas)
Business name: �Pcr- 1 ,z\-- C � /f
( ( - Other:
Address: S 'e - / MECHANICAL PERMIT FEW 1 ',
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) '7,2_ .. Y0
Plan review (25% of permit fee)
CCB lic.: 'Q ‘V t9 State surcharge (8% of permit fee) X,
. TOTAL PERMIT FEE 3 0
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: I Date: • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits\MEC - PermitApp.doc 12/03 440.4617T(II /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:\ Building \Permits\MEC- PennitApp.doc 12/03 2
_ _
, CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00136
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3126!2005
Phone: (503) 639 -4171 /2vueq�, J
Inspection Requests (24 Hrs.): (503) 639 -4175 - - 11.,
INSPECTION WORKSHEET FOR DATE: PAGE:
5/10/2006 TIME: 7:16AM 2
SITE ADDRESS: CLASS OF WORK:
11945 SW PACIFIC HWY 248
SUBDIVISION: LOT #: TYPE OF USE
HOFFARBER TRACTS NO.1 002
PROJECT NAME: FISH MARKET
DESCRIPTION: Installation of refigeration for walk-in freezer & frig.
OWNER: PHONE #:
CONTRACTOR: TIGARD PROPERTIES INC PHONE #:
LIEM TRAN 503 -238 -0638
Inspection Request Scheduled For: Date: 5/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 006518 -01 503- 238 -0638 N
Corrections /Comments /Instructions:
opp
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"sC) Lime Q o _
II Al
I 045 le
[: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ . L F• R INSPECTION ❑ AD DITI AL FEES ASSESSED _ ;.,.
Inspector: t
P / Da te: , l o Phone #: (503) 718- ;