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Permit C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00079 ee I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/23/2006 PARCEL: 2S1 02 C B -01802 SITE ADDRESS: 13405 SW PACIFIC HWY ZONING: C -G SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Type 1 exhaust. Value: $12,000 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: FUEL TYPES 0 - 3 HP: DOMES. INCIN: ELE 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES BARUCH, ISAAC TRUSTEE Description Date Amount BY PACIFIC PIZZA CO 1905 NW 169TH PL STE 201 [MECH] Permit Fee 21231200E $258.50 BEAVERTON, OR 97006 [MECPLN] Plan Rev 21231200E $64.63 [TAX] 8% State Surcha 21231200E $20.68 Phone: Total $343.81 Contractor: A -1 STAINLESS STEEL FABCO. PO BOX 605 OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS Contact #: FAX NA PRI 503- 631 -8896 Reg #: LIC 165278 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: ° J ±�/ �GG Permittee Signature: Call 503 - 639 -4175 by 7:00. a.m. for inspectio s e - . ay. This permit card shall be kept in a conspicuous place on the j . . si u ' til ompletion of the project. Approved plans are required on the job site at the time e - ch inspection. feZ • Su, .. 1Vlechanical Permit i ,;; a E F�>li OFFICE USE ONLY / Received ity of Tigard Date/Bra. 1 O b . •_,.(1. • Permit No. ' '/ _�� � 13125 SW Hall Blvd., Tigard, OR 97223 op Plan Review /�� � Phone: 503.639.4171 Fax: 503.598.1960FE / nn6 _ . , ?r ,,,,, "`` 1 ( DAY / /�1r/ m Permit: Inspection Line: 503.639.4175 _ . : 4 I Date Ready .. """'��� t 13 See S Page 2 for Internet: www.ci.tigard.or.us TIGARD Notified/Method: Supplemental Information C ITY `ur y c�rrY RiP(VO1tRt0I111olv COMMERCIAL FEE* SCHEDULE - USE CHECKLIST j ❑ New construction ,] 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 Q ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. (l CATEGORY OF CONSTRUCTION Value: $ )21 coo `-- RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1 - and 2 family dwelling KI Commercial/industrial ❑ Accessory building - r ID Multi ❑ Master builder For special information use checklist. ❑ Other: Description 1 Qty. I Ea. 1 Total { JOB SITE INFORMATION AND LOCATION Heating/cooling e3 Job site address: I��r�� S �'{, Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State/ZIP: ��,�. R-1 ) 01 1 e - Furnace 100,000 BTU (ducts/vents) 14.00 -� ' Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: K 1 V 1 ¢SC Gas heat pump 14.00 Cross street/directions to job site: ` ` Ir' V Duct work 14.00 Hydronic hot water system 14.00 l 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: I Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 n Gas fireplace 10.00 T4 pC � 4, -/4U9-r i-ir d(') 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 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Business name: Other: _ 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. ' Gas heat pump City /State /ZIP: WalUsuspended/unit heater ' Phone: ( ) I Fax: : ( ) Water heater Fireplace E -mail: Range 51 CONTRACT Q Barbecue B name: -- l ��� /d� Clothes dryer (gas) Other: Address: P, D i 6x ed MECHANICAL PERMIT FEES* ' city /State/ZIP: Dn-E60x j . C.�,t -" , ,i ©� 97045 Subtotal - r^ � �� `7- Minimum permit fee ($72.50) 'VS S Phone: (,,;( 1 _ Q� Fax: ( ) Plan review (25% of permit fee) 3 ll '7 i CCB lic.: I1� -r3 — 69 -a 3 —O '/ State surcharge (8% of permit fee) 20„ s' TOTAL PERMIT FEE a 9�3. Authorized signature: / _ / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: C9 2 c_ I Date: Z O b • Fee methodology set by Tri- County Building Industry Service Board i:\ Building\PcnnibVMEC- PamitApp.doc 12/03 440-4617T (I1 /02/COM/WEB) I • 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- PerrnitApp.doc 12/03 2 CITY OF TIGARD !714: BUILDING DIVISION PERMIT #: Zca —00 d 7 4 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: Phone: (503) 639 -4171 1 " 41 �2, Inspection Requests (24 Hrs.): (503) 639 -4175 I I.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 3 (.0 $ P CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 -1 7 -. � ° Pour Ti <ode Inspection n Description Confirm # Contact # Messa Corrections /Comments /Instructions: - e• Li 2- . i - ,jo 6 Fr efL .., &:R o. .1 ;12E_ g k...14181Q 3 (tuck's 2O , i ii t Ur- ' tr- ' \ / &" " ❑ P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL !I CALL FOR NSPECTION ❑ ADDITI NAL EES ASSESSED Inspector: . 44 Date: / a Phone #: (503) 718-24-7---3