Permit C 1TY OF TIGARD MECHANICAL PERMIT
AI O' • DEVELOPMENT SERVICES PERMIT #: MEC2006 -00102
� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/16/2006
PARCEL: 2S 10X8 -01802
SITE ADDRESS: 13405 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Gas piping for 2 fryers, 1 griddle, 1 broiler, 1 stove and outlets. Value: $1500
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 5
> 10000 cfm: GAS OUTLETS: 5
Owner: FEES
BARUCH, ISAAC TRUSTEE Description Date Amount
BY PACIFIC PIZZA CO [MECH] Permit Fee 21161200E $72.50
1905 NW 169TH PL STE 201 [TAX] 8% State Surchar€ 21161200E $5.80
BEAVERTON, OR 97006
Phone: Total $78.30
Contractor:
WOLCOTT PLUMBING/DBA JACK HOWK
1075 W. HISTORICAL COLUMBIA RI REQUIRED ITEMS AND REPORTS
TROUTDALE, OR 97060
Contact #: PRI 503- 235 -8784 •
FAX 503- 491 -2932
Reg #: LIC 23847
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: Permittee Signature: 1 ' �4,nZd:_ezau .
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 Application FOR OFFICE USE ONL'a
" . Received �t •
. ' City O E�v�D Date/By: • - I 010 b6 PrmitN, '.1 —°_,/& p� /`0
13125 SW Hall Blvd., Tigard. OB. 972 ,'a EC Other Permit: ESIN Phone: 503.639.4171 Fax: 503.598,1 're, v 1
. inspection I .inc: 503.639,4175 13 200 ; A{ , 1,. ��_ i Dille Ready/By: Bl See Page 2 Tor -
Internet: www.ci•tig7rd•or•u•° FEB D c 1 d/Methed: Supplemental Information
"___
TA. '`; •O�A� ('(OINER('IAL FEE' SCBFD1 - USE C'IIE( • r ii Mt Mechanical permstfoe �„ w�ttti c>n •`xa . .:mt ;,; ';,suaAtc
❑ New construction �'Ad ikiR11SL 7t� ep acemtntt performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, a ipmcn la / bor. overhead, and otit.
(.'aTti?GOR1 OF I'ONKTRI'(TION ° Value: $ / h 1 OD
RESIDENTIAL EQUIPMENT / S1'STETIS FEES*
Off 1- and 2- family dwelling ❑ Commercial/industrial Q Accessory building For special Information axe checklist.
❑ Multi- family 0 Master builder ❑ Other: Description 1 Qty. J Ea. I 'total
JOB STYE. 1NIn)RN aTJON AND LOCATION Heatinr000rw -
O V 4 V ' Air conditioning or heat pump
Inb site address: ��� aims site • an AVM _ • eoomcam t 4.00
City /State/ZIP: , .PL f 1 Fom ace 100,000 I3TU (ducts/vent) . 14.00
Furnace 100,000+ BTU (dud:Jvcnta) 17.90
Suite/bldg, /apt. no.: P roject name: A. A .�. _Gras heaiimnr 14.00
Cress streeVdircctions to job site: Duct work 14.00
Hydronic hot water system 14.00 -. '1_. et/(-0— Residential holler (radiator or 111
h dronic 14,00
, Unit heaters (fuel -type. not electric),
in -wall, in -duct. suapcnded. etc. 10.00
Flue/vent for any of above 10.00
Subdivision; Lot no,: Other 10.00
Tax map /parcel no.: Other Patel a0Pllanc
DF,WC'RWPTiON OF WORK Water heater I 10.00
r ; , /7, . 7 3 � , , llu fireplace vent or I L A 10.00
A" : %J�iJ / / i Flue vont frn' water heater or gas
fire�lacc 10.00
Log lighter (at) 10.00
/ l blond/ c� llct stove 10.00
Wood • Iace/insert 10.00
Chinmey /liner /floc /vent 10.00
A PROPERTY OWNER 0 TENANT Other 10.00
Name: A) V 0 , Environmental exhaust and ventilation
Address: ` �� Range hbond/ether kitchen
✓ �..�V V U 1 o�ipmptt 10,00
City'St te/ZTP: / Clothes dryer exhaust 10.01)
._. ��� '%� Single -duet exhaust (bathrooms,
Phone: ( yJ C AF^ r � i a d ) Toilet comTartmcnta utility rooms) 6.80
, ;. aI'PLi(ANT 0 CONTACT PERSON Attie/crawlapacc fans 10.00
Other, r 10.00
Business name: Wolcott Plumbing dba JACK 1OW1C Pi..UMBING & DRAIN Fad
Contact name: 35.40 for first foe r, $7.00 for each additional
Address: 1075 W HISTO CC COLUMBIA RIVER HWY Furnace. etc.
Gas heat pump
City /Sate /ZIP: TROUTDALE, OR 97060 Watt /suspended/unit hotter
Phone: (503)235.8784 Fax:: (503) 4911 -2932 Water heater
Fireplace {�
E -mail: i+ r— !sYD
CONTRACTOR Barbecue
Business name: Wolcott Plumbing dba JACK HOWI< PLUMBING & DRAIN Clothes dryer (gaa� `�
Other: '1
Address: 1075 W HiSPORIC COLUMBIA RIVER HWY ME(TIANI('AL PERMIT FEES'
City/Stale/ZiP: TROUTDALE, OR 97060 Subtotal 6.10
Phone: (503) 235 I Fax: (503) 491 - 2932 Minimum permit fee ($72.50) SD
Plan review (25% of pcmrit fee) j
CCB tic.: 23847 0 1 t (14 10V Sure surcharge (R% of permit fcc r� (
TOTAL PERMIT PE IV t
Authorized signature: 'P p e r adi unification mires if a permit b not obis • • n .
� / D days alter It hat been accepted as comple e--- - - "
I - 7'J
Print name: 7 et , j' ��� / �i7 � �"i C ns
r„„.: ` ,.E $ / I � Fee reediedoi . set by Ti -Comity Building Industry _odd
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Case Activity Listing 7/31/2007 8AM
'C ^C 8AM
�✓G Case #: MEC2006 -00102 9:17:2
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
MEC1010 Application received 2/16/2006 None RECD FAX 2/16/2006
BB
MEC1020 Permit created 2/16/2006 None DONE BB 2/16/2006
BB
MEC1030 Check for parcel tags 2/16/2006 None DONE BB 2/16/2006
BB
MEC1270 Ready to issue permit 2/16/2006 None REDY BB 2/16/2006
BB
MEC1280 Issue permit 2/16/2006 None DONE BB 2/16/2006
BB
MEC2699 Mechanical final 2/20/2006 2/21/2006 _ 2/21/2006 None FAIL MRS 2/21/2006 027208 -01 — 503 - 235 -8784 VM -
STI N -180 •
MEC2699 Mechanical final 3/3/2006 None PASS DAN 3/31/2006
DAN
MEC1740 Case finaled 3/31/2006 None DONE DAN 3/31/2006
DAN
Page 1 of 1 CaseActivity..rpt