Permit 4
CITY OF TIGARD MECHANICAL PERMIT
"il I. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00287
T1GAg_D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/16/2009
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 100
Subdivision: Lot: 0
Project: Panda Express
Project Description: Installation of gas lines for new restaurant. No plan review required per Dan Nelson.
Owner: FEES
SN PROPERTIES PARTNERSHIP Description Date Amount
1121 SW SALMON ST Permit Fee 06/16/2009 $72.50
PORTLAND, OR 97205
12% State Surcharge - Mechanical 06/16/2009 $8.70
PHONE:
Contractor:
PMSI LLC
21195 NW EVERGREEN PKWY #204
HILLSBORO, OR 97124
PHONE: 503 - 466 -2222
FAX: 503- 466 -2211
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $81.20
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notif on Cen e . hose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to OUNC . ling 503.246.6699 or 1.800.332.2344.
I - ued By: A ' /, �� i Permitte ignature: 0 , J L
Call 503.639.4175 by 7:00 a.m. for an inspection that busi • -s 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.
'From: 06/16/2009 13:59 #355 P.001 /002
Mechanical Permit Applicat F ,CEIVED FOR OFFICE 1 SE ONLY
II City of Tigard Received ( toA V9 Permit No.: e 201 ?_ 4
• 13125 SW Hall Blvd., Tigard, OR 97223 1 U N 1 2009
g�j Plan Review
3 Phhone: 503.639.4171 Fax: 503.598.1 Date/By Other Permit:
TI G A R D Inspection Line: 503.639 C IT i �/ OF TIGARD Date Ready/By: 1 El See Page 2 for
Internet: www.tigard or.gov Date Re /Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
❑ 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
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: $ S1,900.00
❑ l- and 2- family dwelling ® Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Master builder For specsl information use checklist.
❑ Multi- family
❑ Description , Qty_ Ea. Total
JOB SITE INFORMATION AND LOCATION Heatmg/cooling
Job site address: 16230 Pacific Hwy Suite 100 Ai conditioning heat pump
(reqq conditioning
site plan shoho wing placement) 14.00
City/State/ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU ( ducu/vents) 17.90
Suite/bldg. /apt. no.: Project name: Panda Express Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
' 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. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas piping only for tenant improvement Flue fireplace 10.00
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
Chimney /liner /flue/vent 10.00
❑ PROPERTY OWNER ❑ TENANT Other. 10.00
Name: Enviromnental exhaust and ventilation
Range hood/other kitchen
Address: 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 Attrc/trawlspace fans 10.00
Other. 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four, $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City / State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax :: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: PMSI LLC Clothes dryer (gas)
Other:
Address: 21195 NW Evergreen Pkwy Suite 204 MECHANICAL PERMIT FEES*
City /State/ZIP: Hillsboro, OR 97124 Subtotal
Phone: (503) 466 -2222 Fax: (503) 466 -2211 Minimum permit fee ($72.50) -7,1.
Plan review (25% of permit fee)
CCB tic.: 158286 , ,, /IQ State surcharge (12% of permit fee) t i � � 0
G�f�/ �� TOTAL PERMIT i s t o t 18 1, ?-0
This permit application expires if a permit not obtained within 180
Authorized signature- days after it has been accepted as complete.
Print name: Lanell Robinson Date: 6/16/09
= Fee methodology set by Tri -County Building Industry Service Board
1:\ Building \Perntits\MEC- PemtitApp_doc 01 /19/07 440 - 4617'(11 /02/COM/WEB)