Permit CITY OF TIGARD MECHANICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit #: MEC2009 -00181
T I CARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/21 /2009
Parcel: 2S 115 BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 160
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Subdivision: Lot: 0
Project: BISCUITS CAFE
Project Description: TI - install refrigeration equipment.
Owner: FEES
SN PROPERTIES PARTNERSHIP Description Date Amount
1121 SW SALMON ST Permit Fee 05/21/2009 $111.60
PORTLAND, OR 97205 Plan Review 05/21/2009 $27.90
PHONE: 12% State Surcharge 05/21/2009 $13.39
Contractor:
COMMERCIAL REFRIGERATION INC
5920 NE GLISAN STREET
PORTLAND, OR 97213 -3790
PHONE: 503 -234 -6445
FAX: 503- 234 -0668
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -2 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: 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 $152.89
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces: 1 Pln Gen COMPACT SPACES SHALL BE MARKED
Clothes Dryers: Other Mech Units: 2 Pln Gen PLANNING FINAL INSPECTION
Gas Outlets: Other Desc: Condensing
Duct Work: unit for
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may • .tain a copy of the rules
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Issued By: � �l tV . Permittee Signature: /`���
NOV
Call 503.639.4175 by 7:00 a.m. for an inspection 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 ONLY
City of Tigard CEDED Received Of D " , T Permit No.:
111111
• 13125 SW Hall Blvd., Tigard, OR
Date/By: 1�0'�6l�'— �l�/
17 P hone: 503.639.4171 Fax: 503.598.1960 Plan Re e t i v e 0th Permit:
Inspection Line: 503.639.4175 D ateBy: �
T I G A It D APR 2 8 200 Date Rea y: — / � Supplemental 7 Is: See Page 2 for
Internet: www.tigard - or.gov N.tified/Method: f7 41 ( , / Supplemental Information
1111 I GARD itr> ' /L__ M D
TYPE : i ' g1PiG DIVISION 7 O /s I t R IAL FE s *'SCHEDULE — USE CHECKLIST
Mechan •permit fee_ 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: $ -7(D
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling (- Eommercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 G 2 3 5 ( � V i F ( L ��rJ Air conditioning or heat pump
l (requires site plan showing placement) 14.00
City/State /ZIP: —FCci orptzti Ovt___ L - 2 26, Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 6,6 I Project name: '9 i 5Cc..11T ' C_ F. 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: I 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
5` Tiye..gil--7--eLlou A � /1M Q � Gas fireplace 10.00
Q" T ' Flue vent for water heater or gas
iVL CJA J L Ai fireplace 10.00
C �L �' 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
Other: 10.00
Business name: CoQLt deg 6 Ip(._ i I7 't 47 .6,-) Fu el piping
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Contact name: •. /1 iittc Co/c/et.! Cf_. $5.40 for first four; $1.00 for each additional
Address: s 20 Ai E 6-6"/540L) Furnace, etc.
Gas heat pump
City /State/ZIP: Po�� 9 7� /3 Wall /suspended/unit heater
Phone: ( 5p ?) 2 &, e/..4/s Fax: : (.993) ,231/ -U6& Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
` C S , Clothes dryer (gas)
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Business name: _l Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal a jD
Phone: (t C 3) 2 a e.1 l� Fax: (503) 234 _06GY
Minimum (25% fee permit fee) r
Plan review (25% of permit fee) �'B�
CCB lic.: O ' ( � ' 7 / State surcharge (12% of permit fee) 1 +
TOTAL PERMIT FEE i ce ''
Authorized signature: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name:c it c C 6 ri_A ,g `c/ - e_ Date/4 - fU — /2/ I • Fee methodology set by Tri- County Building Industry Service Board
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1:\ BuildingWermits MEC- PermitApp.doc 01/19/07 440-4617T(I1 /
Mechanical Permit Application - City of Tigard
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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.
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