Permit •
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00121
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/16/2009
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 160
Subdivision: Lot: 0
Project: Biscuits Cafe
Project Description: Install (6) gas ranges, and associated gas piping. No plan review required per Dan Nelson.
Owner: FEES
SN PROPERTIES PARTNERSHIP Description Date Amount
1121 SW SALMON ST Permit Fee 04/16/2009 $109.30
PORTLAND, OR 97205 12% State Surcharge 04 /16/2009 $13.12
PHONE:
Contractor:
NEWBERRY ENTERPRISES INC
40110 SE MEADOWSONG RD
SANDY, OR 97055
PHONE: 503 - 668 -0375
FAX: 503 - 668 -0375
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 8 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 $122.42
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 6 Other Desc: ranges
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
issuan • ovk- is..uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U ' Notification Center. T se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. Yo ••' obtain a copy of the rules
Issued By: 011,efuLki Permittee Sig ure: ' ag i
Call 503.639.4175 by 7:00 a.m. for an Inspection that busine ay.
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.
Z)
03/.20/200916:26 FAX 5036680375 NORTHWEST WATER WORKS L003
i
Mechaniteal Permit A lication QP , )1 I It I!
I l City of Tigard O Received
Delei ' 20 - 09 . ' • L . 6i:_sw■I a 4
, - ---• 13125 SW Hall Blvd., Tigard, OR 97223
• I Phone: 503.639,4171 Fa : 501598.1960 v .
•-1 (p•
Plan Review
Date/83r. Other Permit
In Line! 503.639.4175
Date Ready/By
il 55 See Page 2 for
linerner www.figard-orgov
NotifiedNethod: M
Sappkmeanir taronnation
.-.,:.,,,•,,'=',.:„,":77,-,:-.7::...„.11,_•••,.-i ., , --- -
..i•l• !,-,t„A.i.,:.71r;12.15:imr.„,_ , ',it•;,?1,4'ii• ' New consuct
11 trion 0 Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed Indicate the value (rtamded to the nearest dollar) of all
0 Demolition 0 Other:
mechanical materials. -• . ' . . ,.• : . ., . overhead. and .rofit
:7;#:2i':'•'.::0.1:10::_i3-k4:41.;. ..:_t j+WAVed ., , . _ ,. „, ..,, V aille: - __,It l iteTWO 6
0 I and 2 dwelling 2rCommercial/industrial 0 Accessory building
infonreagion sae checIdi.g.
0 Multi 0 Master builder 0 Other: For special
DesaiplioQty Ea_ 1 Total
! , : ;.4.** . k.....ii ; .44:7 : - ... '. T ..-:, , .1 ,_!: . :., , 1'1! ,... Head's/mune . .
, . , Air conditioning or beat ptmm
kb sit° address /b (L / f
7SO4 (roatthes siteilao showing placement) 14,00
...-
__.....-; . .1 .,. .,,,
. Furnace 100.000 BTU (clacts/vents) 14.00
City/State/ZIP: / / /;//,•;•"( ; (i/c--
Stute/hIdgJapt no.: 1110 '
I •
„_ . ,---:-. , , .. Furnace 100,000+ BTU (dim/ vents/
rroject name: 1 6 /..../•-•• L), ir. - - -
17.90
14.00
Cross street/directions to job site:
Duct work _ 10.00 .
_
Ilydzonic 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
_ _
Flue/vent for any of above 6.80
Subdivision:
Lot no.:
Other 10.00
Tax map/parcel no.:
Other feel appliances
.,,,.:„.,:;,:,...: ,,,,, .. , ;...:4,-;:,-:;r0:ma,: , ?;. ,, ....'; :: r'7.' ....• - ' jr: - ''. .. -.,-7'.7`:'6";M:4:"'1".'1'"-;7"; ' ::::7 ' ''' '' : '''' ''';''''''' Water heat" 10.00
7 ' - ;,•,,o,r,..;m,: ' ...;'-'1;rax. •i_:','a••:: 1..;'7. ,;:' „'
Gas fireplace. 10.00
-4 --
+. 7.•:,,,../ ) /..41::;. Flue vent for water heater or gag
_ft.lace 10,00
J C
Log lighterjgas) 10.00
Wood/pellet stove ____
•
•
Wood fimplacermsert 10.00
, - - • - Chintney/linekfluevent • 10.00
a:,• I . f „ ! . •••„ ,••- - -: •-• 4n-:,•L:: 7 . 1 f-r,f7-,;•,..ti- r .---.. ".. ''.,;
' .. ..,4._ L..._ - :`..:....k" Other 10.00
Nemo _
.
Environmental exhaust and ventilation
Ronsc hood/other kitchen
Address:
equirersenl 10.00
City/State/Z
_-- . -
IP:
Clothes dryer exhaust 10.00
_
Single-duct exhaust (bathrooms.
Phone: ( ) Fax ( ) toilet cornpartme utility rooms) , 630
juio micicniviisPa- fans 10.00
Other.
. Business name: ..i) 4: 1.6 ;.' 6.% ;(.'' . '.:76•7,17.:'-'4.S '..; kreJ 10 00 Pining
Contact name: -&• ,-) 1, (...! -7
.. ( 4.7"../ic 55.40 for first four $1.00 for each suiditional
Aess: I /-2 ---' Furnace. etc.
ddr 7 TD .se .;.3 (1:9;-- r-
C
- - - '2 • . '' ' -Y Gas heat pump
State/ZIR: D0 Ad rg ..... i - 1•?41. ,
Wall/suspended/unit heater -
.
Phone ( c r g I Fa)c : ( ) Water heater
Fireplace
i E-mail:
431
.;•71.7Ell',',1-pt-It.n5^7#0:74VA'.01f ..''• c_..11:'•.' 7 . : ' . ;•;':g.TiF - g - akIfialr7. - t?... , ;;;: Babccue
• 1 •• - -•i: ..--- •1 • - / - Clothes dryer (gas)
Business rime: Al 6 1 tc? -i ii t, u c 4_-_C
Other.
Address: q C ,Se• lit ee /7 o a) $/7. .)- /. / ktlafai.********OrigetzW::::;:-st
h
City/State/ZIP7 4 J ., - -:• ;) ij (2,e q .-70" -
-
/ ,' ',-:-. ,- Mini Subtotal
mum permit fee ($72.$0)
Phone: (51)- (ei, - j - ) -- .5 Fax: (i..- =:-')&,‘: 2 8 0.37 -
Plan review (25% of permit fee)
CCB lie.: / / 2 q 7 -
State surcharge (12% of permit fee)
-.
TOTAL PERMIT FEE /, ‘N"'
This permit appficadeo espirm if a penal' le not obtained whhin ISO
Authorized sign - 6 .L..E . ,e. 2 , 14i • /,/,'/"..., ,.
days ofbar it tun boon accepted ow anapier&
Print name: / '61 li-E4t _- _5 4 ,,,,/ 6 . e : - . • Fee methodology stet by Tri-Courny Building Winery Service Board
1.