Permit n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00016
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/17/2013
Parcel: 1 S136DB02400
Jurisdiction: TIGARD
Site address: 11640 SW PACIFIC HWY
Project: Georges Giant Burgers Subdivision: AZOIC TERRACE Lot: 1
Project Description: Installing (1) 4 ton gas pack unit on roof and spiral ductwork in restaurant. Moving (1) split A/C in back from
ground to roof
Contractor: RONS HEATING & COOLING INC Owner: CHAMPION, RONALD V & ROBERTA E
13315 SW BARLOW RD 16449 LEXINGTON CT
BEAVERTON, OR 97008 LAKE OSWEGO, OR 97034
PHONE: 503 - 708 -6251 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/17/2013 $254.98
Class of Work: ALT Type of Const: VB Plan Review 01/09/2013 $63.75
Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Mechanical 01/17/2013 $30.60
Stories: 1 Misc Administration Fee 01/09/2013 $0.25
Project Valuation: $6,680.00 Info Process /Archiving - Sm $0.50 (up to 01/17/2013 $0.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressure: 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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $350.08
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: litt ,( /; U Permittee Signature: f�� 7zi
w l Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 RECEIVED Date 1 9 ' u
Permit No
111 III ° 13125 SW Hall Blvd., Tigard,OR 97223 D 3 _���
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review `
Date/By: , t c3 Other Permit:
TI G R D Ins Line: 503 JAN 0 9 2 013 Date ReadyBy: luris: ®See Page 2 for
Internet:. www.tigard - or.gov Notified/Method: 1/ /3 11 Supplemental Information
CITY OFTIGARD c.10.42.L. 4 / Q ■
TYPE OF W hJIiLDING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction 0 Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhea and profit.
Value: $ to, ,-81((``��
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT S YS TEMS FEES*
❑ 1- and 2- family dwelling (Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 116(.10 J$ w Mc (F(c #4/j/ (requires site plan showing placement) k 46.75
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) x 46.75
Cit
y 7 0 0 2 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: G Eof E4 c (f? "T B""Qb� Heat pump
S (requires site plan showing placement) 61.06
Cross street/diredions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
VI VI �� /� Gas fireplace/insert 33.39
f is n -k_ ��t
Tfra-PVG 4 N G� P�k VI T Flue vent for water heater or gas
• t y re(g -DL b(/LrGt/dR / k6SE v,v fireplace 23.32
/' , Log lighter (gas) 23.32
'-- ,So M,0 vi 1V 6 Sep ( ( �G IN &k f7ir1 Wood/pellet stove 33.39
C eo VN�' To go , Wood fireplace /insert 23.32
PROPERTY OWNER I IR TENANT Chimney/liner /flue /vent 23.32
Other: _ 23.32
Name: CaS 6-y I36-g D Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
. City /State /ZIP: _ Clothes dryer exhaust 33.39
Fax: Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
/. _ , Other: . 23.32
Business name: re,„,; d f CODL//v6 //v �/ C. Fuel piping:
Contact name: W At' $14.15 for first four; $4.03 for each additional
Address: C 33/ Sid' it low I ` e Furnace, etc.
Gas heat pump
City /State /ZIP: (3eie,r4 - OK 700 ' Wall /suspended/unit heater
Phone: ( 03 ) 7 62s( Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: Seine Clothes dryer (gas)
Seine Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Q
Phone: ( �) I Fax: ( ) (25% Minimum permit fee ($90.00)
j Plan review (25 of permit fee)
CCB lic.: 40 1 1f C a ( I t df State surcharge (12% of permit fee)
TOTAL PERMIT FEE I' 2 ,.17
4/144-4 This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: /ta /l( — C. 4/#1 I Date 3 ftf g ( �4 `j • Fee methodology set by Tri -C ounty Buil¢fng Industry Service Board
1:\Building\Permi PermitApp.doc 03/07/12 4404 , nt
617T(11/02/COM/WEB) �
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
8
$2.81 for each additional $100.00 or X
fraction thereof, to and including JV
$10,000.00. _
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and 2:;2.1 7
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\ Building \Permits\MEC- PermitApp.doc 03/07/12 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11640 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Mechanical
615 Mechanical rough-in
03/29/2013 00:00
MEC2013-00016
FAIL
No gauge on pipe
Violation Summary:
Inspector Contractor