Permit �� CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00396
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2013
Parcel: 2S101AC01600
Jurisdiction: TIGARD
Site address: 7100 SW HAMPTON ST 130
Project: Commerce Plaza Deli Subdivision: BEVELAND NO.2 Lot: 18 -19, P
Project Description: Install new exhaust hood and make -up air fans.
Contractor: CARLSON SERVICES INC Owner: NEIMEYER, JOHN
499 ROCK ISLAND RD 15 82ND DR STE 210
WENATCHEE, WA 98802 GLADSTONE, OR 97027
PHONE: 503 - 342 -3420 PHONE:
FAX: 503 - 342 -3420
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/18/2013 $525.51
Class of Work: ALT Type of Const: VB Plan Review 07/18/2013 $131.38
Occupancy Grp: A-2 Occupancy Load: 12% State Surcharge - Mechanical 07/18/2013 $63.06
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 07/18/2013 $5.00
Project Valuation: 11x17)
1 $17,000.00
Fuel Air Handlers
Fuel Types: 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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $724.95
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Make up air
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 'o ificatio 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 d• ect questions to oUNC • ' . -Ili • 503.232.1987 or 1.800.332.2344.
Issu = By: ' Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspecti ate.
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 Applicatio ONLY
Tigard � EI�1EI) Dat I Qf FOR OFFICE USE O N tee's - c .3? 40...
City of Ti and / Permit No.:
° 13125 SW Hall Blvd., Tigard, OR 97223
13 Phone: Review �
Phone: 503.718.2439 Fax: 503.598.1960 Date/B % (� Other Permit: "ay 10/ -DD
T I G A K D Inspection Line: 503.639 JUL . 1 6 20 13 Date Rea !iris. El See Page 2 for
Internet: www.tigard - or.gov ® CITY �, Notified/Method: Supplemental Information
TYPE OF WORK INC DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction laAddition/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: $ 7efertj"
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling LK Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
� Air conditioning 46.75
Job site address: 7 10� S t o 1 D ,,,,r3 T a f\ 5 TC. /, r) _Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: 7 �j. q� /.1 OR ! 7 Z 2 3 Furnace 100,000+ BTU (ducts/vents) 54.91
v Heat pump 61.06
Suite/bldg. /apt. no.: /3 O Project name: _ Duct work 23.32
Cross street/directions to job site: h� Hydronic hot water stem 23.32
�� q o2/ Y Y
Residential boiler (radiator or
_i9% -(M A-151Z4 -- hydronic) 23.32
- 7D T<L Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
„ 5 7,9 LL /VGt) g )(44i 4vs7 01) -d 4 vi d.I fireplace 23.32
Al a k e- OP G 1 FQ>7 5 Log d ghte (gas) 23.32
Wood/pellet t stove 33.39 f
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39 06 71S
Address: Clothes dryer exhaust 33.39
City /State /ZIP: Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: (5 ) Attic /crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
I Fuel piping:
Business name:. M 4l L 4✓� U ejt $ $14.15 for first four; $4.03 for each additional
Contact name: J - 4 c k Furnace, etc.
Address: 7 i do 3 W H qov, to ?01' 0 /3 0 Gas heat pump
Wall /suspended/unit heater
City/State /ZIP: y Cp2 d C) / . ? 7 2 2 3 Water heater
Phone: ( rb3) 3 y y t 7S4 Fax: : (so ) Fireplace
Range
E -mail:
Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: ( G n L 5 D� , t 2 vi . e 5 Other:
l ,I, fI MECHANICAL PERMIT FEES*
Address: 9 4 y Roc k -S /4 ✓iCJ PC` Subtotal 66. 9g
City /State /ZIP: 0 Minimum permit fee ($90.00) 363:
�'j/enA t �f '� �R r G g `i' Plan review (25% of permit fee) q , 3 7
Phone: (6m3) 3 9 2 39 7_ I Fax: (5 3 la/ 3 y 2-0 State surcharge (12% of permit fee) .43. W
CCB lip.: I 3.13 3 3//111 5 TOTAL PERMIT FEE S6 7,f0
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: - li /, - wig • Fee methodology set by Tri-County Building Industry Service Board
Print name: 6 111 - 6'srbp�e.a._ N c aytio r oz Date: /ConiLy_i
I:\ Building\ Permits \.MEC_Permi tApp_040113.doc 440 - 46171(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
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$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.
:\ Buildingl PermitsUMEC_PermitApp_040113.doc 2
III Building Division
Oregon State Mechanical Specialty Code Provisio i..' j: !.''k'.WED
TIGARD
AUG142013
CITY OFTIGARD
COMMERCIAL KITCHEN HOOD BUILDINGDNISION
PERFORMANCE VERIFICATION
Mechanical Permit No.: r ZO 1 3 _ 0 c 3 '-f 6
Jurisdiction:
--7-T- a.1/4rd
Site Address: / ao S U J ff 4d (M ��-
13�-
Type of Hood: 4 Type I Hood ❑ Type II Hood
Classification of Cooking Appliances: ❑ Extra Heavy Duty A Heavy Duty
❑ Medium Duty ❑] Light Duty
CFM of exhaust fan intake 10 minute test: Start of test: 7— (/ 171 3
End of test: 2 q
Dimension of duct opening into hood: /If?(7r'
Duct Velocity: / / 00 M.AO veiV FPM
Length of Hood: q / I q i o)
Amount of total makeup air provided for all hoods: /r 4_ 1 110 2,-- ZZto CFM
Signature: /' Date: Ø9//3
Print name of person performing test: rr.A , Ccu7 )r�
Print name of Contractor: C tt.Vl S ink_- t yi?�5 t CCB #: 1 3z-13
This form satisfies the requirements of Oregon State Mechanical Specialty Code provision 507.16. All information
given on this sheet shall be provided by the installing contractor or air balancing agency if applicable. Information
given shall be obtained by the field testing and site verification of installation information.
This form shall be completed and submitted to the inspector prior to final inspection approval.
•
. (:\Building\Forms\COM-KitchenHoodPerfVerif.doc 07/01/08