Permit •',t CITY OF TIGARD MECHANICAL PERMIT
$ : • COMMUNITY DEVELOPMENT Permit#: MEC2013-00663
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/05/2013
. Parcel: 1 S136DA00800
Jurisdiction: Tigard
Site address: 11540 SW PACIFIC HWY
Project: Affordable Granite and Quartz Subdivision: PFAFFLE PLAZA CONDO Lot: 2
Project Description: Hanging 40,000 BTU gas heater with gas piping. 11/7/13,reprinted to correct project name.
Contractor: RONS HEATING&COOLING INC Owner: HIGH HAT RESTAURANTS, INC
13315 SW BARLOW RD 11530 SW PACIFIC HWY
BEAVERTON, OR 97008 TIGARD, OR 97223
PHONE: 503-708-6251 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/05/2013 $99.76
Class of Work: ALT Type of Const: Plan Review 11/05/2013 $24.94
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/05/2013 $11.97
Stories: Info Process/Archiving-Sm$0.50(up to 11/05/2013 $0.50
11x17)
Project Valuation: $1,500.00
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: 1 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $137.17
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, o • 's suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility ••otification 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 ect questions to OUNC b : .232.1987 or 1.800.332.2344.
Iss ed By: / ����� ,�. Permittee ignature:
Call 503.639.4175 by 7:00 a.m.for the next available ins, ion date. •
This permit card shall be kept in a conspicuous place on the job sit- until completion of the project.
• Approved plans are required on the job site at the time of each inspection.
•
CITY OF TIGARD MECHANICAL PERMIT
:I 2 , COMMUNITY DEVELOPMENT Permit#: MEC2013-00663
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/05/2013
Parcel: 1 S136DA00800
Jurisdiction: Tigard
Site address: 11540 SW PACIFIC HWY
Project: Black Rock Coffee Bar Subdivision: PFAFFLE PLAZA CONDO Lot: 2
Project Description: Hanging 40,000 BTU gas heater with gas piping.
Contractor: RONS HEATING&COOLING INC Owner: HIGH HAT RESTAURANTS, INC
13315 SW BARLOW RD 11530 SW PACIFIC HWY
BEAVERTON,OR 97008 TIGARD,OR 97223
PHONE: 503-708-6251 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/05/2013 $99.76
Class of Work: ALT Type of Const: Plan Review 11/05/2013 $24.94
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/05/2013 $11.97
Stories: Info Process/Archiving-Sm$0.50(up to 11/05/2013 $0.50
11x17)
Project Valuation: $1,500.00
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: 1 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $137:17
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. //
I
/V77/P7 --
ssued By:� /r Permittee Sig •�r:
Call 503.639.4375 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received --COQ;
City of Tigard Date/By: i3 •>' • Permit No.: W
13125 SW Hall Blvd.,Tigard,OR 9722 EIVE;i; plan Review
Phone: 503.718.2439 Fax: 503.598.19 0 DateBy: Other Permit. i (7
Inspection Line: 503.639.4175 NOV Date Ready/By: Juris: Si See Page 2 for
f I l A It U g g NOV 5 2013 Notified/Method: •�i Supplemental Information
Internet: www.ti ard-or. ov (`�l /(� (�6 �(O
TYPE OF W&I I OF I IGARD . COMMERCIAL FEE*'SCHEDULE — USE CHECKLIST
�(����1�I(�rt iSION Mechanical permit fees*are based on the value of the work
❑New construction '�flddition/alte►°dtib}b`r¢�119h¢I}{dlYtr performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ f 5-7)'O
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENI4/SYSTEMS FEES*
❑ I-and 2-family dwelling Commercial/industrial ❑Accessory building _ For special information use checklist.
❑Multi-family Master builder ❑Other: Description Qty. I Ea. I Total
' JOB SITE INFORMATION AND LOCATION Heating/cooling:
' Air conditioning 46.75
Job site address: (( O $i/ 13 .(r.4 c_ 1-1--41/ x Furnace 100,000 BTU(ducts/vents) 46.75
—/—�
City/State/ZIP: 9 A 4 Mt I Furnace 100,000+BTU(ducts/vents) 54.91
VI �I Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/diredions to job site: ,��%D,P b,9&f., ,J,re_ eF tQR4Q7-7_, Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric), - —
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
/�,�� t1,, R- 1/i �+ Flue vent for water heater or gas
//Pr/v6 7v1DOD 1 t v( �DT DK, U4� 2/� fireplace 23.32
l Log lighter(gas) 23.32
l../ t!I et.s /[rte_ J ((0 lei �
`'`7 L Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
-0 PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Vi'nt-�.�- v0 Range hood/other kitchen
l n `� r� 2 equipment 33.39
Address: L J /Ef'a'G Clothes dryer exhaust 33.39
City/State/ZIP. (/ v#44/ D� Single-duct exhaust(bathrooms,
,7 toilet compartments,utility rooms) 23.32
Phone:(03) —7.5--,,t_$?t QQ Fax:( ) Attic/crawlspace fans 23.32
�AAP�PLICA�N/T ❑ CONTACT'PERSON Other: I 23.32
�'�"„,,jak Fuel piping:
Business name: /{� $14.15 for first four;54.03 for each additional
ontact name: _ G,.�r
1 1s4G
Address: 1J 3 S— S� Fj', /O / ge
ity/State/ZIP: 6,e_ L ?Q O Furnace,etc.
Gas heat pump
Wall/suspended/unit/unit heater
•
Water heater
Phone:($23) 760 —4,2 c-( Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR . • Clothes dryer(gas)
Business name: Other
�r �IQ�'�`S P ��t ) MECHANICAL fERIMITFE ES"
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) o e
State surcharge(12%of permit fee)
CCB lic.: /s r ° I TOTAL PERMIT FEE j 37.i 7
v This permit application expires if a permit is not obta ned within 180
x days after it has been accepted as complete.
Authorized signature: C * Fee methodology set by Tri-County Building Industry Service Board
Print name: g Ale( e_ it/4 f , Date: /14 J S- >60
I:Building\Permiis\MEC_PermitApp_040113.dac """�"""`"''���_���( 440-4617T(11/OCOM/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.
•
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