Permit � CITY OF TIGARD MECHANICAL PERMIT
11111 ' COMMUNITY DEVELOPMENT Permit#: MEC2014-00202
T f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/22/2014
Parcel: 1S 126CA01000
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 145
Project: Bambuza Vietnam Kitchen Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Installation of a new 13 ft.type I hood,exhaust fan,and 16 ft.of gas line.
Contractor: HM&V CONTRACTORS Owner: CAFARO NORTHWEST PARTNERSHIP
PO BOX 1231 PO BOX 422
CLACKAMAS,OR 97015 FLORHAM PARK, NJ 07932
PHONE: 503-734-4490 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/22/2014 $558.53
Class of Work: ALT Type of Const: VB Plan Review 05/22/2014 $139.63
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 05/22/2014 $67.02
Stories: Info Process/Archiving-Sm$0.50(up to 05/22/2014 $20.00
11x17)
Project Valuation: $18,300.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm: 1
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 $785.18
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folk the rules adopted by the Oregon
Utility Notification n er. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. o ay obtain a copy of the rules
or direct que ns to OU by = • 503.232.1987 or 1.800.332.2344.
-4
Issued Permittee Signature: y
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/By: 11 (I{ r Permit Ho r,/� y- O�j
ricr 13125 SW Hall Blvd.,Tigard,OR Plan ReJiew
Phone: 503.718.2439 Fax: 8. � w Date/By: ( Other 6/fD�LU_ �q ati
Jl�y f vw
TI G A R D Inspection Line: 503.639.41 ^ Date Ready y: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Q ION Notified/Method:J/� iy QO,l.Y'I,�`y Supplemental Information
id/Ce-
TYPE OF • ;I 'c1 _,^w� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST_
((��� �'` Mechanical permit fees*are based on the value of the work
❑New construction Addition/alk cement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,aid profit
❑ Demolition ❑Other: °� p
Value:$ 749,3 )`"
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 70 d 7 5G) /47// 2/ur/ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 757.017 �J y,-�!� _ q 7 f 2'0 3 Furnace 100,000+BTU(ducts/vents) 54.91 y
v !� Heat pump 61.06
Suite/bldgJapt.no.: /t/ Project name: o0.l,t b U za U(G/jet t.-f t Duct work 23.32
Cross street/directions to job site: 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: 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater _ 23.32
DESCRIPTION OF WORK Gas fireplace/insert _ 3 3.39
Flue vent for water heater or gas
f4/s /*lit 4f� i7.4.4., l3 �C - rV/G Z- z fireplace 23.32
1 40 // / Log lighter(gas) 23.32
INS 14 ii +,1 O t we(� ei°X19 / 14114 Oli Ihrfr;-rr 0%Y Wood/pellet stove 33.39
o5 A/C am//v / Fr Wood fireplace/insert 23.32
!//7 / Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: _ _ 23.32
Fuel piping:
Business name: j/J V CallaLhr S $14.15 for first four;$4.03 for each additional
Contact name: (9,v 4,p:!2: Furnace,etc.
Gas heat pump
Address:
PO. Al( /23/ Wall/suspended/unit heater
City/State/ZIP: c/, ka Lu&5 D/. ', fs- Water heater
Phone:(�J3) 73#' Fax: :( ) Fireplace
Range
E-mail: )7 P1 ti r,OiAIL lc/seii,q,m,,/i.cvi >i Barbecue .
CONTRACTOR Clothes dryer(gas)
Other:
Business name: 5,9-A-7�✓ MECHANICAL PERMIT FEES"
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: /6 /8 /2..4-//y TOTAL PERMIT FEE
` This permit application expires if a permit is not obtained within 180
-5:7 days after it has been accepted as complete.
Authorized signature: " Fee methodology set by Tri-County Building Industry Service Board
Print name: CE V /Oyc-2- Date: .31-a)/L/
1:1BuildinglPermihllEC_PennitApp_040I 13.doc 440-4617r(1 I/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.
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