Permit , CITY OF TIGARD MECHANICAL PERMIT
.1111, s , COMMUNITY DEVELOPMENT Permit#: MEC2015-00227
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/23/2015
Parcel: 15 135BA00102
Jurisdiction: Tigard
Site address: 10218 SW WASHINGTON SQUARE RD
Project: Noodles&Co. Subdivision: OAKBURG Lot: 9
Project Description: Gas piping only
Contractor: ROCK CONSTRUCTION INC Owner: PPR SQUARE TOO LLC
PO BOX 2118 PO BOX 847
WILSONVILLE, OR 97070 CARLSBAD,CA 92018
PHONE: 503-568-4043 PHONE:
FAX:
FEES
Specifics; Description Date Amount
Type of Use: COM Permit Fee 04/23/2015 $130.46
Class of Work: ALT Type of Const: VB Plan Review 04/23/2015 $32.62
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 04/23/2015 $15.66
Stories: 1 Info Process/Archiving-Lg$2.00(over 04/23/2015 $4.00
Project Valuation: $2,500.00 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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $182.74
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 d. • NTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center, Those rules are set fort' in OAR 952-00 /010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.:/0.332.2344. )
Issued By:f / 1 - Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard , 1 ; DateBya fr, /5 Permit No.: g 5
ill
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie•8 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: `,' I' 4 p a her Permit: ;-f i 0 �C/s elo l
T I G A R D Inspection Line: 503.639.4175 2, l), ` Date Ready:y: ' Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Cf'/03 /. , /, Supplemental Information
r (1# A 0,0,14,!!'
Mechanical permit fees°are based on the value of the work
tgiNew construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ . •sue • ,I•,l Iif l"'l6rt`•.1 i ! )i 1 ; .1 I
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. I Total
Heating/cooling:
1+ Air conditioning 46.75
Job site address: 10 2.(� s w (A)441,„„,„5"
41,.„„,1.►,,51, fz`. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: /t 0 t2 q--).1-2-3 D Furnace 100,000+BTU(ducts/vents) 54.91
' `" Heat pump 6 LO6
Suite/bldg./apt.no.: Project name: a„„{(e 1. r CO . Duct work _ 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
,,,., 1,204-'1 ,� (�a3►ti,,33v., 57... . hydronic) 23.32
J Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: f Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater AK 23.32
DESCRIPTION OF WORK i Gas fireplace/insert 33.39
/` Flue vent for water heater or gas
(31_,4Zi fireplace 23.32
Log lighter(gas) 23.32
(� Wood/pellet stove 33.39
Wood fireplace/insert 23.32 .
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNE ❑ TENANI 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
Other: 23.32
_ Fuel piping:
Business name: O (a,,,S f y ` S14.15 for first four;$4.03 for each additional
Contact name: (20 tic. ed'Le Furnace,etc.
Gas heat pump
Address: P`,,a,_, a I.(g. Wall/suspended/unit heater
City/State/ZIP: (Ai%(sue,..,✓.j( , p to R 767', Water heater
Phone:(5) )-5-66-- K°43 Fax::( ) Fireplace
Range
E-mail: rc C l4v 4'c, O- .:1; GO/v1 Barbecue
Clothes dryer(gas)
D Other:
Business name: F 4 L e--- N c k c- `M�
Address: Pa.l, a 11 8 ✓ Subtotal
City/State/ZIP: ��J 17 Minimum permit fee($90.00)
ty - l���J�`lam / 0 Plan review(25%of permit fee)
Phone:(31j 3) 5--68 _H,p,4_3 Fax:( ) State surcharge(12%of permit fee)
TOTAL PERMIT FEE /
CCB lic.: i)2 1--) 2.711
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name:,016 �t:i („ge,lcs(.e I-Date:q. - 2—/5
I:\Building\Permits\MEC_PennitApp_040113.dac 4404617„(I 1/o2/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil Fee Schedule:
$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.
I:1BuildingWermits\MEC_Permi1App_040113.doc 2