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Permit
CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2015-00759 'r 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/19/2015Parcel: 2S102AC00500 Jurisdiction: Tigard Site address: 12492 SW MAIN ST Project: Baileys on Main Subdivision: BURNHAM TRACT Lot: 1 Project Description: 1/20/16:REPRINT permit to Change scope of work:Install Class I hood,fan, make-up air unit,control panel and install exterior gas line to hood only. This permit does not include installation of regulators,and testing of each line to cooking equipment. Contractor: AFFORDABLE RESTAURANT HOODS SALES & INST, Owner: WOODARD LIVING TRUST 2121 SE OCHOCO ST PO BOX 23303 PORTLAND, OR 97222 TIGARD, OR 97281 PHONE: 503-805-1463 PHONE: FAX FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 11/19/2015 $339.28 Class of Work: ALT Type of Const: VB Plan Review 11/19/2015 $84.82 Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 11/19/2015 $40.71 Stories: Info Process/Archiving-Sm$0.50(up to 11/19/2015 $10.00 1107) Project Valuation: $9,650.00 Misc Administration Fee 01/20/2016 $45.00 Fuel Air Handlers Fuel Types: Natural Gas Units< 10000 cfm: Gas Pressure: Units> 10000 cfm: Furnaces Boilers 8 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 $519.81 Hoods: Comm Incinerators. Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: 3 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. Issued By: r ittee Signaluii?. 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. CITY OF TIGARD MECHANICAL PERMIT Ct Permit#: MEC2015-00759 . �,� COMMUNITY DEVELOPMENT Date Issued: 11/19/2015 TlGA• 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102AC00500 Jurisdiction: Tigard Site address: 12492 SW MAIN ST Project: Baileys on Main Subdivision: BURNHAM TRACT Lot: 1 Project Description: Install Class I hood,fan,make-up air unit,control panel and install gas line for cooking equipment under hood. Contractor: AFFORDABLE RESTAURANT HOODS SALES & INSTJ Owner: WOODARD LIVING TRUST 2121 SE OCHOCO ST PO BOX 23303 PORTLAND, OR 97222 TIGARD, OR 97281 PHONE: 503-805-1463 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 11/19/2015 $339.28 Class of Work: ALT Type of Const: VB Plan Review 11/19/2015 $84.82 Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 11/19/2015 $40.71 Stories: Info Process/Archiving-Sm$0.50(up to 11/19/2015 $10.00 Project Valuation: $9,650.00 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 $474.81 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: 3 Other Desc: Duct Work: Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: •ermittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY �n 1111 City of Tigard De eve ( Permit No ljf 0?�l S 007"� 13125 SW W Hall Blvd.,Tigard,OR 97223[[�� (��I Y �D ©� /J I Phone: 503.718.2439 Fax: 503.598.196�1� DateBy:Review� � t'j� /�,u f�1 c- 3'0I �e;,i / Other Permit: T I('A P.n Inspection Line: 503.639.4175 Date Ready : El See Page 2 for Internet: www.tigard-or.gov 3 2015 Notified/Method: El Seemental Information Nov fl M /7(11.1. k -, . , TYPE OF WOI�Ii' ., COMMERCIAL FEE* SCHEDULE - USE CHECKLIST i '� .- � Mechanical permit tees*are based on the value of the«ork El New construction El Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑ Demolition Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ 9 co SZ-) CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling Eommercial/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: /„2.1.,€1...2.- /yj,/, S/' Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: -775 4nc.I O Fumace 100,000+BTU(ducts/vents) 54.91/ Heat pump 61.06 Suite/bldg./apt.no.: Project name: 6-4 1 toy rs ' /t�J,p,ti Duct work 23.32 Cross street/directions to job site: J 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 / rr� /l D Flue vent for water heater or gas �h s1-ar it /6 / CIA 1 I 2 �v d) ?r-n M'I(c -v! fireplace 23.32 I / Log lighter(gas) 23.32 4 i r V^ (�/ 6 J/14- ry I pa etc l Q Act Wood/pellet stove 33.39 I A S Ie /1 -y...1 L1 n e, C-kl ecru lc!.0, Wood fireplace/insert 23.32 15" 7 vt m,-, J u ,i L G e i /. / Chimney/liner/flue/vent 23.32 C T �f t'T� Other: 23.32 PROPERTY OWNER TENANT 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: I ) Attic/crawlspace fans 23.32 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Fuel piping: Business name. $14.15 for first four;$4.03 for each additional Contact name: AFFORDABLE RESTAUARNT HOODS Furnace,etc. Address: 2121 SE OCHOCO ST. PDX, OR 97222 Gas heat pump CCB#199914 Wall/suspended/unit heater City/State/ZIP SALES @AFFORDABLERESTAURANTHOO Water heater Phone:( DS.COM Fireplace Range E-mail: Barbecue AFFORDABLE RESTAUARNT HOODS Clothes dryer(gas) Business name: 2121 SE OCHOCO ST. PDX, OR 97222 Other: MECHANICAL PERMIT FEES* Address: CCB#199914 Subtotal SALES @AFFORDABLERESTAURANTHOO Minimum permit fee($90.00) City/State/ZIP: DS.COM Plan review(25%of permit fee) Phone:( 5 d, . 90 S— /y d•5 Fax:(`) State surcharge(12%of permit fee) CCB lie.: f ff7/y--5//7 /7 TOTAL PERMIT FEE (( F This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized sign • Fee methodology set by Tri-County Building Industry Service Board Print name:174 r>1 e L Ma�. Jr,Dam Date: %//i//r 1:\Building\PermitsVMEC_PermitApp_040113.doe 440-4617T(I 1/02./COM/WEB)