Permit (65) CITY OF TIGARD MECHANICAL PERMIT
INCOMMUNITY DEVELOPMENT Permit#: MEC2016-00436
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/22/2016
Parcel: 1$135CB00100
Jurisdiction: Tigard
Site address: 10130 SW NORTH DAKOTA ST
Project: Koi Fusion Subdivision: None Lot: None
Project Description: Type 1 hood installation.
Contractor: BULLDOG MECHANICAL&REMODELING INC Owner: NATIONAL SAFETY COMPANY
3307 NE 39TH ST 17010 SW WEIR RD
VANCOUVER,WA 98661 BEAVERTON,OR 97007
PHONE: 360-901-2610 PHONE:
FAX: 360-693-1505
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/22/2016 $347.71
Class of Work: ALT Type of Const: VB Plan Review 06/22/2016 $86.93
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 06/22/2016 $41.73
Stories: Info Process/Archiving-Lg$2.00(over 06/22/2016 $2.00
11x17)
Project Valuation: $10,000.00 Info Process/Archiving-Sm$0.50(up to 06/22/2016 $7.50
11x17)
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 $485.87
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 foll.w the rules adopted by the Oregon
Utility ' ca(Mr- enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ou may obtain a copy of the rules
or di ct questions to • NC • allin• 503.232.1987 or 1.800.332.2344.
Is ed By: k . / ��(� � Permittee Signature: (
Call 503.639.4175 by 7:00 a.m.for the next available inspection sate.
This permit card shall be kept in a conspicuous place on the job site until completion of t'e project.
Approved plans are required on the job site at the time of each inspection.
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�lui...ur-z ,„mal Af►1..aavw_____- I'OR OFFICE USE ONI.V
.g 't Received
City of Tigard1 1Date/By: ® r1E Permit No.: /
. 13125 SW Hall Blvd.,Tigard,OR 97223 ...,„:„1(,,'c Plan Rev" "" fra 01� � &
11111 s Phone: 503.718.2439 Fax: 503.598.1960 rc 1 tt f Other Permit:
Date/By: �IiL1� *r
-t I 6 IZ I) Inspection Line: 503.639.4175 7
Pi
ay 3 r 1 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov /�1 ;3 Supplemental Information
� 4!<K) Notified/Method:
� FR
�
zx
f. . " **4 - �xin �, ,, f '," a' � ;., k 9 "� °''''''' ✓ rMs A a++:r ,� .., � 3'&�* 8E'.,, N't
3 ,, Mechanical permit fees*are based on the value of the work
D New construction Mi Addition/alterati performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor overhead,and profit.
;' Value $ is 'jt
❑ 1-and 2-family dwellingCommercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description P Qty. Ea. Total
''_ I E ixiii* T ON'ks1 O IOt,1 „ µ Heating/cooling:
f1 11 41.)L5 iy► 11�_ � q Air conditioning 46.75
Job site address: V Z) �"I iT (K 3> f r
City/State/ZIP: 1-2:2-9") Furnace 100,000 BTU(ducts/vents) 46.75
Y � .,Ln
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: V.6 I F-0 12 1151--4 Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
�.�J� P �, -� Residential boiler(radiator or
�� ���' "" 1 ' " S �E� 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
DE (RIPTIONrOF"WORK .= t fireplac insert 33.39
"" Gas e/
I ��1�'�� -FIN Flue vent for water heater or gas
.� . _ , . fireplace 23.32
/ VL-0? AlLog lighter(gas) 23.32
l Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
. . . �I ' ' Oltle, rtzi Ap ;.! Other:
23.32. TY E , '",-4:17711.4.%' Environmental exhaust and ventilation:Name: ^,D V")
UJ OI.1 Range hood/other kitchen
Address: I,0I97i) 1 0"c,Z equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: 716.411-0,0 / 61 '1/-,7 Single-duct exhaust(bathrooms,
-y toilet compartments,utility rooms) 23.32
Phone:(5b ) 1011- v isit/ Fax ( ) Attic/crawlspace fans a s 23.32
� P f/ i t- I i, Other: 23.32
Business name: 6 0") -At\l.,I GA, N 1 ia Fuel piping:
�y6� $14.15 for first four;$4.03 for each additional
Contact name: W 1 Lk/(,2A� l n"` Ml Furnace,etc.
Address: -1,753-Vo 14, J Mil-
heat pump
()0(1...11„4.440
Wall/suspended/unit heater
City/State/ZIP: ell-2-1-i. Water heater
Phone:(t5/-- ) f'1 -9410(� ���� Fax:/:y(/�, ) / ,, Fireplace
nge
E mail
�bo i (Ty (LA I47 6:1 ( it 4i.. .. (.tm I Barbe
r. ! ., 74._.,I
kBarbecue
t a e
�Business name: � � � �; � nn�� ? "; �, � ' ' Clothes dryer(gas)
e: PA i 11�r ii� Other:
t t do ' t< :
Address: ; (?1- p t... "i 6--C' �". ,. 7 at . 1,5'1:1".:7, `;:r.,,,Mi:
Fp ,> �)� Subtotal
City/State/ZIP: V \[r �a, 9 bo) Minimum permit fee($90.00)
Phone:(5(ep) `obi„.14.7.t 0 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee) �/
CCB lie.: I 52``� � TOTAL PERMIT FEE er 455.91
+ This permit application expires if a permit is not obtained within 180
1 , 1' days after it has been accepted as complete.
Authorized slgnat * Fee methodology set by Tri-County Building Industry Service Board
Print name: v IyY' Kuke. Date: 5--4,- I j
I:ABuilding\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/C064/WEB)
Mechanical Permit Application- City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
710407.,
$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.
1:\Building\Pennits\MEC_PennitAPP_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10130 SW NORTH DAKOTA ST, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00436
Jeff Grove
Violation Summary:
Inspector Contractor