Permit (20) CITY OF TIGARD MECHANICAL PERMIT
'111COMMUNITY DEVELOPMENT Permit#: MEC2017 00132
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2017
T r c..A r n g Parcel: 1S136CD00100
Jurisdiction: Tigard
Site address: 11705 SW PACIFIC HWY Z
Project: Papa Murphy's Pizza Subdivision: None Lot: None
Project Description: Modification of ducts,install bath vent fan,exhaust fan&vent dryer. Utilize existing RTU.
Contractor: SALEM HEATING&SHEET METAL INC Owner: PACIFIC CROSSROADS PROPERTIES IN
PO BOX 12005 BY WYSE INVESTMENT SERVICES CO
SALEM, OR 97309 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE: 503-581-1536 PHONE:
FAX: 503-370-3780
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/16/2017 $291.51
Class of Work: ALT Type of Const: Plan Review 02/16/2017 $72.88
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 02/16/2017 $34.98
Stories: Info Process/Archiving-Lg$2.00(over 02/16/2017 $2.00
Project Valuation: $8,000.00 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: 1 Vent Systems: Total $401.37
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: 1 Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 No . ion .-nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir-• questions to e N • -Iling 503.232.1987 or 1.800.332.2344.
Iss ed By: _/, ��J, / 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 Appliliii 6.,.. FOR OFFICE USE ONLY
City of Tigard Received 4 ��
Date/By: 7 Permit No.:
t 13125 SW Hall Blvd.,Tigard,OR 97216-B 16 2016 �g 1'! O�? �3�,
i S Plan Review 44,10 !
Phone: 503.718.2439 Fax: 503.598.1 6T Date/By: Other Permit: ,.AZ/.2-
TIGARD Inspection Line: 503.639.4175 - 1`�., to L Date Read/B )oris: El See Pae 2 for
Internet: www.ti and-or. ov ( ` ' ''/42 L Ready
y g
g g BUILDING IN( DlVa S!ON1 Notified Method: Supplemental Information
E r ;y,� �j i i / .:: mI ' �`f:E>< g r E ogt -,:COIVIMERCIAI ttioSCHEb7t.`o 3C 5g,CHEC.I045T-'
._6I;.EkH"? F `r !4o vE, 7 r,,,, o.11I1 7 f,.�..i�aR .ni,Nx [ .._' ... .,.E,a a .s. : ----
Mechanical
permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
' . i
Value:$
8000.00
;y r� rot � * f Ir , eIL® N' }E aii RE
g,;,,,,gt . ...� ._ .m....8 IC . .i 4 1kik 1 tl ' € Iei
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total
,h JOB'SITE 1NFORMA.TIONgEA D I OCATION ! i if i 44 'i , Heating/cooling:
Air conditioning 46.75
Job site address:11705 SW Pacific Highway Suite Z Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:Z Project name:Papa Murphy's Duct work 23.32
Cross street/directions to job site:Highway 217&SW Pacific Highway Hydronic hot water system 23.32
Residential boiler(radiator or
0. 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
n t r /'''"�{ & E@'Esr E '" r t ..;,,,,h, Gas fire lace/insert 33.39
R.-.,,,,,6 1fr„ 11011 1t- .. S to •. 21) - .. AORW .._glib . E 9..� :: ' i�€i°, 4 p
Flue vent for water heater or gas
MVAC Modifications for new Tenant,new duct distribution,install/vent bathroom fireplace 23.32
Exhaust fan,vent dryer. Utilize existing RTU. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
,, •, t o l*; r 16 t r I E Other: 23.32
' . SR ..a� s=- °'�° y�.'' �"°" ��--- '" . " 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,
w toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
ti# I'EOther23.32
. Q. � LOAN3 € t; ❑ GN GT ISOI s ,: :
Business name:Salem Heating&Sheet Metal Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Brooks Gladow Furnace,etc.
Address:PO Box 12005 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Salem OR 97309 Water heater
r._,
Phone:(503)581.1536 Fax::(503.)370.3780 Fireplace
ao
Range
E-mail: bgladow@salemheatingandsheetmetal.com Barbecue
1 1 t f �4r"+$ 0§R + riE.O } z! ! 4-
Clothes dryer(gas)I 9 . 1 " I.Pg .s E u M ir1 ,, . t 3 €
Other
Business name:Salem Heating&Sheet Metal
Address:PO Box 12005 Subtotal a,i.5
City/State/ZIP:Salem Heating&Sheet Metal Minimum permit fee($90.00) -
Plan review(25%of permit fee) -
Phone:(503.)581.1536 Fax:(503 )370.3780 State surcharge(12%of permit fee) 311.98
4. CCB lie.:1505 TOTAL PERMIT FEE $3z6•H 1
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
Z(
Print name:Brooks Gladow Date:2/16/17
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(t 1/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
,ss H11 3 ..! �,.,.,,_ ` ...........a_....
$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.
Gi
Note: All new commercial buildings require 2 sets of plans.
G1„
I:\Building\Permits\MEC PermitApp_040113.doc 2