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Permit (42) CITY OF TIGARD MECHANICAL PERMIT 'a COMMUNITY DEVELOPMENT Permit#: MEC2017-00315 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/24/2017 T[ � 9 Parcel: 1S135BD01200 Jurisdiction: Tigard Site address: 9802 SW SHADY LN Project: Portland Bagelworks Subdivision: None Lot: None Project Description: Installing oven,and hooking up to natural gas piping. Contractor: SALEM HEATING&SHEET METAL INC Owner: BURDICK-FORBES INVESTMENTS LLC PO BOX 12005 BY DONALD C BURDICK SALEM, OR 97309 434 RIDGEWAY RD LAKE OSWEGO, OR 97034 PHONE: 503-581-1536 PHONE: FAX: 503-370-3780 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 05/24/2017 $102.83 Class of Work: ALT Type of Const: VB Plan Review 05/24/2017 $25.71 Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 05/24/2017 $12.34 Stories: Info Process/Archiving-Sm$0.50(up to 05/24/2017 $37.50 11x17) Project Valuation: $1,600.00 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 $178.38 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Bagel oven Duct Work: and vent Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility • -- • Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or.'ect questions to *UN - ailing 503.232.1987 or 1.800.332.2344. Is•ued By: 0 / 0/ Permittee Signature: 4/-7-// r 1 � Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONI_v City of Tigard Received Date/By: 5 i, 7 a" Permit No.:�/t C } 13125 SW Hall Blvd.,Tigard,OR 97223 , r 1 , Phone: 503.718.2439 Fax: 503.598.196 a Plan Rev1- �� �F Date/Rca :�' Other Permit: TI G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Date Rea`. : H See Page 2 for n�v/ �„17 Notified/Method: Supplemental Information TYPE OF WORK F U COMMERCIAL FEE* SCHEDULE - USE CHECKLIST �' p n�� Mechanical permit fees*are based on the value of the work ❑New construction 0 Addition/alterralhl .L+` 91�6S1�� performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition 0 Other: U It mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ 4 bob RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Fa. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: 9O �:2 S(-v 5ft/40 r L / Air conditioning -46.75 C H /6-.4-12,0 Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: 'j )6_,412,-1) & R- 9 77-2_7) Furnace 100,000+BTU(ducts/vents) 54.91 Suite/bldg./apt.no.: Project name: t� Heat pump 61.06 ��t T L-�F�uJ 8/46 -«/" 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: Lot no.: � 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 0 ;` DES, w PTIO Off' WOE ,; It s,„ 4 Gas fireplace/insert 33.39 n ��. ' ' _ Flue vent for water heater or gas ...1-.11,JTALi-IA./6- 01/&(-I, l-74-)=''Kt-t/t5.- Vi' A1/1-T1)17-4-L. 64S fireplace 23.32 lighte fC9:- ` Log (gas) 23.32 k U S') / (oC` FT/ 9 ' Ce c/,in5/ 1 ZTo Wood/pellet stove 33.39/a-0c' ,� Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 - t ®I PER i'U1!NF 7 a. Other: 23.32 ,, 4 ",, , . '"'' b Environmental exhaust and ventilation: Name: R. /C.-44417--D X44 R .. , i -rz„-rec. Range hood/other kitchen Address: equipment 33.39 O/0� "Al C=.¢L ii"t.,41 ,-UG Clothes dryer exhaust 33.39 City/State/ZIP: J)titLTi.„,scuL.� q 7 Z.3 Single-duct exhaust(bathrooms, Phone: toilet compartments,utility rooms) 23.32 o ) S7' t1 fS s Fax ( ) Attic/crawlspace fans 23.32 1• P . x.. w 3 ,z ONTAt i PE' . ; Other: ,.> OI .. 23.32 Business name: Fuel piping: 115 q 1lc'h�_ $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace E-mail: Range Barbecue N ,- # # ,s CONTRACTOR ^ice '4 I Clothes dryer(gas) Business name: Other: 4(..0 N1 1.(.6-4T,4)6_ `' 4 tMECHANICA.,PERMIT Fist ES w Address: (Z Z S 2:2_`ii b �° S t Subtotal City/State/ZIP: 5,4 LZ:M a i-L Minimum permit fee($90.00) Phone:(co ) Sl / ©oFax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) CCB lie.: (�j� Yi___ligqTOTAL PERMIT FEE 1/7This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. / Authorized signaturefl / 1i �✓, * Fee methodology set by Tri-County Building Industry Service Board Print name: 1atc.,04 tto 13 4 F EL Date: /. // ) I:\Building\Permits\MEC_PermitApp_040113.doc 440-46171(11/02/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. I:\Building\Permits\MEC_PermitApp_040113.doc 2