Permit (29) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00737
TE c-ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2017
Parcel: 1 S 136AD06100
Jurisdiction: Tigard
Site address: 11419 SW PACIFIC HWY
Project: Busters Barbecue Subdivision: None Lot: None
Project Description: Remove and replace existing cooler and freezer.
Contractor: COMMERCIAL REFRIGERATION INC Owner: SCHOLIBO, GEORGE E JR&
5920 NE GLISAN STREET SCHOLIBO, STEPHEN A
PORTLAND, OR 97213-3790 12241 SW TERWILLIGER BLVD
PORTLAND, OR 97219
PHONE: 503-234-6445 PHONE:
FAX: 503-234-0668
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/06/2017 $1,109.71
Class of Work: ALT Type of Const: VB Plan Review 10/06/2017 $277.43
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 10/06/2017 $133.17
Stories: 1 Info Process/Archiving-Sm$0.50(up to 10/06/2017 $37.50
11x17)
Project Valuation: $40,000.00
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 $1,557.81
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: walk in
Duct Work: cooler
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permi - if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requ - you to fo s,. e rul-s adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-#1 090. Youobtaina copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /' Permittee Signature: A ,
Call 50 .639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ON El
Received
City of Tigard Date/By: / v�-y/1 7 /3,7,7_ PermitNo.:p 1. .7.�y j 737
III13125 SW Hall Blvd.,Tigard,OR tI k�rl2" W
g _ ^,.' Plan Revue-- •
is Phone: 503.718.2439 Fax: 503.59I;. A' ' Date/By: l Z Other Permit:
Inspection Line: 503.639.4175 2 ry{� `1 Date Read ® See Page 2 for
TIGARD el LU1i
Internet: www.tigard-or.gov � j' Notified/Method:/v /7 tXi Supplemental Information
TYPE.OF , DIVISION COMMERCIAL FEE* SCHLD1JLE USE CHECKLIST
1� .....1...# Mechanical permit fees*are based on the value of the work
❑New construction %Addition/a teration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and prpSit.
Value:$ t�G�
CATEGORYOF CONSTRUCTION RUCTI(1N RESIDENTIAL EQPME STEMS FEES* .
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
•
JOB SITE IMFORMA ON AND LOCATION Heating/cooling:
�
/�/ g 46.75
Job site address: �� ��7 FurnaceAirconditionin
100,000 BTU(ducts/vents) 46.75
City/State/ZIP: // rge ,( /` Furnace 100,000+BTU(ducts/vents) 54.91
� -0 '�
Heat pump 61.06
Suite/bldg./apt.no.: /Project name: " tiS Duct work 23.32
Cross street/directions to job site: /Ara 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
Other: 23.32
Subdivision: 1 Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
-e: ,��' iv Flue vent for water heater or gas
/�k.0/0Vitt/ 4 i�C.4/``-4 Lx/'<7 / fireplace 23.32
019C-A- Zi ' ^ Log lighter(gas) 23.32
�� Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
-.PROPERTY OWNER .',I L :'d'LNANT m,
.v �. r� ' � Environmental exhaust and ventilation:
Name: ,., .,0 # 5e14p z...,// 4/ Range hood/other kitchen
/ 4114
equipment 33.39
Address: / / .191 _�.'L�f f�C-- Clothes dryer exhaust 33.39
City/State/ZIP: / / 4 7 G� 9 72-2-3 Single-duct exhaust(bathrooms,
r toilet compartments,utility rooms) 23.32
Phone: �\//[[//��//JJ��) Ill__ 2..,//I'�//Zy Fax:( ) Attic/crawlspace fans 23.32
' APPLICANT: ' 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: y � ,‘...i1:4jimiCs $14.15 for first four;$4.03 for each additional
Contact name: ,Lt, M Furnace,etc.
%� � � j S 4� Gas heat pump
Address: Z �� L.),<, /�� � C ` Wall/suspended/unit heater
City/State/ZIP: 1IJ_i 9 < Water heater
Phone: ) f:7gIC�- gp '� Fax::( ) ` Fireplace
C` Range
E-mail: /reissue.ype �'S --f 11
, fr ?I[e *-Com- y �
' ' , Barbecue
CONT Clothes dryer(gas)
" Other:
Business name: �� i�L ,eofe^ - MECHANICAL PERMIT FEES*
Address: [ /�) Subtotal
City/State/ZIP: ./ZTIs .I /3
1 / Minimum permit fee($90.00)
3. Plan review(25%of permit fee)
Phone:(�) / Fax:( ) State surcharge(12%of permit fee)
2"
CCB lic.:b 'l [J TOTAL PERMIT FEE
6 ' This permit application expires if a permit is not obtained within 180
�� 2._ days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:' f ` Dategri
f
1:\Building\Permits\MEC_PermitApp_040113.doc 440-46 (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 14
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
I:\Building\Pennits\MEC_PermitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11419 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-00737
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor