Permit (152) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-01010
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/11/2018
T r 'A h.l 7 9 Parcel: 1 S 136CD00100
Jurisdiction:
Site address: 11705 SW PACIFIC HWY X
Project: Donut Day Subdivision: None Lot: None
Project Description: Type I hood installation.
Contractor: DAN CO CONSTRUCTION Owner: PACIFIC CROSSROADS PROPERTIES IN
55695 VIEWCREST PL BY WYSE INVESTMENT SERVICES CO
WARREN, OR 97053 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE: 503-997-3744 PHONE:
FAX: 503-366-0405
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/11/2018 $344.90
Class of Work: ALT Type of Const: VB Plan Review 01/11/2018 $86.23
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 01/11/2018 $41.39
Stories: 1 Info Process/Archiving-Sm$0.50(up to 01/11/2018 $10.00
Project Valuation: $9,900.00 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: Vent Systems: Total $482.52
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of,tie rules
or direct questions to UNC by calling/03.232.1987 or 1.800.332.2344. ,/
Issued By: 14,4� Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONE)
Cityof TigardReceived "� ')
IN " ga P Date/By: 117' 1 / Permit No.:�f'_,- 7���l el
13125 SW Hall Blvd.,Tigard,OR 97AEC'p C:E / L°
C ED Plan ' t
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �1i1% 1 16 to Other Permit:
T I G A K D Inspection Line: 503.639.4175 11 L 1' 1 9 Z 01 r Date Read : : Juris: sr See Page 2 for
Internet: www.tigard-or.gov J� (yy �}y{ p Notified/Method: " Supplemental Information
.di P OF Y GA D ', '° ,
TYPE O Vt'e ING DIVISION ; : �. I I RCIAL F'EE* SCHEDULE'-USE CHECKLIST
' Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,andprofit.
Value:$ 99p0 R
CATEGORY OF CONSTRUCTION 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. Ea. Total
JOB SITE;INFORMATION AND"LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: //7
D�' j /
/'teCa 74C. /"liv. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: // oea K / U
Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
_
Suite/bldg./apt.no.: I Project name��e.+v r, Duct work _ 23.32
lr
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
A Lk I Unit heaters(fuel-type,not electric),
_ � S�a -cS ��n�,t- Sf��'rC}?� in-wall,in-duct,suspended,etc. 46.75
e ., f ' Flue/vent for any of above 23.32
r .41/ iT ito ,.. - sA1 , J ther: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
4'. DESCiUPTION OFA►'ORI{ ..-,,,,,414„.
,. , � `z ij Gas fireplace/insert 33.39
�� Flue vent for water heater or gas
/ c/ 24 cro,c771171 fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 /
±. 0 PROPERTY Other: 23.32'OWNER ❑ [E:NANT //
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑y APPLICANT ID CONTACT PERSON n Other: 23.32
Fuel piping:
Business name: ,40,ti _,G 0
$14.15 for first four;$4.03 for each additional
Contact name: ��� Furnace,etc.
Address: C" Gas heat pump
v�� �� v��' C �� Wall/suspended/unit heater
City/State/ZIP: 6,0 /1z,terjrz&A) O ! 2 0.173 Water heater
Phone:(Tea) 5 p7 07x5, Fax::( )) Fireplace
E-mail: 04160 j L,+ e / s1 �,� / Range
� N t� J'�G$��/� C�1'� Barbecue
• y-= ' - ON CTOR Clothes dryer(gas)
Business name: �} Other:
o9Ci�?/'►j _....0 C�
C �L MECHANICAI'PERMIT FEES!'
Address: c f-d A.5,-- U/� C"'�! p/ Subtotal
City/State/ZIP: Minimum permit fee($90.00)
�.0„.t-tv e 4 ,77sJ -
Phone:(_rd) 9,9? .2/” � Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.: //O 5"7 & TOTAL PERMIT FEE
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 IndustryService Board
Print name LAN �+�y� 6/1
Date:�a�����
I:\Building\Permits\MECPermitApp 040113.doc 440-4617T(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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11705 SW PACIFIC HWY X, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-01010
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor