Permit (181) CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2017-00906
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2018
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12280 SW SCHOLLS FERRY RD
Project: Firenza Pizza Subdivision: None Lot: None
Project Description: Mechanical for TI.
Contractor: UNIVERSAL HVAC INC Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 1950 PO BOX 790830
GRESHAM, OR 97030 SAN ANTONIO, TX 78279
PHONE: 503-912-0108 PHONE:
FAX: 503-482-5895
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/24/2018 $550.91
Class of Work: ALT Type of Const: VB Plan Review 01/24/2018 $137.73
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 01/24/2018 $66.11
Stories: 1 Info Process/Archiving-Lg$2.00(over 01/24/2018 $6.00
11x17)
Project Valuation: $18,000.00 Info Process/Archiving-Sm$0.50(up to 01/24/2018 $10.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Fumaces>=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: 2 Vent Systems: Total $770.75
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: 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 Notification 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 direct questions to OUNC by calling 503.232 1987 or 1.800.332.2344.
Issued By: , K,,,,./ ..---..,... .7,
/� ^ �� 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 l OR OFFICE 1 SE("LI
City of Tigard T Received q
E • Date/By: lJ(/5"a/7 PermitNo.:/ a Yl�j
II
4 13125 SW Hall Blvd.,Tigard,OR 97223 -t- plan Review y 1 1 ` (t e^
_ Phone: 503.718.2439 Fax: 96tty
Date/By: -+ {� Other Permit: y
J a , K7 11,16)17"oci'iq
i-1 G A R D Inspection Line: 503.639.4175 r,v (� j Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov U 3 g2'°1` Notified/Method: (i�( - /P Supplemental Information
#� / i ,
° Ill -4Ii4 ka p'+t l C1Ai 1 t. :,,c lE z:::
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alter ' performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ®Other:Tenant Improvem mechanical materials,equipment,labor,overhead,and profit.
Value:$$1800 0
to.N-sTVC IN ;
. .,,
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description 1 Qty. I Ea. I Total
9 W I ,F;04 Xt'r0 L A'1€'llE3i*
Heating/cooling:
Air conditioning 46.75
Job site address:12280 SW SCHOLLS FERRY RD 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.: Project name:FIRENZA PIZZA Duct work 23.32
Cross street/directions to job site:SW 121ST AVENUE Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
/ Unit heaters(fuel-type,not electric),
t 6A/V t VOA VYvv/) I' e f Wf littan-,0 t2&(,Ct Gt in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
�, S � t�vA �� Other: 23.32
Subdivision: - 9 .. Lot no.:
�-^�^l • Other fuel appliances:
Tax map/parcel no.:1S134BC00300 Water heater 23.32
6;i�Mk:o 6:kkGas fireplace/insert 33.39
Flue vent for water heater or gas
TENANT IMPROVEMENT-REMODEL INTERIOR TO CREATE FIRENZA fireplace 23.32
RESTAURANT Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
tWit *PE� OWNER Other: 23.32
- ' NAI , . . ..._
Environmental exhaust and ventilation:
Name:KAITENPDX LLC DBA FIRENZA PIZZA PORTLAND Range hood/other kitchen
equipment 33.39
Address:12280 SW SCHOLLS FERRY RD Clothes dryer exhaust 33.39
City/State/ZIP:TIGARD OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(971)282-7860 Fax:( ) Attic/crawlspace fans 23.32
APuut ANT Other: 23.32
Business name:WINDWARD DESIGN SERVICES LLC Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name:MISAEL CONTRERAS Furnace,etc.
Address:424 OLIVE ST. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:SANTA BARBARA CA 93101 Water heater
Phone:(805)886-0784 Fax::( ) Fireplace
Range
E-mail:MISA@WINDWARDENG.COM Barbecue
C�IC < Clothes dryer(gas):
Business name:TBD }, Other:
Address: 100 j2 /'S 0 Subtotal 550.91
X
City/State/ZIP: (JY PS�tGi ��� ?L2 7 Minimum permit fee($90.00)
Phone:(s-03) ?7,2„ Plan review(25%of permit fee) 137.73
�� -(771,2 -- Fax:( ) State surcharge(12%of permit fee) 66.11
CCB lic.: I j 7 it D.3 0 /� 117 TOTAL PERMIT FEE 754.75
` I 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
Print name: MISAEL CONTRERAS ` Date:11/7/2017
I:\Building\Permits\MEC Permi App_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi Family Fee Schedule:
' � Iua tons Pe t Vie .
$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
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1111 = Tr
ansmittal Letter
T c,A li C) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: 000 DATE RECEL,V
DEPT: BUILDING DIVISION4,,
RECEIVED
JAN 17 2018
FROM: g�'1'�til 2_to, t/ CITY + �.iG
a"�1
Abp 1,lit,DING IVISIO
(`7 COMPANY: KAtr�lii, fax LL L Ft/'�,z z �i zz et
PHONE: 171 -2- r2- CIF O
RE: (SiteA�dr s� L&v S al I'C�✓� ,t/'11176Ak4 � � t 7 W/O()
(Permit Number)
✓frIvzk
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE°USE ONLY
Routed to Permit Technician: Date: J---a 4 - ) Initials: TJ
Fees Due: ❑Yes No Fee Description: Amount Due:
$ Jv
Special
Instructions:
Reprint Permit(per PE): [ I Yes No [ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12280 SW SCHOLLS FERRY RD, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-00906
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Duct detector pass
Violation Summary:
Inspector Contractor