Permit CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2018-00242
Date Issued: 04/12/2018
TIC,tilt is 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136DA00700
Jurisdiction: Tigard
Site address: 11530 SW PACIFIC HWY
Project: Lu's Sports Bar&Lounge Subdivision: None Lot: None
Project Description: Adding(2)single duct exhaust and duct work for TI.
Contractor: CCR IMPROVEMENT LLC Owner: LU,XU JIAN
24323 SE HOFFMEISTER RD HUANG,WEN HUI
DAMASCUS, OR 97089 4798 AUBURN LN
LAKE OSWEGO, OR 97035
PHONE: 503-327-6022 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/12/2018 $78.27
Class of Work: ALT Type of Const: Plan Review 04/12/2018 $19.57
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 04/12/2018 $9.39
Stories: Info Process/Archiving-Lg$2.00(over 04/12/2018 $2.00
11x17)
Project Valuation: $800.00 Info Process/Archiving-Sm$0.50(up to 04/12/2018 $0.50
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 $109.73
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Batheroom
Duct Work: 1 exhaust fans
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OW by calling 51..232.1987 .r 1.800.3 2.2344.
Issued By: / II Permittee Signature:
>/77-0"-/tf..."
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A Received Heat' .__ FOR OFFICE [SE 011.1
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er:k. ,,,,,,, 1,f;'.',--- n 1...,
Date/By:iew / , /,,,,14 Permit No..,i,„te - ,. 0•.-ct... ? 4
City
SWHallHTali1gBalvrddTigard,OR 97223
II Phone: 503.718.2439 Fax: 503.598.1960A P R 1 r." 2 013 Date/By: Other Permit:Au ,,A, • -
TIGARD Inspection Line: 503.639.4175
Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov C:,' Notified/Method: Supplemental Information
SU','
TYPE OF woiu COMMERCIAL FEE* SCHEDULE 7 USE CHECKLIST
Mechanical permit fees*are based on the value of the work
0 New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION ' -RESIDENTIAL EQUIPMENT/SVgfiiisaii:-
...
0 1-and 2-family dwelling a Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
' -
JOB SITE INFORMATION AND LOCATION Heating/cooling:
i i•• Air conditioning 46.75
Job site address: //, )..., 5w Pa*C.+C. er/ Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 1'Ty .4. c/2 7/'2-2 1 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump _ 61.06
Suite/bldg./apt.no.: Project name: LA, 5, s r c=i-1 5 Duct work 23.32
Cross street/directions to job site: Hydronic hot Zfer 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: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK 1 '' •• ' 't Gas fireplace/insert 33.39
, •, ,, Flue vent for water heater or gas
(..g...)C-- 115(e-- At cf e)/14 g 4 sf (h 61-4)f--- ) fireplace 23.32
I
I
Log lighter(gas) 23.32 tiki c'if k
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
..,. - iiopptTy,cnyNtit ' 0 TENANT, ' , Environmental exhaust and ventilation:
Name: )44 1:-A 4, LA,
Range hood/other kitchen
equipment 33.39
Address: 4_7 k A.4.4 i.,t:rip 1-V9 Clothes dryer exhaust 33.39
City/State/ZIP: L‘,..Ic )x.,-ej (K 7 j 0.3 ...I^ Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) ., 23.32
Phone:(s,... ) 4,6_ )5,1 ,./.. Fax:( ) Attic/crawlspace fans 23.32
ji)E•ITAPFERSOI4 , Other: 23.32
Fuel piping:
Business name:
t $14.15 for first four;$4.03 for each additional
Contact name: )64. 7,A,,.... L...,, Furnace,etc.
Address: t/S-1..... 5..4." 4--,c )-f wr Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: 72,c;.....k. c az.. ) 72 2.3 Water heater
Phone:( ) Fax::( )
Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name: C c g 1 t.,--t I,iz,,v- 2_1.2A2_./v7-, Lt_ c.
MECHANICAL PERMIT FEES*
•
Address: 7 trL• 1 2- $ L-
Subtotal
City/State/ZIP: 12 74-ph. /4 c s.. (....t 0 ii,.. 7 7 .-'5)7 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( (5 4" - 47 - 6- 2 2.- Fax:( )
State surcharge(12%of permit fee)
CCB lie.: ,,.2 )6( /2_1(-1-ii TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
,...7 days after it has been accepted as complete.
Authorized signature: )/t... I, A--L.4.- * Fee methodology set by Tri-County Building Industry Service Board
Print name: - 7t A,- L Date: C-/-/ ///(--i
I.\Budding\Permits\MEC_PennitApp_040113 doc 440-4617T( 1/02/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