Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2018-00659
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2018
TIGARD g Parcel: 1S134BC00300
Jurisdiction: Tigard
Site address: 12286 SW SCHOLLS FERRY RD A
Project: Kaba Grill Subdivision: None Lot: None
Project Description: Installing kitchen hood for TI.
Contractor: PCI PERSONAL CONSTRUCTION Owner: FW OR-GREENWAY TOWN CENTER LLC
410 BEAVERCREEK RD, STE 513 PO BOX 790830
OREGON CITY, OR 97045 SAN ANTONIO,TX 78279
PHONE: 503-679-3461 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/18/2018 $474.71
Class of Work: ALT Type of Const: VB Plan Review 09/18/2018 $118.68
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 09/18/2018 $56.97
Stories: 1 Info Process/Archiving-Lg$2.00(over 09/18/2018 $8.00
11x17)
Project Valuation: $15,000.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units> 10000 cfm: 2
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 $658.36
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ou may obtain a copy of the rules
or direct questions to OUNC by calling 503.23 .1987 or 1.800.332.2344.
Issued By: A' Permittee Signature
Call 503.639.4175 by 7:00 a.m.for the next available in pection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatiort-c FOR OFFICE USE ONEN'
City of Tigard Received z,,, /r Pernii2Pt fl--1.0/F--006.... ,
Date/By: 4
13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 1 2018 X
• il
' Phone: 503.718.2439 Fax: 503.598.1960
,III DPlaatne/RBeyv:Review. .$) .23
.- ...,1 t Other Plr6,re _0,,3
(_.,1 ! y ,, ,,- ;,-I., '. ,
TIGARD Inspection Line: 503.639.4175 - , s I'',' - - Date Ready/By: • ? Juris: See Page 2 for
Internet: www.tigard-or.gov r-,:= ° ,'`'e',• . f''- ".''' Notified/Method: t'/Q
1 e/ 7 Supplemental Information
TYPE OF WORK , a, i r CO '1 Item FfE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
O New construction D Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and proA
Value:$
coy:II:myoF CONSTRUCTION .. ,
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
O 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
,JO1 gr''1:'vfNi'ORIVIATION AND'LOCATION , Heating/cooling:
Air conditioning 46.75
Job site •
address/ S tA) cvevep•Sr_A 40/*Vc 1Z Furnace e., A90/ Furnace 100,000 BTU(ducts/vents) 46.75
7 Furnace 100,000+BTU(ducts/vents) 54.91
City/State/ZIP: -/-7,
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: - -
. . „, , I , .\_ ., Duct work 23.32 /
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
/ 4-64- 641 Z--L--- 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
"4"*.';1'tsEscRipricji. 17, -'„,"04. .74710, Gas fireplace/insert 33.39
''''''' '''''' ""'''''''''. ' ''' Flue vent for water heater or gas
bG;$/',Nr2S-p( fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
t1'PR&RTY OWNER. -k, ITENANT Other: 23.32
- , ,ezt...A '' Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39 7
Address: 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
0 AppLie4iff,,,„*.*.t: Jr :- 0 CONTACT;P*::ON Other' 23.32
Fuel piping:
Business name:pc/pcz y-5.0 n a.../(17)..?s fict.,0_,?(;.....3_,
$14.15 for first four;$4.03 for each additional
Contact name: pX,V/ii, r‘4:4- Furnace,etc.
Gas heat pump
Address: ,,.•
I-42-dr-ic R-001 #.5-!3 Wall/suspended/unit heater
City/State/ZIPy-4,), ,,,-?L.-7 ,, c, /Z 9 7e) c4.....f" Water heater
Fireplace
Phone:97c) 7-7 7 _0 sr.__74. I Fax: :( )
E-mail: Barbecue
",!:..„,*1,41i,','" OR ,.,,„ ...z Clothes dryer(gas)
Business name:p
r "0"..,.s..,e.r.,./ /e-a_.,..." vie_e_./e,/) sn...„ Other: ,...„,e_._ .
mNI
wHACAL FERMI
Address: 4‘/.45 /3...e:, .....,a.,..e...,fr_.....04.1,...- 42,,z," ,e ....., .. Subtotal
Minimum permit fee($90.00)
City/State/ZIP:
e9 7 e Ode , ;'-7.0 •-....C---
Plan review(25%of permit fee)
Phone:,77,) _.•7 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: r3
o
op --o-
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
rdays after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:rpt), ,,, e k 0,....,,.
_ Date:sA- f72 ;
44 4617T(11/ /COM/WeEpB)I:\Building\Pennits\MEC_PermitApp040113.doc
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
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
Transmittal
Letter
'L;n It t) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO:
C� DATE RECEIVED:
DEPT: BUILDING DIVISION EGEIVED
ry_ AUG 2 9 2018
FROM: ?VI
t [ C Vl�-t. CITY uf- TIGARD
3UILDING DIVISION
COMPANY: ( C? ( 141(
+•Sa-yi �a� S .c a d
PHONE: p7/7 7 7 d�7�/ By
RE: � <-c.i SC J. ,//S Yr `/ oZ i I �I
(Site Address) / (Permit Number)
(Project name or subdivision name an. 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): ,J
REMARKS: —; lith-�^ Cr-34
FOR O FICE USE ONLY
Routed to Permit Technician: Date: ' -'Z — 16 Initials:
Fees Due: ❑Yes ]Nee Description: Amount Due:
$ �---
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ,] o ❑ Done/A\
Applicant Notified: Date: ,2� / 1f Initials:
I:\Building\Forms\TransmittalLetter-Revisions 061316.doc