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Permit CITY OF TIGARD MECHANICAL PERMIT : I ' COMMUNITY DEVELOPMENT Permit#: MEC202000113 1- i i_ , i' r-, 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03l03/2020 Parcel: 2S102AA00490 Jurisdiction: Tigard Site address: 12085 SW HALL BLVD 120 Project: La Real Subdivision: None Lot: None Project Description: Installation of new hood(type 1)and repairing existing gas line to new code. Contractor: CAESARS CONSTRUCTION Owner: HALL STREET CROSSING LLC PO BOX 1231 BY MR&MRS ROGER W TOM CLACKAMAS, OR 97015 8067 SW RIGERT COURT BEAVERTON, OR 97007 PHONE: 503-734-4490 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 03/03/2020 $538.21 Class of Work: ALT Type of Const: VB Plan Review 03/03/2020 $134.55 Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 03/03/2020 $64.59 Stories: 1 Info Process/Archiving-Sm$0.50(up to 03/03/2020 $10.00 11x17) Project Valuation: $17,488.00 Lull Air Handlers Fuel Types: Natural Gas Units<10000 cfm: 1 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 $747.35 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set f in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OU !ling 50 232.1987 r .800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard /ci Received/� /y �/ /�� 111 • 13125 SW Hall Blvd.,Tigard,OR 97223 - y/ • 6"�J /" ` • 7W 1 13 Phone: 503.718.2439 Fax: 503.598.1960 Dan Review., 1 Plan By: _ Other Permit: Inspection Line: 503.639.4175 Date Ready/By:' ���-/�/ to s: ® Sce Page 2 for Internet: www.tigard-or.gov Notified/Me od: !!!�� '����C/ / Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees*are based on the value of the work ❑New construction ' Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition Other: mechanical materials,equipment,labor,overhead,and profit. — Value:$ / , yeg CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling cil Commercial/industrial ❑Accessory building For special information use checklist ❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: / �7 / ` Air conditioning 46.75 Job site address: !Z(. gi$ 5cu l7a7/ .7/u Furnace 100,000 BTU(ducts/vents) 46.75 , City/State/ZIP: r/�223 Furnace 100,000+BTU(ducts/vents? 54.91 9 Heat pump 61.06 Suite/bldg./apt.no.: PO Project name: (Q V r?a( II G Duct work 23.32 Cross street/directions to job site: 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 Subdivision: Lot no.: er' 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 33.39 Flue vent for water heater or gas 1Ks 411(4,, O/' d`1C'iti-' //wel A/fc- �_ -I fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 e*5 4LI Gyet 5 /l�G U-- l t y( 7c) Wet,/ (- ,PG Wood fireplace/insert 23.32 (J Chimney/liner/flue/vent 23.32 i ❑ PROPERTY OWNER ❑ TENANT 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 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32 Business name: /y // Fuel piping: i'e`er Y + i5, 'UL/j'on_S /!C- $14.15 for first four;$4.03 for each additional Contact name: i/Ce.SA �U Address: p G �>e /.�z Furnace,etc. Gas heat pump ' Wall/suspended/unit heater City/State/ZIP: C/OC/(clk4(Zi / . �'37o� Water heater Phone:(.5f,3) 73V-i/9.9O Fax: :( ) Fireplace Range E-mail: r 6 �v%l�i[G�✓'> F') Orwell/• Ct-srir.; . Barbecue v CONTRACTOR Clothes dryer(gas) / Other: Business name: ��C, ()- j�v )1S LT/UYt s /16 MECHANICAL PERMIT FEES* Address: P ©, BDK /23/ Subtotal City/State/ZIP: Gi/l(C ka toaS c'-- 72 )($ Minimum permit fee($90.00) Phone:( ) ! Fax:( )�'` Plan review(25%of permit fee) / State surcharge(12%of permit fee) CCB lie.: ! O Z9l g 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 Td-County Building Industry Service Board Print name: t�e 54V 4Date: Dr /Q- 2e) 1:'Euilding'Permits\MEC_Peim tApp_040113.doc 440-4617f(I1/02/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