Permit i q C ITY ®F TIGAR® MECHANICAL PERMIT
= a COMMUNITY DEVELOPMENT Permit #: MEC2009 -00594
T t GARL) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/10/2009
Parcel: 1 S 136AD06503
Jurisdiction: TIGARD
Site address: 10900 SW 68TH PKWY
Subdivision: WAY LEE Lot: 2
Project: Changs Mongolian Grill
Project Description: Install walk -in cooler.
Owner: FEES
WAY W LEE GENERAL CONTRACTOR Description Date Amount
5210 SE 26TH AVE
PORTLAND, OR 97202 Permit Fee 11/10/2009 $957.31
Plan Review 11/10/2009 $239.33
PHONE: 12% State Surcharge - Mechanical 11/10/2009 $114.88
Contractor:
APEX REFRIGERATION INC
2870 NE HOGAN RD #413
GRESHAM, OR 97030
PHONE: 503 - 492 -9940
FAX:
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -2 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $1,311.52
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Cooler,
Duct Work: Freezer
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 -0100. You may obtain a copy of the rules
or direct questions o OUNC by calling 503.246.6699 or 1.800.332.2344. "
Issued By: A L�J I (\ Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 � - . - -4 [o12,0 ici u� 0 Ni i A�..t ` - � ' �„
1 Cl of Tigard eceiv ` ila Permit No .: {� /
City g � l ateB / t / r�' 409 Bo 5
III
13125 SW Hall Blvd., Tigard, OR 97223 tltl
Phone: 503.639.4171 Fax: 503.598.1960 � v � �( Other Permit:
9 Inspection Line: 503.639.4175 'lS i ` y Read Ty: '
I r C A It'Dl ``II 0 5 4ate Read :y: Juris: ® See Page 2 for
. _._.. Internet: www.tigard - or.gov 0 Notified/Method: l it ��0,00( Supplemental Information
i l . TYPE OF WORK . ��,,' 1 �G �I �1 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Addition/alteration/reph 4 t1? Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, ove and profit.
• CATEGORY OF CONSTRUCTION
Value: $ 33 / . L 7 r0 0
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling 0 S / �9j A Air conditioning
Job site address: J 09 d (� lc ' J-} (requires site plan showing placement) 46.75
City /State /ZIP: 7 A-K(1 O s L.- � -''3 Furnace 100,000 BTU (ducts /vents) 46.75
+ Fumace 100,000+ BTU (ducts /vents) 54.91
�(-
Suite/bldg. /apt. no.: Project name: U `Q V t H� J 1 c I 1 Q /\ (jr l Heat pump 61.06
Cross street/directions to job site: �" Duct work 23.32
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.:
Other: X 23.32
Tax map /parcel no.: Other fuel appliances
. DESCRIPTION OF WORK Water heater 23.32
'�-� r / Gas fireplace 33.39
„LOS I ( lV X1.0 Cc / R -/- } E2 ee �✓! '4 ! 1 Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
C pa l Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
. ❑ PROPERTY OWNER I • ❑ TENANT
Other: 23.32
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment _ 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; 54.03 for each additional
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONT TOR '• • 1 . • Barbecue
•
Business name: / 2 \ 5 ` eIt Or\ Clothes dryer (gas) .
� � � � Other:
Address: ( ')a ipE ,�" *113 5U I/` MECHANICAL PERMIT FEES* '
City /State /ZIP: Subtotal
Phone: ( z.,/ — 9 4' `�t U Fax: (Z3) Z/ c j 2 ` L 7 -13 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 1 Li c Q [ 0 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
� p— ■u,_.)
days after it has been accepted as complete.
Print name
ry \ �� Date: "I �— -{� * Fee methodology set by Tri- County Building Industry Service Board
!Mudding \ Permits\ MEC- PermitApp.doc 10/01/09 4401617T(1l /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.
1: \Building \Permits \MEC- PermitApp.doc 10/01/09 2