Permit CITY OF TIGARD MECHANICAL PERMIT
` • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00424
Date Issued: 12/09/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 1 S 136AD06000
Jurisdiction: Tigard
Site address: 11437 SW PACIFIC HWY
Project: Carl's Jr. Restaurant Subdivision: VILLA RIDGE Lot: PTS 1 -2
Project Description: Mechanical for new restaurant.
Contractor: ADVANCED HEATING & AIR CONDITIONING Owner: EJM PROPERTIES INC &
5825 SE FOSTER RD MAVERICK DECATUR GEORGIA LLC
PORTLAND, OR 97206 3633 E BROADWAY
LONG BEACH, CA 90803
PHONE: 503 - 774 -0161 PHONE:
FAX: 503 - 774 -4391
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/09/2011 $1,463.31
Class of Work: NEW Type of Const: VB Plan Review 12/09/2011 $365.83
Occupancy Grp: A-2 Occupancy Load: 12% State Surcharge - Mechanical 12/09/2011 $175.60
Stories: 1 Info Process /Archiving - Lg Sheet (over 12/09/2011 $14.00
11x17)
Project Valuation: $54,000.00
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: 2 Vent Systems: Total $2,018.74
•
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Exhaust fans
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
Utilit otification =ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain . c•py of the rules
or d' ect questions to 0 C b - .: ng 503.232.1987 or 1.800.332.2344.
Issu By: I A // 4 ) ■ 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 ro OFFICE I'SF 0\1.1
City of Tigard Permit No.:
14 13125 SW Hall Blvd., Tigard, OR 97223 a �� �r '�� ��
L . V r ' ,� ,` Date/By: k.., Plan Reese • +..
• � wq Q
Ins Line: 503.639.4175 �'" '" L�1I11�I. `� Permit:
Phone: 503.718.2439 Fax: 503.598.1960 I'I v (11( ) t:1
T 1 G r\ R D kb`2" k1 Date R . .• , y: ,,J See age 2 for
Internet: www.tigard - or.gov 'O Notified/Method: / y Supplemental Information —
2 fi ��:
TYPE OF WORK \��` �• CO I I RCIAL FEE* SCHEDULE - USE CHECKLIST
,�q 0 . eery �� Mechanical permit fees* are based on the value of the work
[1New construction ❑ Addition/ alteration /repl xauen \ N performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: 05)\ mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION ) ' / Value: $ ` y G
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Q Commercia1/industrial ❑ Accessory building For spedal information use checklist.
❑ Multi- family ❑ Master builder ❑ Other. Description I Qty. I Ea ( Total
`1 i./ 7 JOB SITE INFORMATION AND LOCATION Heating/cooling:
P L Air conditioning •
Job site address: 44.- PCIt t 1 t C. Old y (requires site plan showing placement) 46.75
e + Furnace 100,000 BTU (ducts/vents) 46.75
City/ State/ZIP:
L5 a 0 e..._ _ Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgJaptno.: Project name: &Ns Heat Pump
(requires site plan showing placement) 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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other. 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
1104 /� 1` for i 1 Gas fireplace 33.39
c__ f�(5) ++ � 1 v 1✓1 t L `� y1 Li C T S i Flue vent for water heater or gas
__G--(. Us Cs 'f rc.l $ lL t T L -e_ vL S Roo Cl S a, c.t fireplace 23.32
, as) 23.32
/►
lS r � dtA Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER I 0 TENANT Ot y/liner /flue/vent 23.32
e - Other. 23.32
Name: k (4) k 6 — ■ Environmental exhaust and ventilation:
Address: 7.,L 6 3 L i n d Q j C-#. Range hood/other kitchen
equipment 33.39
City/ State/ZIP: ( /is 0 to Li 1 ( -¢ t /� ) 4.... 9 p 7C, 7 0 Clothes dryer exhaust 3339
Phone: (S I) 3) 6 g- z_ - `6 7 Y Fax: ( ) Single -duct exhaust (bathrooms,
_ toilet compartments, utility rooms) 23.32
❑ APPLICANT l.� CONTACT PERSON Attic/crawlspace fans 23.32
Business name:
Other. 23.32
Fuel piping:
Contact name: e 4, $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspendedhmit heater
Phone: (S ) ?ct 3 . 1( 0 Fax: : ( ) Water heater
J Fireplace
E -mail: rod si,tea R: a i- .5 C G - LI -Cowl Range
CONTRACTOR Barbecue
Business name: A j U avk ce j v. 44 t_,„ (.it 4 At C� Clothes dryer (gas)
�+ J Other:
Address: S J s 'e MECHANICAL PERMIT FEES*
City/State/ZIP: e (.I ILL t1 j 0 , f 7) o (¢ Subtotal
Minimum permit fee ($90.00)
Phone: (Sp3) 7 -7y , 0 f( i I Fax: (S ) 7 74/ - 4/3 7 / Plan review (25% of permit fee)
CCB lic.: f T j 73 1 State surcharge (12% of permit fee)
TOTAL PERMIT FEE e i - 7 y
Authorized signature: -- A- _ P Z 2 This permit application expires if a permit is not obtai w ithin 180
I days after it has been accepted as complete.