Permit CITY OF TIGARD MECHANICAL PERMIT
l'' +".. .- - C OMMUNITY DEVELOPMENT Permit #: MEC2012 -00083
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/16/2012
TIGARD
.. Parcel: 1S136AD06000
Jurisdiction: Tigard
Site address: 11437 SW PACIFIC HWY
Project: Carl's Jr. Restaurant Subdivision: VILLA RIDGE Lot: PTS 1 -2
Project Description: Install refrigeration equipment for walk -in cooler, freezer & ice machines. Remote condenser for all equipment on
roof.
Contractor: PORTLAND MECHANICAL CONTRACTORS Owner: EJM PROPERTIES INC &
2000 SE HANNA HARVESTER DR MAVERICK DECATUR GEORGIA LLC
MILWAUKIE, OR 97222 3633 E BROADWAY
LONG BEACH, CA 90803
PHONE: 503 - 656 -7400 PHONE:
FAX: 503 - 655 -0620
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/16/2012 $207.21
Class of Work: ALT Type of Const: Vg Plan Review 02/16/2012 $51.80
Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Mechanical 02/16/2012 $24.87
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 02/16/2012 $6.50
11x17)
Project Valuation: $5,000.00
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: Vent Systems: Total $290.38
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units: ,
Gas Outlets: Other Desc: condenser
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 ,foltb he rules adopted by the Oregon _
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You ///J' obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.
r
Issued By: • i ce / - -- ermittee Signature: c / /
Call 503.639. • .. .by_7:00_a.m._for the next available insp.- tion 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 ApplicaaRC2JVE FOR OFFICE USE ONLY
R eceived
City of Tigard Date /By: ' 1 p ermit No.: 17g v a -04
- '' 13125 SW Hall Blvd., Tigard, OR 972FEe Plan Revie
Phone: 503.718 2439 Fax: 503.598.1960 1 Z�12 Date /B 4 f �i . Fj Other Permier A 9(jl(r efOrCe,
TIGARD Inspection Line: 503.639.4175 CITY C F ' p j Date Ready /By: luris: PI See Page 2 for
Internet: www.tigard or.gov Bun I N CARD Notified/Method: 1/ / • Supplemental Information
1VG DIVISI i ...! • ® .>
, , , .T,YPE OT W ` ": „, -,.. `, , ,'`,r O R <IA E * SCHEDULE rUSE CHECKLIST
use -. -- - _.. -.
-
. - ,
- 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, rhead, o and profit.
ai' CATEGORY�OF• CON
�., , ESID E QUI P M EN T, ' /iSYSTE FEES
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
s � Heating /cooling:
JOB`.SITE INEORMATION AND . C PON r ': '
Air conditioning
Job site address: 11437SW Pacific Hwy (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Carl's JR 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 ` - ,•;. -, -, ,,,, Water heater 23.32
Gas fireplace 33.39
Attached to building permit #201100100. Install refrigeration equipment for Flue vent for water heater or gas
walk -in cooler, walk -in freezer & ice machines. Remote condensersf for all fireplace 23.32
Log lighter (gas) 23.32
equipment on roof. Wood /pellet stove 33.39
Wood fireplace /insert 23.32
• r .,. �_ . , Chimney /liner /flue /vent 23.32
PROEERTY'NER - ,1 ., s . ® TENANT- - & .. ' . .
Other: 2332
Name: Carl's Jr Environmental exhaust and ventilation:
Address: 11433 SW Pacific Hwy Range hood/other kitchen
equipment 33.39
City /State /ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
) Fax: ) Single -duct exhaust (bathrooms,
Phone:
( ( toilet compartments, utility rooms) 23.32
'''' "`'`''”' Attic /crawls
°-" -> ° =*APPLICANT " - -; -: .: ; .: , :,CONTACT, P•.ERSO,N:: P
�- '.w,- �i ".': � i�`;`4 �.,_n: n . n . '�; ;,,. w• -,. , '�' E, v, �,,. <. � i ace fans 23.32
Business name: Portland Mechanical Contractors Other: 23.32
Fuel piping;
Contact name: Dave Brannon $14.15 for first four; $4.03 for each additional
Address: 2000 SE Hanna Harvester Drive Furnace, etc.
Gas heat pump
City /State /ZIP: Milwaukie, OR 97222 • Wall /suspended/unit heater
Phone: (503) 656 -7400 Fax: : (503) 655 -0620 Water heater
Fireplace
E -mail: dbrannon @pmc -g.com Range
, ,:'` , ' , , ., CONTRACTOR ' '` ' ',: ''= ,.x.. „ , Barbecue
Business name: Same as above. Clothes dryer (gas) .
Other:
Address: , .- ' r.. ;�iT . � ,;;
= � , , ;;,'; ,; � „. MECHANICAL'PERIYIIT FEES ;,� ' ,
City /State /ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lic.: 151807 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature. This permit application expires if a permit is not obtained within 180
c days after it has been accepted as complete.
Print name: Dave cannon Date: 0 2 /17/7 * Fee methodology set by Tri- County Building Industry Service Board
1: \Building\Perm its\MEC- PermitApp.doc 09/09/10 440 -4617T (I I /02 /COM /WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total. on, =, 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.
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