Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00251
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2005
PARCEL: 1S136CD-00100
SITE ADDRESS: 11705 SW PACIFIC HWY J ZONING: C -G
SUBDIVISION: PACIFIC CROSSROADS LOT: JURISDICTION: TIG
Project Description: Mechanical TI, adding exhaust duct with firewrap, shaft closure. Tenant providing hood. Project Value:
$3,900
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PACIFIC CROSSROADS PROPERTIES, I Description Date Amount
BY WYSE INVESTMENT SERVICES CO [MECH] Permit Fee 6/2/2005 $116.20
200 SW MARKET ST STE 345 [MECPLN] Plan Rev 6/2/2005 $29.05
PORTLAND, OR 97201 [TAX] 8% State Surchar€ 6/2/2005 $9.30
Phone:
Total $154.55
Contractor:
CUSTOM METAL FAB INC
50602 BIRCH AVE REQUIRED ITEMS AND REPORTS
SCAPPOOSE, OR 97056
Phone: 503 - 543 - 3170
Reg #: LIC 0064901
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: �� ' •
� � G Permittee Signat �, . l
tea T
Call 503 - 639 -4175 by 7:00 a.m. for inspections 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.
, /x5 S o Qcze -to Ji ' a,r
Mechanical Permit Applicat FOR OFFICE USE ONLY
City of Tigard Ctl1 _ Date/By: 5 it oS' � P Permit No.: ti o�1)OS 'OO H
13125 SW Hall Blvd., Tigard, OR 9 Plan Review o
Phone: 503.639.4171 Fax: 503.598.1960 � % wivrd(yiNU � Date/By: � Other Permit: a 1A045 A
/tr
Inspection Line: 503.639.4175 p\ — „_.,,O,1 I_ a J Date Read /B Y Juris: See Page 2 for
\ \ �a�� Ready
/By:
www.ci.tigard.or.us 1 ,P� N Notified/Method: Or Imo Supplemental Information
v'O \ 1
lliIiE' .:.tJ E`GIiECiiZti1SIF*
❑ New construction
,-4
, Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all Q •
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. �
:_: ..,,,�-, sar ; >., :ajyc,,. , �.;.. ;;kd,`.. _ ,,. „ a:�•� =.2' is.' `t± ,n`3, ,`�Fn. ; `�S'; :
�, � .: ,,,mss.;, :;�. >. ;f, , y ,
a 'CO TRU.C'I`�ION�� Value:
0
and 2 dwelling
, V - GORY': >OTt. 1VS [i
' :;:5..� .;• i s „, . ,.., d . e�:�,,..
1 - family [� Commercial /industrial ❑Accessory building
;' ' :'1 a t"1 . " Q: PMEIV T /;5S STEMS , ;3 : H1 -�:;� ;;
For special information use checklist.
❑ Multi- family t Master builder ❑ Other: Description Qty. Ea. Total
,,,-,� ,. ;,.� ”' •�t3�.n:y 1 �:�<. - ; \; , �s-yc?,
.14„ '"':JUB , SITE *::.0 ,AND LOGAT U ";}• ,, - -,', - Heating/cooling
� �' :�. .�` - �, ..., mm�r.., «3s „ -x� �w�r✓>: °.�a>�,; %aRr- ,.,,, v,r.- '�?k�'fr.- � � ... � r- :_...�w
Air conditioning or heat pump
Job site address: (( 1 0 , �,_) ( ( 1 f. 1.4 . (requires site plan showing placement) 14.00
City/State /ZIP: —It U U t 0 Furnace 100,000 BTU (ducts /vents) 14.00
- . Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Burk, Project name: S ush t �0X Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
is <, ,_�fi u O
's; Water heater 10.00
,, � ;� :,'. ,
- :;::,- .1)ES ,,.RIC ' ° ° >,�
y
�'4 , "z: '' s" „ �,t«'' ' .. " .:, , ..:w `..;,F.\.i F' % ;.x::= 3i; *..: 'iza'. ` ... r :: :
Gas fireplace _ 10.00
• N.A,h (I,uS- - i ) t „ i t , i l t ' I c r E , o , - ) AW , Sh a i-f t i t, S 1 A fA', . Flue vent for water heater or gas
1 - fireplace 10.00
1 e- ct0.1). -tr 7 (t;sf 11\ l t'(V' 1 1100 (k t - Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
,; Chimney /liner /flue /vent 10.00
PROPERTX ;,3V1'1VER: "'`,',3, t ' ” F' " TEI V AN P ;<;..
�.- �:,,,,,,. _ � a ..,� „ s � . 10.00
•�� �„ ,a_, .,�� >•'.:. -: -" ,. , ��. , , -.. -, -, ,, �.��_ .. ;�' Othe _
Name: C Environmental exhaust and ventilation
t1 (ft� t:-
J v Range hood/other kitchen
Address: 111.0 r S pa (t.-; t J u • S (A,G(SL ii equipment 10.00
City/State /ZIP: i uP� Clothes dryer exhaust 10.00
ctuYT}� Single -duct exhaust (bathrooms,
Phone: ( C :, i3 �'-f • 161,0 Fax: (BO ) 2,& �- - 1 L94 toilet compartments, utility rooms) 6.80
, ,, , , I Ce1 , NTF , .µ , Vi \ � N: ;_ < eA . '; : ,; Attic /crawlspace fans 10,00 ,
, 3 'PP y; _ .: ° ;";, : , ❑>-, PEItSO ; .,,
Other: 10.00
Business name: Cu-S ( pm aO,, C"ah t (n0• Fuel piping
Contact name: (L j - r 1p v 1 f'(\Q,( —
�' N 0tk(1 R (1\ S^ $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: Sot 7l y (I R i 0 • Gas heat pump
City/State /ZIP: Sc L D 6 1 09 on o C Wall/suspended/unit heater
_Water heater
Phone: (5o'4) 2 D1,U Fax: : (�j0;) 5� 2,61114 _Water
_
E -mail: Range
t
__,.” :« I,;; ^� yY < .� ♦/'tom+ . ;��u , �=� Barbecue
#fT r ''?�`:” fal_'=..,t`: %,. ,. , '�'�'' :3lart.- � -, ,e . -., r ,,. , . ,, .. � , . �ryy����,r,�y::i '?: -,• ,.,. ,. .e ,.,� � ��'i.� ��- �:e:�E
. Clothes dryer (gas)
Business name: _
SCJ�t�� UJ fi t�D(I ( fl fl� Other:
r - ,ter == >= "m', -
Address: ,_` E,•- E CIIAk�IiG rA7 :, i PE RMIT : k'E ES : ,, < i”
City/State /ZIP: Subtotal
Minimum permit fee ($72.50) ' 2 , 5C
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) ,2 y 0S
CCB lie.: (01-kfi t \ State surcharge (8% of permit fee) 2, 6
TOTAL PERMIT FEE /55 55
Authorized si nature: This permit application expires if a permit is not obtained within 180
g (A I A A 1 li. A k k ,_ ('� f l' \k days after it has been accepted as complete.
t � )
Date: 5. 19 — 05 * Fee methodology set by Tri- County Building Industry Service Board
t l�l G o \ r
Print name: m( �
J
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00251
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2/2006
Phone: 639 -4171 ?
Inspection Requests (24 Hrs.): (503) 639 -4175 _..'
INSPECTION WORKSHEET FOR DATE: 7/7/2006 TIME: 7:10AM PAGE: 20
SITE ADDRESS: 11705 SW PACIFIC HWY J CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS LOT #: TYPE OF USE:
PROJECT NAME: SUSHI HANA
DESCRIPTION: Mechanical TI, adding exhaust duct with firewrap, shaft closure. Tenant providing hood. Project
Value: $3,900
OWNER: PACIFIC CROSSROADS PROPERTIES, I, PHONE #:
CONTRACTOR: CUSTOM METAL FAB INC PHONE #: 503 -543 -3170
Inspection Request Scheduled For: Date: 7/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010939-01 603-984 -6656 N
Corrections /Comments/ Instructions:
, i 4 . . - - - I) li .,:f to r
owir , , , (1/4_, 7
•
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Ti FAIL Ti CA L FOR INSPECTION ❑ ADDIT..ONAL FEES ASSESSED
Inspector: I , Date: V Phone #: (503) 718 -