Permit CITY TIGARD MECHANICAL PERMIT
it F DEVELOPMENT SERVICES PERMIT #: MEC2002 -00479
r DATE ISSUED: 10/28/02
- I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 104
SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS: 1
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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of oven and Type I hood for manufacture of tortillas.
Project value: $1,312.
Owner: FEES
TIGARD PROPERTIES INC Description Date Amount
2106 SE OCHOCO ST [MECH] Permit Fee 10/28/02 $72.50
MILWAUKIE, OR 97222 [MECH] Permit Fee 10/28/02 $0.00
[TAX] 8% StateTax 10/28/02 $5.80
Phone: [TAX] 8% StateTax 10/28/02 $0.00
Contractor: Total $78.30
CARLOS TRUJILLO
11945 SW PACIFIC HWY #104
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503 - 969 - 3000 Mechanical Insp
Hood Inspection
Reg #: 119067 Duct Inspection
• Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 - • : i :. ou may obtain copies of these rules or direct questions to OUNC by calling
(50 246 -6699.
Issue. :y: L • j a ar, _ �/ , � • Permittee Signature: Q11 6�
Call (503: 9 by 7:00 P.M. for inspections needed the next business day
•
Mechanicalfermit Application
Date received:, fl$' p9" Permit no.:H ?pp,,I.6,7 V79
_,4; .. I City of Tigard Project/appl. no.: ' e date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: B I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCIEDULE •
•
Job address: / ) 9'Lf5 St t.) d i_e>"/: ° Jay 4e/D/f Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanicalff;aterialk, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ t a/4g' QUU .
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: T / /e i 9 9 r „e/ , LLG jurisdiction's fee schedule for residential permit fee.
City /county: (ZIP. 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on pre ise : AND COMMERICALIINDUSTRIAL EQUIPMENTSCIIEDULE
' /1 ;/4 / . ' _ , ■ . / . _ ,.AlrM7/r711r '. , Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? CI Yes CI No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
MECIIANICAL CONTRA TOR Boiler /compressors
A
Business name: State boiler permit no.:
T i, /Q/%,I .SAS Avg � HP Tons BTU/H _
Address: / / 0/ /S Sk PQ
i C{ c, / ' /6' Fire/smoke dampers/duct smoke detectors
City: 77 , I State: ,9 ZIP: g-70: Heat pump (site plan required)
Phone: r 94,93/g0 I Fax: - I E - mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: // 9,04 7 Install/replace/relocate heaters—suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
Name: C fie 5 Trcf '. 1 1,1._q Exhaust fan with single duct (bath fans)
Mailing address: 571./ g e 5 PL Exhaust system apart from heating or AC
' Fuel piping and distribution (up to 4 outlets)
City: / //S `()YO I State: aL, I ZIP: q 7/23 Type: LPG NG Oil
Phone: CO % 0/ 3vva Fax: E - mail: Fuel pi ing each additional over 4 outlets
rocess p ping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert — type
Phone: I Fax: I E - mail: Woodstove/pelletstove
Applicant's signature: . I Date: Other: r
: ,
Name (print): .
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ 7A. 67)
CI Visa ❑ MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
. $ TOTAL $ •
Cardholder signature Amount 440-4617 (6i00/COM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see Comp or Pump Cond
fraction thereof. footnotes below. .
Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit
to 100K BTU 14.00
8% State Surcharge $ 8) 3 -15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb 35.00
Required for ALL commercial permits only unit .5 1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU -
11) >50HP; absorb
unit >1.75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12) Air handling unit to 10,000 CFM 10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) Amount 17.20
Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct
ducts & vents 6.80
Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater -
17) Hood served by mechanical exhaust
Vent not included in appliance 445 10.00
permit 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101 k to 500k BTU 10.00
15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
mil. BTU 5.40
30-50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each)
1 -1.75 mil. BTU • 1.00
>50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656 8% State Surcharge $
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not included in 656
appliance permit
Hood served by mechanical exhaust 1 656 Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge - two hours)
Domestic incinerator 1,170 $62.50 per hour.
Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge - half hour)
Other unit, including wood stoves, / 656 $62.50 per hour
inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum
Gas piping 1 - 4 outlets ® 360 charge- one -half hour) $62.50 per hour •
Each additional outlet 63 *State Contractor Boiler Certification required for units >200k BTU.
TOTAL COMMERCIAL $ `*Residential NC requires site plan showing placement of unit
VALUATION: All New Commercial Buildings require 2 sets of plans.
Bdsts\forms\mech- fees.doc 02/11/02