Permit • •
I CITY OF TIGARD
MECHANICAL PERMIT
` ° COMMUNITY DEVELOPMENT Permit #: MEC2009 -00464
T E G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09109!2009
Parcel: 1 S135DD03301
•• ` Jurisdiction: Tigard
Site address: 11945 SW PACIFIC HWY 205
Subdivision: Lot: 0
Project: Gaffer's Fish & Chips
t•.
Project Description: Replace existing fire damaged unit; RTU change out.
Owner: FEES
TIGARD PLAZA LLC Description Date Amount
8320 NW HWY 99
VANCOUVER, WA 98665 Permit Fee 09/09/2009 $238.25
• Plan Review 09/09/2009 $59.56
PHONE: 12% State Surcharge - Mechanical 09/09/2009 $28.59
Contractor:
ROTH HEATING & COOLING
PO BOX 1265
CANBY, OR 97013
PHONE: 503 - 266 -1249
FAX: 503 - 266 -3478
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: Natural Gas 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 $326.40
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
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 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 • • questions to a NC • ailing 503.246.6699 or 1.800.332.2344.
Issued By: 411_ � ` . / Permittee Signature: ■ �∎ / •
Call 503.639.4175 by 7:00 a.m. for an inspection that busines • ay.
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.
•
, , AUG731 -2009 MON 03:00 PM ROTH HEATING FAX NO. 5032663478 P. 01
Mechanical Permit Applies :'14-' ' CEIVED
pP butt ul,l;l('L: Ilhl: ()NIA'
City of Tigard Received
Dato/By: / / , �
( Permit No,
.� ■ 13125 SW Hall Blvd., Tigard, OR 97223 r- ,' �'aa� ?.....e,0
I
Phone: 503.639.4171 Fax: 503,598.19 P 2009 Plan • to -
Tic It l - Inspection Line: 503.639,4175 lkhtcBy: / e ir k i rip Other Purmir
Internet; www.tigard -or.gov CITY OF TIG ARD Dino • "y By' r T See Page 2 for
DIVISION Notified/ elhod: / ` /
. . a , Supplemeatolloformalian
;x, BUILDING Y� 1,..,, _ -•... -' 1 FKQRK :' > :':.,=.',.' , , .. ;..:..' MIVIER ,4 • 0 " •SCttDUII4 � .-
0 New construction �ddition /alteration /replacement Mechanical p' it fees are based on the value of the work
❑ Demolition 0 Other: performed. Indicate the value (rounded to the nearest dollar) of all
Demolition materials,,cquipment, labor, overhead, and profit
.. v ir.:.;! ' r` :.. . .,.,`r;= `c;(O, r 9 PR'Y',:OF':COINSTgucrf Value $ /
6-O
❑ 1- and 2- family dwelling L Commercial /industrial ❑Accessory building ' ' i�b',SWEN'1 ML E�,QIdi'pMENT 4J EES' ::; �::
0 Multi- family ❑ Master builder El Other:
For special 1pformo/lon use checklist
Y �h
,,.,;� �, Description Qty. Ea. Total
:;: -:.,•. j ,w i Q ,'�Sti'1�,.'.lFNFOIt1 1( ON= 411*/ O ►:TIQ
: .. lY. ;'' Heatin_ cooling
- Job site address: i 1 { (-t S rc L1 Air conditioning or heat pump
Ti ••"" �` l `'�l Hwy y l (requires silo plan showing placement) 14,00
City /State/ZIP: d , „ pia 9-7 2_i Furnace 100 000 BTU (duela/vents) 14.00
Suite/bldg. /apt no.: Project name: L r Furnace 100.000+ BTU (ducts/vents) 17.90
l e ,P oat boat pump 14.00
Cross street/directions to job site: T Duct work
- /,+/ "i/17-01 t c #Li'd 1 4.00
64 f. �� �� !a , ,, - H (Ironic hot waters em 14.00
'q J Residential boiler (radiator or
� 'rte Ff G1 1./t/n It (Ironic 14.00
`�� Unit heaters (fuel -type, not electric),
in -wall, in-duc sus. dud etc. 14.00
Subdivision: Lot no.: Fluo/vont for any of above 6.80
Tax map/purcol no - :� 10.00
Other fuel appliances •
:N �: /'- '' ei . :. : ei ON WOR ; . ` Water heater
% .,.' RC ' _ ' '" dr. . i' 10.00
0 Gas fireplace 10.00
Ill ' Y •'a a ea ; t e.- Flue vent for water heater or gas
� k . /TV to elhoA, O 11'1(.
fir dace 10.00
A Log lighter (gas) 10.00
ip.itmoy /444 O(rd$ / Wood/1 Iles stove
10.00
n,...i1 .. 0. Wood fireplace/
" Y'.1`�" a' 1( h : WNIGA!` . , dvent 10.00
�•
_Tb1NA1k'r''. ';; Oth Chimnoy/liner /1lu 10,00 i
Nam i, � Environmental exhaust and vendlntiva
Address: I � T j G /ir • � c/Fic jj /✓ Rangehood/nthorkitchen
1 1(-t: y� J _ equipment 10,00
City/ State/ZIP: 7 c 7 c i Z. -1 0 Z.14 Clothes d er exhaust 10.00
Phone: () � t a�J Fax ( ) Singlo-duct exhaust (bathrooms,
I � utility rooms _
:. 4�AAIT:. . w1S a ce fans
:..... . ;
.... . .. .. ::';CQIY!1'AC°i'�A�RS�Itf'; :.
6.80
Att ic/cm � 10,40
Business numo: to . y , id 4,/, . ..
.. . Other: 10.00
Fuel plpiak _
Contact name; J5 /)/�� _ 10 ---r _ $5.40 for first four; $1.00 for each additiona
Address: (gep) : � /s, n � / Furnace, etc.
City/State/ZIP: / " S � j Gas haat . urn
04 , , , j 00/ I 7- Wall /suspended/unit heater
Phone: (503 ) i0 __),2L34 Fax:: u3 ) 2 Water heater
E -mail: ' e �. - Fir lace
S
/r Ran e
:::7. r : ° :;:,', ,. ,:,:f',.:..:...,.., ... , . Barbecue •
Business nam p e: r i/ / "' Clothes d r (: as
Addre Address; q�b err J / r Other:
ss:
tate/ZIP: i capl --c AT tor . : 04 ""
, 1 1 012 '77 s�;,...
_ Subtotal
Phone: (SUS ) /(,,,‘, (•Z 0 F ( S03) �6 r . 3 � � Minimum permit fee ($72.50)
'F Plan review (25% of permit fee)
CCB lie.: f if oa r State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature T This permit application expires if a permit w oat obtained within 1$0
days after it has boon accepted as complete.
Print name: 1 _ i 1 . , a Date: + El • Fee methodology set b by y Tn� 2 - / Tri -County Building i i us industry Service Board
1: 1 a ulldingWmmitsnMeC- permitApp,doe 01/ 9/07 440-4617T (r 1/o'LtoM/WmB) C ( /9471 0A e '
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