Permit CITY OF T MECHANICAL
- DEVELOPMENT SERVICES PERMIT # PERMIT. MEC96 -0096
DATE ISSUED: 12/06/96
PARCEL: 2S110DB- 00700
SITE ADDRESS...: 15520 SW PACIFIC HWY #D
SUBDIVISION • WILLOW BROOK /TIGARD PROMENADE ZONING: C —G
BLOCK • LOT •10
CLASS OF WORK..:NEW FLOOR FURN - 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 4
OCCUPANCY GRP..:A3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 1 BOILERS /COMPRESSORS HOODS.......: 3
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
: /GAS/ / / 3 -15 HP : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: N 30 -50 HP : 0 WOODSTOVES..: 0
GAS PRESSURE...: M 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 1 GAS OUTLETS.: 7
FURN > =100K BTU: 2 > 10000 cfm: 0
Remarks: Mechanical for fast food restaurant
Owner: FEES
STERLING DEVELOPMENT CORP type amount by date recpt
3252 HOLIDAY CT PRMT $ 69.00 DRA 10/24/96 96- 285693
SUITE 225 PLCK $ 17.25 DRA 10/24/96 96- 285693
LA JOLLA CA 92075 5PCT $ 3.45 DRA 10/24/96 96- 285693
Phone #: 619 -546 -8841
Contractor:
ENVIRONMENTAL COMFORT SYSTEMS
INC
8385 CANOGA AVE
CANOGA PARK CA 91304
Phone #: 818 - 700 -8385 $ 89.70 TOTAL
Reg #..: 086851
REQUIRED INSPECTIONS
This peroit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Shaft Inspection
approved plans. This perait will expire if work is not started Hood Inspection
within 180 days of issuance, or if work is suspended for tore F ire- Suppr Insp
than 18S. days. Final. Inspect ion
Permittee Signatur : , Pr / \
1
Issued B 'J � '" A
Call for inspection — 639 -4175 —
II
. . 4..dimill
I
�/'( ID #J44�
City of
City MECHANICAL PERMIT Planck/Rec. # ads - ` s
13125 CAN Hall Blvd. APPLICATION Permit # �i - - L ? D07I
Tigard, OR 97223 ( N.-P q(
(503) 639 -4171 /'�( 7 !o \crb
V
r a Vu fi cc_
i t(
- Name Vrweiopment Description '
/ /CL�! �� Table 3A Mechanical Code QTY PRICE AMT
��.
Job *�� - 'L 2 1) Permit Fee -0- -0- 10.00
Address w �t e
2) Supplemental Permit 3.00
Name to name of buaeroaa? Furnace to 100,000 BTU
e- r te .., ���'e ZA 1) incl. ducts & vents 6.00
Jng Address r Y P11°n• Furnace 100,000 BTU +
Owner ✓ 52 ne2A.Ve 5..- � `'' S X
2) incl. ducts & vents , . 7.50 � a= ,_)
4v •-rl, Floor Furnance
L.q �� G;4 / 2O 7_S 3) incl. vent 6.00
Name ; name of Maness) Suspended heater, wall heater
l' . �i�c 4) or floor mounted heater 6.00
adng Address Phone Vent not incl. in
Occupant
jaf ii ,ei�f�YG . 5) appliance permit 3.00
".sat. uP Repair of heating, retrig.
// �lr/7/ /e�. grit .93._57 6) cooling, absorption unit 6.00
Nana - Boiler or comp, heat pump, air cons.
- 7 4 C , ` ®r j0 - 7c•cn - ai 7) to 3 HP; absorp unit to 100K BTU 6.00
Maing Address Phen• Boiler or comp, heat pump, air cond.
Contractor 8) 3 -15 HP; absorp unit to 500K BTU 11.00
a�• � — Boiler or comp, heat pump, air cond.
9) 15 -30 HP; absorp unit .5 -1 mil BTU 15.00
State Regravaton No. Cay cue. Tax No. Boiler or comp, heat pump, air cond.
10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that I have read this application, that the Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with Air handling unit to �, r ,,
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 1 4.50
Board, that the number given is correct. (If exempt from State Air handling unit
registration, please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected 1--) 9 15) to a single duct 3.00
X^ / , • Ventilation system not
,; �_ _ 16) included in appliance permit 4.50
- . r — .= er or agent) •ate Hood served by -')
17) mechanical exhaust 4.50 / -y-
Describe work new addition 0 alteration 0 repair 0 Commercial or industrial
to be done residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etc. 4.50
r
Proposed use of 20) Gas piping one to four outlets 2.00
building or property �� ��il /i
Type of fuel -oil 21) More than 4 -per outlet (each) Jt 2.00 -.'�'
yp Q natural gas 0 LPG 0 electric Q
�7,-, /
NOTICE (\
Minimum Fee $25.00 SUBTOTAL • ) 6 0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 7 -,4 '/
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE iZS
IF CONSTRUCTION OR WORK IS SUSPENDED OR j11 e ( t. 4 ,
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL '10 � ,I a1S"
AFTER WORK IS COMMENCED.
TOTAL ' � I
Special Conditions
Date issued by
HiLOGiMOSTSMECHPMT r 9
r
Page No. 1 CASE HISTORY FOR CASE NO.: MEC96 -0096
CARL KARCHER ENTERPRISES
15520 SW PACIFIC HWY Unit: D
09/16/97
Action Description Reg/ Schd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
MECC007 Application received / / / / 08/12/96 PASS JDA 08/19/96 JDA
MECC008 Permit created / / / / 08/19/96 PASS JDA 08/19/96 JDA
MECC015 Routed to Plans Examiner / / / / 08/19/96 1p2a PASS JDA 08/19/96 DS
MECCO25 Reviewed Plans Routed to DSTS / / / / 10/01/96 1p2a PASS DS 10/01/96 J *H
MECC080 (F) Ready to issue / / / / 10/15/96 JMH 10/15/96 J *H
MECC090 (F) Issue permit / / / / 12/06/96 PASS JSD 12/06/96 JD
MECC705 Gas Line Insp 10/01/96 / / 01/14/97 PASS TLP 01/24/97 TLP
MECC710 Mechanical Insp 10/01/96 / / 01/21/97 PASS TLP 01/24/97 TLP
MECC725 Shaft Inspection 10/01/96 / / 02/05/97 PASS TLP 02/25/97 TLP
NECC730 Hood Inspection 10/01/96 / / 02/05/97 PASS TLP 02/25/97 TLP
MECC735 Fire Suppr Inep 10/01/96 / / 02/18/97 PASS TLP 02/25/97 TLP
MECC740 Duct Inspection / / / / 02/05/97 PASS TLP 02/05/97 TLP
MECC799 Final Inspection / / / / 02/05/97 PASS TLP 02/25/97 TLP
MECC800 Case Finaled / / / / 02/18/97 PASS TLP 02/25/97 TLP
MEW A 1101 S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238 -5700'
11111111 i � I , •�«>V 8 ONGER • EUGENE, OREGON 97402 • (503) 683 -9333
IMU SAFETYCOMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
CERTIFICATION - 1NSTALLATION /INSPECTION
Customer Name
Address
SYSTEM
Model(s) and serial numbers
Number of nozzles and Part No.
Number of detector(s) and degree rating
Energy shut -off devices — type and size
Other accessory equipment provided (pull station, electric switches, etc.)
COOKING /VENTILATING EQUIPMENT
Number of duct(s) and size
'
Hood size and plenum size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those
being protected.)
1. 4.
2. 5.
3. 6.
TO BE COMPLETED BY INSTALLER
❑ YES ❑ NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard
96 and 17 (current issue), and all applicable state and
local codes. Exceptions to other provisions of NFPA 96 ❑ YES ❑ NO
that were observed are noted below. I understand that it is the recommendation of ANSUL
Exceptions: and of the National Fire Protection Association
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly.
CUSTOMER NAME AND TITLE
❑ YES ❑ NO
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DATE
INSTALLER NAME
SIGNATURE
DISTRIBUTOR
ADDRESS
DATE
MIIMINCA-IAIEWA &I ' 1101 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238-5700
� agW W 1, `850 CONGER • EUGENE, OREGON 97402 • (503) 683 -9333
1111111i� SAFETYCOMP , Y 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
CERTIFICATION - INSTALLATION /INSPECTION
Customer Name
Address
SYSTEM
Model(s) and serial numbers
Number of nozzles and Part No.
Number of detector(s) and degree rating
Energy shut -off devices — type and size
Other accessory equipment provided (pull station, electric switches, etc.)
COOKING /VENTILATING EQUIPMENT
Number of duct(s) and size
Hood size and plenum size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those
being protected.)
1. 4.
2. 5.
3. 6.
TO BE COMPLETED BY INSTALLER
O YES ❑ NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard
96 and 17 (current issue), and all applicable state and
local codes. Exceptions to other provisions of NFPA 96 LI YES ❑ NO
that were observed are noted below. I understand that it is the recommendation of ANSUL
Exceptions: and of the National Fire Protection Association
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly.
CUSTOMER NAME AND TITLE
❑ YES ❑ NO
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DATE
INSTALLER NAME
SIGNATURE
r
DISTRIBUTOR �- -- .
ADDRESS
DATE
=•11Nre'A411A1ert"A•1 1101 S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503)238 -5700
111 1, VM IW 850 CONGER • EUGENE, OREGON 97402 • (503) 683 -9333
SAFETY COMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
CERTIFICATION - 'INSTALLATION/INSPECTION
Customer Name
Address
SYSTEM
Model(s) and serial numbers
Number of nozzles and Part No. Ion +..
Number of detector(s) and degree rating
Energy shut -off devices — type and size
Other accessory equipment provided (pull station, electric switches, etc.)
1J �
COOKING /VENTILATING EQUIPMENT
Number of duct(s) and size
Hood size and plenum size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those
being protected.)
1. 4.
2. 5.
3. 6.
TO BE COMPLETED BY INSTALLER
❑ YES ❑ NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard
96 and 17 (current issue), and all applicable state and
local codes. Exceptions to other provisions of NFPA 96 ❑ YES ❑ NO
that were observed are noted below. I understand that it is the recommendation of ANSUL
Exceptions: and of the National Fire Protection Association
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly.
CUSTOMER NAME AND TITLE
❑ YES ❑ NO
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DATE
INSTALLER NAME A
SIGNATURE
•
DISTRIBUTOR !, ' !` . J
ADDRESS
DATE