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Permit CITY F TI GA R D MECHANICAL PERMIT ��1 DEVELOPMENT SERVICES PERMIT #: MEC2001 -00444 a`�' - � I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/11/01 PARCEL: 1 S134BC -00300 SITE ADDRESS: 12220 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ADD. FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM . UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M . 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: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: NEW TYPE 1 GREASE HOOD OVER CHICKEN FRYERS Owner: FEES BPP RETAIL LLC Type By Date Amount Receipt BY BURNHAM PACIFIC PROPERTIES PRMT CTR 12/11/01 $110.50 2720010000 ATTN: JOHN WATERS PLCK CTR 12/11/01 $27.62 2720010000 SAN DIEGO, CA 92101 5PCT CTR 12/11/01 $8.84 2720010000 Phone: Total $146.96 • Contractor: CUSTOM METAL FAB INC 50602 BIRCH AVE SCAPPOOSE, OR 97056 REQUIRED INSPECTIONS Mechanical Insp Phone: 503- 543 -3170 Final Inspection 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 -0080 ou may obta'n copies of these rules or direct q - - stions to O d by calling rnfl»as ! 1 R• / Issue By: I!", , / Permittee Signature: — =�,- • Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day G / 4 rj U ' / 0O ,4.S e "� Mechanical Permit Application r Y I'i� y ( Datereceived:'I L_ -U I Permit no.: 7 _a0opt City of Tigard 1 m� °__ J g Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: Byq I Receipt no.: Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT 0 l & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction JgAddi tion/alteration/replacement 0 Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE . Job address: I1.Z2o SW SciA0 C - wy A . Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical mates, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ (o and') . Lot: (Block: I Subdivision: 'See checklist for important application information and Project name: Lei Ws. t . .5 - I Prt4.1A-'I' jurisdiction's fee schedule for residential permit fee. City /county: YsBard I ZIP: c! 7 2Z3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: _,Ves...) De... AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE Woo Fee(ea.) Total Est. date of completion/inspection: Va../o - Description Qty. Res. only Res. only Tenant improvement or change of use: Ii r ha n • Is existing space heated or conditioned? Yes 0 No Air handling unit CFM Is existing space insulated? es ❑ No Air conditioning (site plan required) Alteration of existing HVAC system i1lECIIANICAL CONTRACTOR Boiler /compressors Business name: �'ugy9,,� /q ` p.R. > State boiler permit no.: HP Tons BTU/H Address: 50(0 2 ' 0 r /2G (& A.VE Fire/smoke dampers/duct smoke detectors City: r-x ce00S.e- I State: ©A.4 ZIP: 9 _j$ Heat pump (site plan required) Phone: 503 543 7 o I Fax: ° ✓ t( 3 3/ 711 E- mail:C/6F' F ( «g,� Install/replace furnace/burner BTU /H Gig q Including ductwork/vent liner O Yes O No CCB no.: " Install /replace/relocateheaters suspended, City /metro lic. no.: It�/ k2p 000066 (pi wall, or floor mounted Name (please print): 1::)0N 'ZEE5 Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: �p,...) Chillers HP Com ressors HP Address: 50602. fRc(ti �i� �' Environmental exhaust and ventilation: City:"e 'State: 0 I ZIP: �S' Appliance vent Phone: 5 3 3C7o Fax: S9 E- mail:Cote E., )ados, Dryer exhaust OWNER Hoods, Type U II/res. kitchen/hazmat � hood fire suppression system ! . Name: ,Ertl% 7t` Gt:_ -.4MVO L(,C.- Exhaust fan with single duct (bath fans) Mailing address: 3 z,55 LAD, L , t Rd E xhaust system apart from heating or AC City: 1 /Vf c rUs �e I State: CE I ZIP: 9 7O7U Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: ( 8 z 05 Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Name: Number of outlets Address: Other listed appliance or equipment: Decorative fireplace City: 'State: I ZIP: Insert—type Phone: Fax: 1E-mail: J Woodstove/pellet stove Other: Applicant's signature: I Date: /y -7�/ Other: Name (print): ,CO/. -J z Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ rm 0 Visa O 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 (6A0/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. induding 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 or Pump Cond fraction thereof. footnotes below. Comp ** 7) Minimum Permit Fee $72.50 SUBTOTAL: 00K BTU b unit $ to 14.00 to 1 100K 8) 3 -15 HP; absorb 8% State Surcharge $ unit 100k to 500k BTU 25.60 (of subtotal) u) unit . 5-1 mi l absorb 25% Plan Review Fee ( ) $ unit .5-1 mil BTU 35.00 Required for ALL commercial permits only 10) 30 -50 HP; absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1 -1.75 mil BTU 52.20 11) >50HP: absorb unit >1.75 mil BTU 87.20 12) Air handling unit to 10,000 CFM ASSUMED VALUATIONS PER APP LIANCE: • 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 applicance 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 101k 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 Other Inspections and Fees: Hood served by mechanical exhaust 656 1. Inspections outside of normal business hours (minimum charge -two hours) Domestic incinerator 1,170 $72.50 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 $72.50 per hour inserts, etc. 3 Additional plan review required by changes, additions or revisions to plans (minimum Gas piping e 1 - 4 outlets 360 charge-one-half hour) $72.50 per hour Each additional outlet 63 * State Contractor Boiler Certification required for units >200k BTU. ** Residential NC requires site plan showing placement of unit TOTAL COMMERCIAL $ VALUATION: i:\dsts \forms\mech- fees.doc 08/06/01 CITY OF TIGARD 24 -Hour BUILD4G Inspection Line: (503) 639 -4175 ST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requeste / —/ D AM 1 BUP 1 Location ) D--D4) F�em '' " Suite / \G // MEC a / V ! 4 f 4 / T Contact Person / Ph ( ) Sl -5 `t (p 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: / J SIT Post & Beam , % 0 Shear Anchors / • / Ext Sheath/Shear Int Sheath/Shear Framing ?--- Insulation ' ( -/�X l ( � �) 9-,nom\ _ 5 Drywall Nailing Firewall - Fire Sprinkler Fire Alarm , A S o_. \� _� eL Susp'd Ceiling Roof -�._ \ Lax \sq ef . Other: Final PASS PART FAIL '1 ^ , ` PLUMBING ` / V LV G V S \ Post r B eam r p Q r_ � 1 fir —T/ Under Slab r '�-�"—' C C Rough -In C� C�� \ 6� 0 `�� Water Service `�� Sanitary Sewer Rain Drains \ \ n Catch Basin / Manhole ;1-- e � _ $ , (.........z.„--, ✓� `TD_� -- 1/ ^ Storm Drain Shower Pan . --� �— r `- e ���� Other: Final () PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers ina SS PART 40 ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA `� Approach/Sidewalk Date 0q0 Inspector v` Elct l Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY ORTIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST Received Date Requeste .2_,? AM PM BUP Location / -- L ' --L-10 JC S -� f' Re/ Suite 61C)20.9( i d0 Contact Person F>/ / / !O 'h ( ).D- (/ T - O 7 71 PLM Contractor Ph ( ) s15-7 8" Ir q SWR BUILDING Tenant/Owner ( 4e .&- ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Note /1____ � C-e- _ c ;p SIT Post & Beam Shear Anchors _ __ � ` Ext Sheath/Shear �� �� _ Int Sheath/Shear Framing ' Insulation / a .5- 5 - � - I Drywall Nailing 1. k Firewa I �j i ire Spr kl 4 / Ci,1� CJ ire arm l�l Rosp'd Ceiling Oi\-A' c ,�t S Roof V ` Other. I — ) �_ �� � Fin Y� AS PART FAIL PLUMBING Post & Beam Under Slab Rough -In ) csi i Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole r Storm Drain Shower Pan Other: Final PASS__ PAT FAIL ECHANIL o & eam CrEiougb-ln Gas Line Smoke Dampers Fina emo ir PART FAIL RICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Eil Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line , ADA l L�l \ ` j2---- 3 1 Approach/Sidewalk Date Inspecto E7ct Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL