Permit CITY OF TIGARD MECHANICAL PERMIT •
I - COMMUNITY DEVELOPMENT Permit #: MEC2012 -00396
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2012
T [ C ,1.RD 9 Parcel: 1 S136DA00700
Jurisdiction: Tigard
Site address: 11530 SW PACIFIC HWY
Project: King's Buffet Subdivision: PFAFFLE PLAZA CONDO Lot: GCE
Project Description: Relocating (1) Type 1 hood.
Contractor: NW EAGLE MANAGEMENT CO INC Owner: HI HAT INC K �ro5 r `L �
13531 CLAIRMONT WAY, #28 11530 SW PACIFIC HWY
OREGON CITY, OR 97045 PORTLAND, OR 97223
PHONE: 503 - 752 -2655 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/02/2012 $145.81
Class of Work: ALT Type of Const: VB Plan Review 08/02/2012 $36.45
Occupancy Grp: A -2 Occupancy Load: 12% State Surcharge - Mechanical 08/02/2012 $17.50
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 08/02/2012 $7.50
11x17)
Project Valuation: $3,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $207.26
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or _ 1.8000.332.2344.
Issued By: CJ'A / a T Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Mechanical Permit ApplicationREPMVE1 FOR oFFICI: USE ONLY
City of Tigard R p e a ce e d 7M O. / Permit No.: w D e�o�� -00 i
13125 SW Hall Blvd., Tigard, OR 97223 JUL 2 6 2012
Plan • RevtCw
Phone: 503.718.2439 Fax: 503.598.1960 p �' q Other Permit:
Inspection Line: 503.639.4175 ` '�'p / 1 '• y : � �Ll
T I G A k D p
CITY
ti � T A D Date Ready :: / kris: ® See Page 2 for
w
Internet: ww.tigard- or-gov r ° Notified/Method:
_Pak tp P 'r 4 f , , Supplemental Information
B!J! D�o G DtVIS O � . M /<. 9
TYPE OF WORK CO FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work -
❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 3000 42°
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. ] Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
/� Air conditioning
Job site address: f 1 S30 PQ C 1 (C j G ` _w y . (requires site plan showing placement) 46.75
City/State /ZIP: T 19 q r d O r•' .P, A 3 Furnace 100,000 BTU (ducts/vents) 46.75
/ Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Pro -� -
Project name: / J ����1 - , Heat pump (requires site plan showing placement) 61.06
Cross street/directions to job site: / .J lA //\.. I 0 lot c,. PeriA. r itf Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: [ 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRI PTION OF WORK Water heater 23.32
Gas MO i/t. EXis T .T eX ha US* /,-00 c/ Flue vent for water heater or gas
/
QPtor° X /d in /�,s-7z4 ur n / fireplace 23.32 •
/ Log lighter (gas) 23.32
/
>" t 7C A cam° Y1 • Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
Other: 23.32
Name: 571-e v e , L_ l OLD Environmental exhaust and ventilation:
Address: See Q�0 y Range hood/other kitchen
/ C. equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( .. A- 0 $S- 7 Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name:
Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: /V _W . E / /1f G /. C • / /7 G . Clothes dryer (gas)
t/ Other:
Address: ) 3S 3 / C/Q / r/NQh f 10ek `l (f N / o Z $ MECHANICAL PERMIT FEES*
City/State /ZIP: p , J 4 0 ., C - , e" . , q 70 y.- Subtotal
� / Minimum permit fee ($90.00)
Phone: (' ) 7s"� - . ' .S`S Fax: ( ) Plan review (25% of permit fee)
OX CB CB lic.: J t / Q 9 0 if/9-21 f �- State surcharge (12% of permit fee)
V /� TOTAL PERMIT FEE
Authorized signature: �/'C This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: "c d de. / R. /4k- c. A E,-- Date: 7( �-- • Fee methodology set by Tri - County Building Industry Service Board
1:\ Building \PermitsVEC- PermitApp.dac 03/07/12 44 17T (1I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 • $69.06 for the-first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and •
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00. •
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00. _ •
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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