Permit CITY OF TIGARD MECHANICAL PERMIT
II II * COMMUN DEVELOPMENT Pe rmit #: MEC2013 00165
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/04/2013
Parcel: 2S 113AA00500
Jurisdiction: Tigard
Site address: 16112 SW 72ND AVE B18
Project: Acosta Food Service Subdivision: ROSEWOOD ACRE TRACTS Lot: PT A & F
Project Description: Installation of remote refrigerated system
Contractor: ROYAL COMMERCIAL EQUIPMENT LTD Owner: PACIFIC REALTY ASSOCIATES
2134 SE 9TH AVE ATTN: N PIVEN
PORTLAND, OR 97214 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 236 -1370 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/04/2013 $344.90
Class of Work: ALT Type of Const: IIIB 12% State Surcharge - Mechanical 04/04/2013 $41.39
Occupancy Grp: B Occupancy Load: Plan Review 03/26/2013 $86.23
Stories: Info Process /Archiving - Sm $0.50 (up to 04/04/2013 $10.00
11x17)
Project Valuation: $9,875.00
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 $482.52
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Walk in
Duct Work: refrigerator
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 folk the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -009. i
/ may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 4 % / // Permittee Signature: /''�/ ��;!�^
iLa/ -__._.._./ , Lam / / �:i;! /.i
Call 503.639.4175 by 7:00 a.m. for the next available inspectio
This permit card shall be kept in a conspicuous place on the job site until co • , t • of the project.
Approved plans are required on the job site at the time of each in --e tion.
a,(ee, x13 -001( v
• °' t))� " "° � --5P-t# ( r � : ,. - 1 � �� City of Portland, Ore.on - Bureau of Development Services ->'i f; \C •� J 1900 SW 4th . 4,;.; ' • ,'a' '1 w - . on 97201 •503 -823 -7363 • TTY 503 - 823 -6868 • www.portlandoregon.gov /bds I� / /�
Type of work This permit application expires if a permit is ttor
!'� f 4 ration/re lacement
obtained within 180 day after it ha •ee .ccepted
❑ New construction ? � L '
'gr
EAMID i' 1 p as complete. ' r . co(
❑ Demolition = et er: Commercial Fee Schedule - Use Checklist
Category of construction Mechanical permit fees' are based on the value of the work
❑ 1 & 2 family dwelling ,Commercial /industrial ❑Accessory building performed. Indicate the value (rounded to the nearest dollar of all
mechanical materials, equipment, labor, overhead and profit.
❑ Multifamily ❑ Master builder ❑ Other: Value: $ 4. ,, - 7 S t G
Job site information and location Residential Equipment / Systems Fees
t r For special information use checklist
Job no.: Job address:
= I (3 I l 2 5 itJ' �2nr� 111/6 Description Qty. Fee Total
City /State /ZIP: J n Q (- c 7 9.---, {-i- Heating / cooling
Suite /bldg. /apt. no.: 0 Project name: c Air conditioner (site plan required) $26
S IZLJ)CE Furnace / burner including duct work I
Cross street/directions to job site:
vent / liner
$55
Heat pump (site plan required) $51
Air handling unit $26
' Hydronic hot water system $32
Subdivision: Lot no Tax map /parcel no.
Residential boiler (radiator or hydronic) $32
Description of work (example: upstairs bath fan /dryer exhaust) includes piping
l Of kkeT C-'t i t L I /� ) Unit heaters ) $26
1 t J i1 L n -wall, in -duct, (fuel suspended not , etc. electric
yS � Vent for appliance other than furnace $22
I Alteration of existing HVAC system $32
Other fuel appliances
Decorative gas fireplace S26
Flue vent for water heater or S22
Provide RS permit no. gas fireplace
1 Property owner • Tenant Wood / pellet stove $57
l Gas or wood fireplace / insert $57
Name: ‘ - Z0cu E -mail: Chimney / liner I flue I vent $22
Address: Other $32
Environmental exhaust and ventilation
City /State /ZIP: Range hood / other kitchen equipment $14
Phone: I FAX Clothes dryer exhaust $14
Single -duct exhaust (bathrooms, toilet $14
Owner installation: This installation is being made on property that I own, which is not intended for sale, lease, rent, compartments, utility rooms)
or exchange. Attic / crawl space fans $14
Owner signature: Date: Other: $32
• Contractor • h Subcontractor
�f,' $14 for the first four, S2.57 for each additional. Please indicate num-
Business name: ICY fl� yj jRk E - mail: hhVv 5E'rf - - IZS t� - (�RQ , (�' 1 ber of fuel gas piping outlets below:
Address: 1— 8 'LS 5 J l l h-- 4 E Furnace, etc.
V Gas heat pump
City /State /ZIP: CF. (119. , Cg C: 17 M S Wall / suspended / unit heater
Phone: — 3,- \ 3 9-C FAX: -3 _,2.36 -- bZ - 9 -7- Water heater / boiler
Lic. no. COB lic. no. +/ g�- j cd! „/ Fireplace
Range
..-- Barbecue
Authorized signature: Clothes dryer
Print name: d h l) 5 JE Date: f Cif Other:
U Applicant • Contact Person Other appliances
Including oil tanks, gas and diesel
Business name: generators, gas and electric kilns, $32
gas appliances / equipment not
Contact name: included above
Mechanical permit fees
Address:
Subtotal
City /State /ZIP: Minimum permit fee ($95)
Phone: I FAX: Commercial plan review (60% of permit fee)
State surcharge (12% of permit fee)
E - mail: TOTAL PERMIT FEE
RS Permit/No Fees Due El
Residential Combo permit subcontractor submittals only can be faxed to 503 - 823 -7693. insp _perrnitapp_mechanical 06/12/12
S4, 3-3
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COMMERCIAL EQUIPMENT. MD.
Specializing in Custom Refrigeration
15865 SE 114th Ave Suite O ALAN JEFFERS
Clackamas, OR 97015 (503) 236 - 1370
CCB# 68375 (Fax) 236 - 0977
WA# ROYALCE099LG alan @royalcommercial.com
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