Permit • -, CITY OF TIGARD MECHANICAL PERMIT
4
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00243
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/09/2013
Parcel: 1 S133AD16200
Jurisdiction: Tigard
Site address: 12700 SW NORTH DAKOTA ST 100
Project: Sesame Donuts Subdivision: 1995 -073 PARTITION PLAT Lot: 3
Project Description: Change out ducting in existing hood
Contractor: SANDY RIVER METAL WORKS Owner: PACIFIC CREST PARTNERS SCHOLLS L
PO BOX 666 ' 7000 SW HAMPTON ST, STE 130
TROUTDALE, OR 97060 TIGARD, OR 97223
PHONE: ' 503 -774 -3570 PHONE:
FAX: '
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/09/2013 $99 76
Class of Work: ALT Type of Const: VB Plan Review 05/09/2013 $24 94
Occupancy Grp: A-2 Occupancy Load: 12% State Surcharge - Mechanical 05/09/2013 $11.97
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 05/09/2013 $1 00
11x17)
Project Valuation: $1,500.00
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 $137.67
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 -00 - 090 • • I ay obtain a copy of the rules
or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344. �
Issued By:
/ / „ (n Q r Permittee Signature: Via 401 ‘,C#
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 Applicatio ... FOR OFFICE USE ONLY
' City of Tigard Received
° 13125 SW Hall Blvd , Tigard, OR 97223 MAY 0 8 2013 Date /B 6 g 13 - P No I } (GC • -iGA / f 3�0oaV3
Plan Revii'.w eft ° Phone. 503 718 2439 Fax 503.598 1960 Date /By AR / 1 919 )'3 Other Permit
TIGARD Y t
Ins Line 503 639 4175 C OF TIGARD D ate Read Ju ns
0 See Page 2 for
Internet' www tigard-or gov BUILDING DIVISION Notified/Method- 6,-1f 3 i Supplemental Information
TYPE OF WORK COMMERCIAL 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. $ ( S COY "
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSI'EMS FEES*
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty I Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
(� Air conditioning 46 75
Job site address: 1 d .. r? � S t ,,,, t I 1 n, i✓ e h Furnace 100.000 BTU (ducts /vents) 46 75
City /State /ZIP:71 c d 1L. 9 9 ZZ 3 Furnace 100,000-F BTU (ducts/vents) 54 91
Suite/bldg. /apt. no.: l00 Project name: C� j Z�
Heat pump 61.06
Duct work I 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
/ Residential boiler (radiator or
&u 1.1 S f e ( (' `y K IA L hydronic) 23 32
t Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other 23 32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace /insert 33 39
//�� Flue vent for water heater or gas
`l , 0....„1, ( 1 � c3-c�<- txhc - r, ,_, $)e, t , -.!' V -1Old fireplace 23.32
11` Q 1 0. 5 S --1 D " ` - _ 1 a /� Log Wood/pellet t stove 33 39
) 23.32
l " t .6._,..,1& �'�`� � ,, Wood /pellet sto
c f 117 W C'^" f. 9 a 12 " )c k 9 >Lh %' N to (kJ. Wood fireplace /insert 23 32
Chimney /liner /flue /vent 23.32
❑ PROPERTY OWNER I ' 15 TENANT Other 23.32
Environmental exhaust and ventilation:
-
Name: LA q , ci \ � _ + Range hood/other kitchen
equipment 33.39
Address: I '\ co 5 w 1,, m -i.‘J ciir.,'L-,a A1 Clothes dryer exhaust 33 39
City /State /ZIP: i• net( -4 cry. 1 i 2 3 3 Single -duct exhaust (bathrooms,
- toilet compartments, utility rooms) 23.32
Phone: (s-6 3 i 2_p - OG . ({ Fax: ( ) Attic /crawlspace fans 23 32
❑ APPLICANT ' CONTACT PERSON Other 23 32
p ((77 ( Fuel piping:
Business name:
c' 1`" LY�C r"e - � " fir- 'St $14.15 for first four; $4.03 for each additional
Contact name: '� c - 5-. 17 r Ci t--. Furnace. etc.
Gas heat pump
Address: ) . l': r)x ( (yt 6, Wall /suspended/unit heater
City/State/ZIP: �-F (� ci R t '�' � Water heater
Phone: (a 0 3) 7") r ) Li, - S ` - v I F ax:: ( ) Fireplace
Range
E -mail: I,..f rv+- -. 4S`123 G•t Barbecue
CONTRACTOR Clothes dryer (gas)
1 Other
Business name: 1' v...- r e , fQ v_x,r1,— S MECHANICAL PERMIT FEES*
Address• p.o fit.„x
/A Ls. Subtotal
City /State /ZIP: ; � . • l� cn 1 I-} Co/R Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: i r cf.., -3,a r-1 O Fax: ( ) State surcharge (12% of permit fee)
CCB tic.: I <2 a rl .I I(3 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
,' o days after it has been accepted as complete.
Authorized signature: �/y' /Lid • Fee methodology set by In- County Building Industry Service Board
I_ //146 I