Report ilq , Building Division
Oregon State Mechanical Specialty Code Provision 507.16
TIGARD
COMMERCIAL KITCHEN HOOD
PERFORMANCE VERIFICATION
Mechanical Permit No.: M E Zo 1 , r -°en Z,/
Jurisdiction: ._I-7 4 A O
Site Address: 7 3 S.? G co V EL�x..)D Q. 0 •(l o p
Type of Hood: Type I Hood ❑ Type II Hood
Classification of Cooking Appliances: ❑ Extra Heavy Duty ❑ Heavy Duty
I1 Medium Duty ❑ Light Duty
CFM of exhaust fan intake 10 minute test: Start of test: 2._s---Q d
End of test: 25 p 0
Dimension of duct opening into hood: I C.f,1> ( `t
Duct Velocity: ( bon FPM
Length of Hood: f 'o
N
Amount of total makeup air provided for all hoods: 2400 CFM
e'VZ
Signature: )e_ Date: Z Z? l
CAWPrint name of person performing test: 6C-Circ—
Print name of Contractor: allevwf.42.0-j5 -4,« yr�.4j ( c c"�� CCB #:
This form satisfies the requirements of Oregon State Mechanical Specialty Code provision 507.16. All information
given on this sheet shall be provided by the installing contractor or air balancing agency if applicable. Information
given shall be obtained by the field testing and site verification of installation information.
This form shall be completed and submitted to the inspector prior to final inspection approval.
I:\Building\Forms\COM-KitchenHoodPerfVerifdoc 07/01/08