Permit (74) CITY OF TIGARD MECHANICAL PERMIT
, ,_
IN • COMMUNITY DEVELOPMENT Permit#: MEC2018-00883
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/28/2018
T f C;;ti I'1) 9 Parcel: 1S134BC00300
Jurisdiction: Tigard
Site address: 12286 SW SCHOLLS FERRY RD A
Project: Kaba Grill Subdivision: None Lot: None
Project Description: Installing walk in cooler for TI.
Contractor: PCI PERSONAL CONSTRUCTION Owner: FW OR-GREENWAY TOWN CENTER LLC
410 BEAVERCREEK RD, STE 513 PO BOX 790830
OREGON CITY, OR 97045 SAN ANTONIO,TX 78279
PHONE: 503-679-3461 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Building Misc Fund(copies/prints) 11/28/2018 $0.75
Class of Work: ALT Type of Const: VB Permit Fee 11/28/2018 $291.51
Occupancy Grp: B Occupancy Load: Plan Review 11/28/2018 $72.88
Stories: 12%State Surcharge-Mechanical 11/28/2018 $34.98
Info Process/Archiving-Sm$0.50(up to 11/28/2018 $12.50
Project Valuation: $8,000.00 11x17)
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 $412.62
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
1 Bolts in Concrete
Gas Outlets: Other Desc: walk in
Duct Work: cooler
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specia Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not st rted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules dopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtai a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: , Permittee Signat re: ,• C__
Call 503.639.4175 by 7:00 a.m.for the next available insp tion date.
This permit card shall be kept in a conspicuous place on the job site it completion of the project.
Approved plans are required on the job site at the time f each inspection.
Mechanical Permit Application rt
ri FC 1, ' FOR OFFICE USE()NEN'
City of Tigard - ',-,- ' -zr ceived AT 1 •
in
I
: 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 1 3 2018
• 11 iii Plan Review P e r
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Phone: 503.718.2439 Fax: 503.598.1960 ,
, / .
Date/By: ) J
---)...,C -J
Inspection Line: 503.639.4175
TIGARD a TY , Date Ready/By: 7 7 Jurls' re See Page 2 for
Internet: www.tigard-or.gov Supplemental Information
BuILD , ,- died/Me d:
TYPE OF WORK , , , , ,C IAL FEE* SCHEDULE - USE CRECICLIST
,
Mechanical permit fees*are based on the value of the work
/jZI New construction E=I Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
1=1 Demolition El Other: mechanical materials,equipment,lab r,overhead,and profit.
4 r7
Value:$ e:raf -----
, CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT
I SYSTEMS FEES*
D 1-and 2-family dwelling pl/Commercial/industrial 1=1 Accessory building For special information use checklist.
El Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION
Air conditioning 46.75
Job site address:/ .2. 2._‘. 6 ‘ 4.,..) g 'i)eljfit 776.)
- / Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -7", ,cyy......ci e.:3,,C 2:7 ;2..>._
ik -2, Furnace 100,000+BTU(ducts/vents) 54.91
......2 ..-1/7,
Suite/bldg./apt.no.: Project name: -..ii,bek_ c. ..)--, , Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: 7 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
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
'- DE1/4,11:47,:e*:47-.4j* WORK :::„..:z, ite.,. Gas fireplace/insert 33.39
Flue vent for water heater or gas
/I/N--C 5 7.01.-Z /4-)e :-/-1_, 2 C r"--evr/.. .____.)---- fireplace 23.32
7 Log lighter(gas)
23.32
Wood/pellet stove
33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY1,0iiiten.,40,,br ,..,, Other: 23.32
-' Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans _ 23.32
0 APPLICANT i'', , 0 CONTACT PERSON -:-,,:t1 Other: 23.32
Fuel piping:
Business name: 1 - s_t.-L4
$14.15 for first four;$4.03 for each additional
Contact name: .t t t; le c k e„ 3 Furnace,etc.
Address:
Gas heat pump
,u 6 (z.:;_e_.,,w,,, e_ v_, j,c 2,4 7t.(,_.7, 3
Wall/suspended/unit heater
City/State/ZIP: 6)L,..6, , - '1--- 6 -,-1' 7 c--; SZ.-f- Water heater
+,
Fireplace
Phone:p7/) 7,77 _ 0___C-7)2„ Fax: :( )
Range
E-mail: Barbecue
h 1,1• '.:,'", = CONTRACTOR '' Clothes dryer(gas)
Other:
Business name: 0._ 1 p.,€),--4;,,-1.--,„.___O e..,...„1 ii-AA f-.1-1.*-"1"'N MECHANICAL PERMIT FgES, ..,,
Address: V.,/ 6) ,,,...,„. kr J .4_ c_....„ 3 Subtotal
Minimum permit fee($90.00)
City/State/ZIP: ".) .4" `-__Iri 8 ..k5 2 6 .,.:.(--
Plan review(25%of permit fee)
Phone:y7/) 7 2 7 ____e...,._,'-7 -_- I Fax:( ) State surcharge(12%of permit fee)
CCB lie.: / 3 , TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatureC - <"'
4- * Fee methodology set by Tri-County Building Industry Service Board
Print name: I-I' 1 c_,L..,) e -_,-,ii / •,-Zr--- Date:i// ,..3.,,/,
I/Building \ C_PermnApp_040113 loc 44d-4617T(11/2/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit l'te•
$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 or
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.
I:\Building\Permits\MEC_PennitApp_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12286 SW SCHOLLS FERRY RD A, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2018-00883
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor