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Permit (108) CITY OF TIGARD MECHANICAL PERMIT `11 I • • COMMUNITY DEVELOPMENT Permit#: MEC2019-00497 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/11/2019 Tic'�I''1-) g Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9753 SW WASHINGTON SQUARE RD D02 Project: 85C Bakery Subdivision: None Lot: None Project Description: Installation of gas line to kitchen appliance. Contractor: STANLEY BROOKS PLUMBING Owner: PPR WASHINGTON SQUARE LLC 6310 MCEWAN RD PO BOX 847 LAKE OSWEGO, OR 97035 CARLSBAD, CA 92018 PHONE: 971-317-2959 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 07/11/2019 $207.21 Class of Work: ALT Type of Const: VA Plan Review 07/11/2019 $51.80 Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 07/11/2019 $24.87 Stories: Info Process/Archiving-Sm$0.50(up to 07/11/2019 $0.50 11x17) Project Valuation: $5,000.00 Fuel Air Handlers Fuel Types: Natural Gas 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 $284.38 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: Fire/Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules :re set forth in OAR 952-001-0010 through OAR 952-011-0090. You may obtain a copy of the rules or direct questions to OU by call g 503 32.19' or .00.332.2344. Issued By: /�/ I Permittee Signature: , ^ � _ i%,' Call 503.639.4175 by 7:00 a.m,for the next available inspection dat> This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONE\ 2 --- 1 City of Tigard i 4R ��+ « M"` Received Permit No 13125 SW Hall Blvd.,Tigard,OR 97223 Date By: �� �/ �d.�� ` C q f { Plan Review 1 Phone: 503.718.2439 Fax: 503.598.1960 s ` i 0+i Date/By: OtheN t: 4,.......„ 9__0e2,, TI G A R D Inspection Line: 503.639.4175 ,, Date Ready/By: Juris: 65 See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information , E. ' " '.,...TYPE:OF w0RK . _ ...., � ; " " C�tl�l(IYIERGIAL FEE* SCHEDULE UL..F ,USE CHE�:KLICSTh Mechanical permit fees*are based on the value of the work ❑New construction ,gj Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ 5"COO CATEGORY OF C©IVSTRUCTI(?1V - RESIDENTIAL EQUIPMENT/SYSTEMS FEES*" x. ❑ 1-and 2-family dwelling It Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total tHeating/cooling: ,TOB SITE INFORMATION AND LOCATION rV Air conditioning 46.75 Job site address:qt% ^ ,�3 , \ via-sz(, , ,t . (1 l � `. -� Furnace 100,000 BTU(ducts/vents) 46.75 i City/State/ZIP"`"C 9, ,) ' CAC S6,C...)6,11,--, 47vt t.a OZ Furnace 100,000+BTU(ducts/vents) 54.91 n Heat pump 61.06 Suite/bldg./apt.no.: Project name: .j C 6,ti 1/^ e C 1 Duct work 23.32 r s street/directions to job site: J Hydronic hot water system 23.32 / i i /'fin Residential boiler(radiator or i�octi.___Vickae, 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: 1 Lot no.: Other fuel appliances: pp es. Tax map/parcel no.: Water heater 23.32 DESCRIPTION ©F-'w®IiK , _ Gas fireplace/insert 33.39 Flue vent for water heater or gas •c...(24.).64l - 4, 0 C 1 1 fireplace 23.32 l IvCr-t U i OL t '• _ ` - _ 11..,'—1 .141V-4L°I lit ter(_as 23.32 ood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 A, Other: 23.32 `PROPERT'Y OWNE t • „� = . D NMI 41 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 `CONTACT PERSON Other: 23.32 Fuel piping: Business name: $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( ) Fax::( ) Fireplace Range E-mail: Barbecue CONTRACTOR Clothes dryer(gas) Business namelD ,ey 00t`25 �1,v i...4AO t 4 Other: C�3ANICAL PERMIT FEES* Address: vL 3\.0 .t� Lte 1��� 0... J o! Subtotal City/State/ZIP: e D� 11, (1n�` Minimum permit fee($90.00) �'Q t `'�1 {V J Plan review(25%of permit fee) Phone:O (bctl 3J I Fax:( ) State surcharge(12%of permit fee) CCB lic.: 2 C p ?Z f� /r f/( TOTAL PERMIT FEE 6/� I This permit application expires if a permit is not obtained within 180 4 days after it has been accepted as complete. Authorized signature: .'• a i ' Q, * Fee methodology set by Tri-County Building Industry Service Board Print name ek C • O e?�"• l:r7A,(11 I I.ABui1dingAPermitsAMEC_P 't pp_040113.doc 440-4617T(1 1/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family Fee Schedule: Total Valua px v a-,-seot 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 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_PermitApp_040I 13.doc 2 City of Tigard Tel: 503.718.2439 Location: Inspection Date: 9753 SW WASHINGTON SQUARE RD D02, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Mechanical MEC2019-00497 Inspection Type: Inspector: 610 Gas line Jeff Grove Result: PART Comments: 10 psi for 15 min standard pressure verified Violation Summary: Inspector Contractor