Permit T Y OY OF TIGARD MECHANICAL PERMIT
I" DEVELOPMENT SERVICES PERMIT #: MEC2006 -10068
DATE ISSUED: 6/28/2006 --' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S101 DD -00100
SITE ADDRESS: 07000 SW SANDBURG ST ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Install approximately 60' of gas line for replacement of pressure washer.
Project value: $2,000.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
PAPE' PROPERTIES Description Date Amount
7000 SW SANDBURG RD [MECH] Permit Fee 6/28/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchaq 6/28/200E $5.80
Phone: 503 639 - 8910 Total $78.30
Contractor:
TEMP CONTROL MECHANICAL SERVICE
4800 N CHANNEL AVE REQUIRED ITEMS AND REPORTS
PO BOX 11065
PORTLAND, OR 97211
Contact #: PRI 503- 285 -6139
FAX 503- 735 -3690
Reg #: LIC 103165
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through 0 A - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 -; s I- 332 -2344.
Iss ed By: i ; � Permittee S' nature: . ��rr�1 / � --�
Call 503 - 639 -4175 by 7:00 a.m. for inspections that busines day.
phis 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 a :'; s • i't�lz \ 0r ' l WA' NS!' cMN ° i 4 II; •
°,; Ci ty of Tigard Received
Date/By ( ,,,,/ 0 ' t , (� Permit No ��G /�}O(
, i1 , q 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review """ /�
® '' Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit:
"* N'1> Inspection Line: 503.639.4175 D ate Irrrs.
® fil GA•I(D Read /B Ready /By: see Page 2 f or
ftrd it r++7ti. Internet: www.tigard- or.gov Notified/Method • � t . Supplemental Information
. , TYPE OF WORK COMMERCIAL FEE* SCHEDULE -.USE CHECKLIST •
❑ New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 07
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
rJob sitete address: pGj l Air conditioning or heat pump
70 Sul Ea vt C b C< f - - (requires site plan showing placement) 14.00
city/State/ZIP.7 p a n/f 0YL C - Z 3 Furnace 100,000 BTU (duets/vents) 14.00
` Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: � �3
S' T Gas heat pump 14.00
Cross street /directions to job site: 7 j, „Tay, ii / Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' D SCRIPTiONTOF , Water heater 10.00
Gas fireplace 10.00
�vr. ST S e GZd - a , ({ 1LC[ -( 9 . e- C Flue vent for water heater or gas
i J fireplace 10.00
CC7,,1 a/ `..5.-CD / Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
( ROPERTY$OWNERJ . I ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: j /..1 ,7,- Pa ' / A.. „.c 9 Environmental exhaust and ventilation _
Range hood/other kitchen
Address: 769 pd J C' ' „ 1, ,C.--r equipment 10.00
ity /
State /ZIP: 1pOt� L J.6 .0 � J 2 9 - 7 Z . z 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone:,(_,'3/. 3 6 3 `1 (3'2/ CJ • Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
_ Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone:( )
Fax:: ( ) Water heater
Fireplace
E -mail:
Range
(CONTRACTQR) • Barbecue
/ �- _ _
usines 1 /off
s ne: am '[
,° u I C 11/1- S Ac-,,,,j Lt �;2/�l"lt/ °.� Other: ri zarfamm
Address; P -MECHANICAL PERMIT FEES*
City/State/ZIP: 00., 9 7 bll i Subtotal
Minimum permit fee ($72.50) 7A 50
(Phone. ( 5& 9 g5 3 - 6' 13 j I Fax: ( ) Plan review (25% of permit fee)
C CB tic. /o3 / j, 5" t l 19.1 p ( -- State surcharge (8% of permit fee) 5: ga)
I i TOTAL PERMIT FEE 78 .
c � _ �( C
A,uth This pp p pe permit application e: Tres if a rmit is not obtained within 180
oriied signa[ure:
W„! +w ] _ - `� - "��� / days after it has been accepted as complete.
t Print - name: -- � r �r� z D ate: (�/7�/6
:4/.1 * Fee methodology set by Tri , unty Building Industry Sq Board
I:\ Building \Permits\MEC- PermitApp.doc 04/06/06 440 -4617T(II /02/COM/WEB)
Mechanical Permit Application - City of Tigard - -•
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation;) Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
ti� J
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