Permit r CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00217
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/19/2006
PARCEL: 2S 113AD -01900
SITE ADDRESS: 16600 SW 72ND AVE B10 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 009 JURISDICTION: TIG
Project Description: Replacing rooftop unit like for like. Value: $6200
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 5/19/200E $163.10
[TAX] 8% State Surcha 5/19/200E $40.78
Total $203.88
Phone:
Contractor:
ACCURATE HEATING, INC.
P.O. BOX 2276
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 650 -1229
FAX 650 -4845
Reg #: LIC 88423
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 OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
I .
Issued By: , i`; Permittee Signature:
—
Call 503 - 639 -4175 by 7:00 a.m. for inspections that busin s day.
This permit card shall be kept in a conspicuous place on the job site until c mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
a 1 :* w ' 4- fi t! t+' 'i *.�c,iri c�`�' ` ifom " , sue^
Mechanical Permit Application w,: d a � I ()IZ I I( ttiS 0 NIrl4' t ' ; y. �s F� . ( + ; .
City g Of T1 and - C I V E D Received / /
4.j % i .0 Permit No
Date/By: t _ _00._ / 0 13125 SW Hall Blvd., Tigard, Q Plan Review Other Permit:
Inspection Phone: 503.639.4171 Fax: 503..98.1960 /(a � :±�. Date/By:
Ins Line: 503.639.4175 w.4 : b „ "
p { 2006 5 �: : Date Ready /By: Juris ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TICARD
RI �T QF o • . N COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction dition/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: $ eoZ.-t00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling mmercial/industrial ❑ Accessory building
For special information use checklist
Multi-family Master builder
❑ y ❑ ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: //�� r Air conditioning or heat pump
Q ( Q � � . 72 , 10 It1V( (requires site plan showing placement) 14.00
City / State/ZIP: --7; G 1,....sl. of _ Furnace 100,000 BTU (ducts/vents) 14.00
t Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: `.t - 0,? Gas he pump 14.00
Cross street/directions to job site: 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
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
• DESCRIPTION OF WORK Water heater 10.00
�-7 r T cc Gas fireplace 10.00
2e .��C T.__ \ -
OA. f- (.41 t ' / 1 Flue vent for water heater or gas
fireplace 10.00
t i 1.7,>f 1- 'LL , Log lighter (gas) 10.00
- .- it.CJ (,()„ t � c2,0 S Wood/pellet stove 10.00
66 Wood fireplace/insert 10.00
• ID PROPERTY OWNER TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: ,o s _ 1_,,, Environmental exhaust and ventilation
Range hood/other kitchen
Address:
Co £! &Tr, 5 4 7 Z/ p -A U L equipment 10.00
City / State/ZIP: 7 6 t L a Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
E3.PPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
e 4 4 . V \ . 1 l,r,..N L. 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 1673 v D
9T 1
E -mail: Range 1
CONTRACTOR Barbecue "t *di O
Business name: R e _ G ajv� 'k �, _!,/_ Clothes dryer (gas)
u"`� Other:
Address: ��_ _ 72_71 (,, MECHANICAL PERMIT FEES*
City /State/ZIP: CI iks_C (c_jkre vf) , O 1 1./ Subtotal
( ) Fax: (S °3) � (l4L /S Minimum permit fee permit fee)
Phone:
�� t � 22 Pl an review (25% of permit fee)
CCB lic.: e s , 2 ..., 3 State surcharge (8% of permit fee) t:SA
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtaine within 180
1,1V � ,�I 5/1911
days after it has been accepted as complete.
Print name: c4 k 164 , I Date: * Fee methodology set by Tri-County Building Industry Service Board
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