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Permit v CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00496 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/7/2008 PARCEL: 1 S135BD -00100 SITE ADDRESS: 09600 SW OAK ST ZONING: C -P SUBDIVISION: PLAZA WEST LOT: 005 JURISDICTION: TIG PROJECT: EVEREST INSTITUTE Project Description: Installing gas furnace. Valuation: $4979.00 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: 1 STORIES: 5 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Owner: FEES PLAZA WEST, LLC Description Date Amount 121 SW MORRISON ST. STE. 200 PORATLAND, OR 97204 [MECH] Permit Fee 10/7/200€ $141.50 [MECPLN] Plan Rev 10/7/200€ $35.38 [TAX] 12% State Surch 10/7/200€ $16.98 Phone: Total $193.86 Contractor: HEINZ MECHANICAL 2615 NW ST HELENS RD. PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS Contact #: Reg #: LIC 43866 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. Issued y: Permittee Signature: k Call 503.639.4175 by 7:00 a.m. for inspections that b mess day. This permit card shall be kept in a conspicuous place on the job si until completion of the project. Approved plans are required on the job site at the t' a of each inspection. ■ 10I€ echanical Permit Application n O N L Y OFFICE L � Received - City of Tigard 1 Date/By: �. •i fey _�� . J t . e I 13125 SW I tall Blvd., Tigard, OR 97210 3 15 L P Lai Plan 111- it , 10 �• Other Permit r I. Phone: 503.639.4171 Fax: 503.598,1 IVO DaldHy: /t .(� v Inspection Line: 303.639.4175 e O Date Roe =y: r,.rts la $cc Page 2 far TI G A R D Internet: www,tigard- or,gov 1 p �� \ N. ificd/Mcihod: eio' •Z et .• ', , Supplemental lefarmatinn TYPE OF WOR Atli CO • RCIAL LEE* SCHEDULE —' USE CHECKLIST Mechanical permit ices* are based on the value of the work ❑ New construction gAdditiOn/alteratil91..'iri performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials equipment, labor, overhead, and profit. Value: S 1-4 4 1,1 C I . DU CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling OCommcrcial /industrial ❑ Accessory building Fgr,rpecial information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total .TOB SITE INFORMATION AND LOCATION Heidi _ coolie_ Air conditioning or heat pump lob site address: q IO�V & ' •uires wile .Ian ahowin .lncement 14.00 Furnace 100.000 BTU ductrlvenla) - 14.00 CitylStatd7.IP: Furnace 100,000+ BTU ductslventa r 17,90 ii ti ostasmill Suitc/bldg. /apt. no.: Project name: ,j _ „/! Gas heat .um' 14.00 Duct work 10,0(1 II I... Hydmnic hot water system 14.00 Residential boiler (radiator or h dronic 14.00 Unit heaters (fuel -type, not electric), • in -wall, in -duct suspended, etc. 1 p • - Hue/ventfor any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel a • .Rance Wuter heater 10,00 DESCRIPTION OF WORK Gas fir�rla 10.00 V ��� A Flue vent For water heater or gas r ; fire•lacc 10,00 $ 1 , A A. / • . Lo• li_hter gas 10.00 _�� - t_ "- PC4'24 Wood /.cllctstove 10,00 IV/ 63.7. Wood fire• lace /insert 10.00 Chimne /liner /flue/vent 10.00 74 PROPERTY OWNER ❑ TENANT Other, 10.00 t Nam[:. I1r1/I UP./ �� Environmental �g51/ nviropmental exhaust and ventilation 1 Range hood/other kitchen Address: el (p00 (/) (ocL c ui. mcnt 10.00 •-- 1. Clothes drvcr exhaust 10,00 City /Start /7.1P: GL. Single -duct exhaust (bathrooms. • Phone: ( ) Fax: ( ) toilet cam. aliment, utili rooms r 6.80 Attic/crawl, ace fans 10.00 APPLICANT f ❑ CONTACT PERSON Other: 10.00 ti l — � - I ,t�I &—Y t V-C.. Fuel •i in Contact name: DCA_ Vt. t , / SS.40 for first four; 51.00 for each additional Furnace, etc. • Address: IA, C C .411. Pat '. Gas heat .um. City /State/Z1P: • A 4_0 r1 a Wall /sus ded /unit heater � 7 -� r� }, Water heater Phone: (Me I�UO - V Fax : ( 1 Fireplace E -mail: • ' vu • ei , Z- 1A - . • Ran e CONTRACTOR Barbecue lirl Clothes d r as) Business name: Other. lr Address: -'L 1. 1 _ a MECHANICAL PERMIT . FEES* 0 _ Subtotal City/State/ZIP: '► w *l L • .4 Minimum permit Fee (572.50) ,SD Phone: ( • - a� S Fax: (4� • ' O�() Plan review (25% of permit fee) State surcharge (12% of permit fee) • AO � CLH 1ic 6_ 0 , TOTAL PERMIT FEE: • � T: f , x „ f � This permit application expires if a permit is not obtained within Ian Authorized signature: r' `J�/(�f (� days after it has bven accepted at complete. Print name: 0 i ` , / Nli • Fee methodology set by Tri•Cniimy Building Industry Service BORN I: lauildinalPannitrlMEC :•PermitApp.dac 01,15 /0' 4an -4 1 it (I IInp1COM/WEB) C TY PF TIGARD BUILDING DIVISION PERMIT #: M }0OS6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: � 10/7/2008 9 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 �' :. fI. INSPECTION WORKSHEET FOR DATE: 10/14/2008 TIME 7:OOAM PAGE: 15 SITE ADDRESS: 00500 SW OAK ST f}0 CLASS OF WORK: SUBDIVISION: P AZA _,� f LOT #: 005 TYPE OF USE: PROJECT NAME: 1. INSTITUTE DESCRIPTION: • Inciallinc gas furnace. Valuation: $4979.00 OWNER: PHONE #: I'L.AZA WEST, L.LC, CONTRACTOR: HEINZ MECHANICAL PHONE #: Inspection Request Scheduled For: Date: 1O/•14/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 076677 -01 503 -954 -5800 ¥ Corrections /Comments /Instructions: v . 1 40 L.cs.4'/ - .,: '(—.--d 0 ' Ad/ -GLs s.A - (c • • ❑ PASS PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: P Date /b /II oe Phone #: (503) 718- Zytq/