Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00035
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/23/2009
PARCEL: 1 S135CA -00600
SITE ADDRESS: 11200 SW GREENBURG RD OFC ZONING: R -12
SUBDIVISION: AUTUMN OAKS APARTMENTS LOT: 001 JURISDICTION: TIG
PROJECT: AUTUMN OAKS APARTMENTS
Project Description: Install furnace and a/c with associated ductwork.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: ME UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: 5 VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
AUTUMN OAKS PROPERTIES LLC Description Date Amount
6036 SW MADISON ST
PORTLAND, OR 97201 [MECH] Permit Fee 1/23/2000 $211.70
[TAX] 12% State Surch 1/23/2000 $25.40
Phone: Total $237.10
Contractor:
HEAT RELIEF CO
13122 NE DAVID CIR # 800
PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -261 -9915
FAX 503- 261 -9814
Reg #: LIC 122424
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 By: I. A i O • t! 1 Permittee Signature: i^/
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
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.
Yf
Mechanical Permit Applicatl _ � -- FOR OFFICE USE ONLY
Cl O Tigard Received
City � � �� 7a�p Permit No.: tt�t� cos J gr g I � LIA ll /A/ Date/By: (• 3 •O _ � 1 V l „Ai- • v` �1
- ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ,' "+J-`, ') 3 nog Date /By: Other Permit: mE. C200. • 6 4
Inspection Line: 503.639.4175
TIGARD Date Ready/By: EN El See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified /Method: Supplemental Information
F MAI DI G D IS x:, ,: �IJS
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�.�....... >,_ ��...�.. � �W. °4V.ORK �F ; >' �COMIYIERCIA W i E *SCHE DULE; " = LTS'I��`:
M = echanical permit fees* are based on the value of the work
❑ New construction RAdditio alteratio replacement performed. Indicate the value (rounded t the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
M f �:`r; ,ry., : °, - fix,; Value 00
• ��" <- CA'TEGCIRY' UF,�:CO'NS7'RIJC7'ION'�si' ", s� u�
•
.w RESIDENTIAL EQUIPMENT' /?SYSTEMS FEES *^
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
`£'
For special information use checklist.
Multi- famil ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE�°IlVFURMA`I'I('
3N;ANO `LOCAIbN " <:- ='
�, ,E a � Heating/cooling
a ..�. -.�' w�i��'r"t%, .e <:- �1..,�. _.�� ..... _ r.,.� ��7�.- ,.,.,...,. ......... ....�:=s,: tip.`: T :•.:a,,>�a�......._�- ''_'�.::; � ._,.
Air conditioning or heat pump 'f
Job site address: 2 O6 �� F� (requires site plan showing placement) f 14.00
9
City/State /ZIP: F k_b �� � Q'7,, ' �y Furnace 100,000 BTU (ducts /vents) 14.00 -
�) 1 y `
Furnace 100,000+ BTU (ducts /vents) I 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work rj 10.00
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. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
cam=as„ Water heater 10.00
- `: _ . DESCRIPTION ` W ::... � to t . <
'� � Li A Y7% e y . FIR vWY � Gas fireplace g as
10.00
!' �
� r � �3 fireplace 10.00
l'Q N / � ' l� �� �N'� -R44 Flue vent for water heater or � Log lighter (gas) 10.00
' i t 7_. 19 0 4/ Wood/pellet stove 10.00
Wood fireplace /insert 10.00
: a 's,,;- .,,,, rr .,,,,,...: ; .,,;_";:, Chimney /liner /flue/vent 10.00
PR PERT- OWNER 't': r TENA u >: _; _ rc , ::. " > :W
f
t -�- . "��...m �s,. =<.�s_ .....,;..�`. �_� ~� - - _, ���- ,` :�� - �- ��--�� Other: 10.00
Name: 5) A ry jyo rd r,,,-„, , R.,C 1 Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
�. ; °�?`"`�y� °' `"��'" "x`�` "'° Attic /crawls ace fans 10.00
-,=,, 4 � GO . - ACT« PE ON P
{ I Other: 10.00
Business name: /- E A L 1 R.6 1,,' Fuel piping
Contact name: C ti R L for first four; $1.00 for each additional
Address: 1 3 2 2 N� �v � , j. Gas heat e um
�W pump
City/State/ZIP: < y 4��j C) Q 7 Wall/suspended/unit heater
Phone: ) (no - 1 Fax: : (5 ) / erq Water heater
Fireplace
E -mail: Range
�� . nom _ � -��:,
,3 :;r �. M;' ,:: " „ €;•: , Barbecue
.CQIy'PRACTOR j � >' " `: °' �`= ���� � ,� ,
Business name: A' Clothes dryer (gas)
Other:
Address: - W= ; < .. H * )
%` NIEC r*7 CAG PE RMITa,3EEES
City /State /ZIP: Subtotal a
Phone: ( ) Fax: ( ) Minimum pennit fee ($72.50)
Plan review (25% of pennit fee)
CCB lic.: i 2 2_ 14 f State surcharge (12% of permit fee) L5 . 1.{0
Authorized signature: (j
This permit application expires if a permit is not obtained within 180
d ays after it has been accepted as complete.
Print name: /, !! ' / ./, 4 ` ., Date: la?/ �� * Fee methodology set by Tri- County Building Industry Service Board
6
1:\Building \ Permits \MEC- PennitApp.doc 01/19/07 440-46 17T (11 /02 /COM /WEB)
CITY OF TIGARD
BUILDING DIVISION ` c PERMIT #: MEC2019.00035
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/23/2009
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 ... ` 'I I .
INSPECTION WORKSHEET FOR DATE: ?.111/2009 TIME: 7 :00AM PAGE: 5
' SITE ADDRESS: 11200 SW GREENf3URG RD OFC CLASS OF WORK: .
SUBDIVISION: AUTUMN OAKS APAR TMENTS LOT #: 001 TYPE OF USE:
PROJECT NAME: AUTUMN OAKS APARTMENTS
DESCRIPTION: Install furnace and a/c with associated ductwork.
OWNER: AUTUMN OAKS PROPERTIES LLB`, . PHONE #:
CONTRACTOR: HEAT RELIEF CO PHONE #: 503.261-9915
Inspection Request Scheduled For: Date: 2/11/2009 Pour Time:
Code # Inspection Description - Confirm # Contact # Message
699 Mechanical final 090495 -01 503 -261 -9915 N
Corrections /Comments/ Instructions:
s l _ /
❑ PASS m 7 APPROVAL ❑ CANCEL ❑ NO ACCESS
Ii AIL / I LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Date: 1 ` )ie Phone #: (503) 718- ° 6 %0 ( )
CITY ��N�~�� ������N��������
OF m o���mmm��
BUILDING DIVISION ` PERMIT #: W1EC200900036
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/23/2009
Phone: (503) 639-4171 Awropit
Inspection Requests (24 Hrs.): (503) 639-4175 ^ h!.
INSPECTION WORKSHEET FOR DATE: 2111/2009 TIME: 7:O0AKH PAGE: 6
SITE ADDRESS: 11200 SW GRE[NBWRG CLASS OF WORK:
SUBDIVISION: AUTUMN OAKS APARTMEWTS LOT #: 001 TYPE OF USE:
PROJECT NAME: AUTUMN OAKS APARTMENTS
DESCRIPTION: Install furnace and mircvvNh associated ductwork.
OWNER: AUTUMN OAKS PR0PERT|ESLLC. PHONE #:
CONTRACTOR: HEAT REL.IEF CO PHONE #: 603.281
Inspection Request Scheduled For: Date: 2/11y2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 kAmchsmimdr*uohin 08049401 503-261-9916 N
Corrections/Comments/Instructions:
taps PARTIAL APPROVAL El CANCEL El NO ACCESS
FAIL 1/ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
/�/ �7 & *1 Z- — � |Inspector: ^� �^_�m~~-_ Da1e: /o\ / [� / Phone #: (5D3) 71B' ' 2(
CITY OF TIGARD
BUILDING DIVISION �~ PERMIT #: MEC2009 -00:35
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/:2321109
Phone: (503) 639 -4171 kw � �������A.
Inspection Requests (24 Hrs.): (503) 639 -4175 .. �!+`
INSPECTION WORKSHEET FOR DATE: 1/27/2003 TIME 7:00AM PAGE: 16
SITE ADDRESS: 11200 SW GREENBURG RD OFC CLASS OF WORK:
SUBDIVISION: AUTUMN OAKS APARTMENTS LOT #: q01 TYPE OF USE:
PROJECT NAME: AUTUMN OAKS APARTMENTS
DESCRIPTION: Install furnace and a/c: with associated ductwork.
OWNER: AUTUMN OAI <S PROPERTIES LLC, PHONE #:
CONTRACTOR: (HEAT RELIEF CO PHONE #: 503- 261_99Th
Inspection Request Scheduled For: Date: 1/27/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Messa•e
0 5 (3; Misc. inspection 080032 -01 503- 820.1248
Corrections /Comments/ Instructions:
L f ►O kid .e F1 / 76 T
(1 CC.- e 7./.6 ,p, 2 y
14/ G //---L___1(___- - /( Jo Ae_
❑ PASS iI`;h. - .. L ❑ CANCEL _ NO ACCESS
❑ FAIL %1 CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
if ' ANIII■ . tg/ L. 'ff
Inspector: _ Am1111.111. _ Date: 1 / t7 " I Phone #: (503) 718Z-6