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Permit
;ice /, lianr C ITY OF TIGAR I MECHANICAL PERMIT A l$0 , 0 6 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00406 ' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/24/2004 PARCEL: 1 S125DA -07900 SITE ADDRESS: 09161 SW 69TH AVE SUBDIVISION: KINGS VIEW ZONING: R -4.5 BLOCK: LOT: 074 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: ELE 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: > 10000 cfm: Remarks: AC install. Owner: FEES PAINE, JEFFREY C Description Date Amount 9155 SW 69TH AVE [TAX] 8% State Surchar€ 6/24/200 $5.80 TIGARD, OR 97223 [MECH] Permit Fee 6/24/200 $72.50 Phone: 293 -1379 Total $78.30 Contractor: PACIFIC NW HEATING & COOLING 16609 NE 80TH ST. VANCOUVER, WA 98682 REQUIRED INSPECTIONS Phone: 503 - 793 -0807 Cooling Unt Insp Final Inspection Reg #: LIC 150253 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. Issued By. , jr411 . Permittee Signature: 1e Call 503) 639 -4175 by 7:00 P.M. for inspections needed the nex business day CITY OF TIGARD 24 -Hour �•- BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST -� BUP Received C Date Requested (.0 AM PM BUP Location / / 6. (294 Suite_ MECd `L Contact Person Ph ( ) j 3 - 7 9 PLM Contractor Ph ( ) `'l 3 -0 8'07 SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear 11-14 -1 ✓ " _ � _ l � £ " 0 ' k _ 0 0 3� 2 Framing - f' r (n li Insulation Drywall Nailing '�E� =o cLGc�ns Cis- - �-- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In i■, � /' Gas Line Smoke Dampers Final PASS FAIL ELECT A L Service Rough -In UG/Slab Low Voltage Fire Alarm Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date ` 2J 4 9----- Inspector - Ext Other: Final DO NOT REMOVE thls Inspection record from the job site. PASS PART FAIL w, , C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 -00406 -'' ' '-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/24/2004 PARCEL: 1 S125DA -07900 SITE ADDRESS: 09155 SW 69TH AVE SUBDIVISION: KINGS VIEW ZONING: R -4.5 BLOCK: LOT: 074 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: ELE 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: > 10000 cfm: Remarks: AC install. Owner: FEES PAINE, JEFFREY C Description Date Amount 9155 SW 69TH AVE [TAX] 8% State Surchart 6/24/200 $5.80 TIGARD, OR 97223 [MECH] Permit Fee 6/24/200 $72.50 Phone: 293 -1379 Total $78.30 Contractor: PACIFIC NW HEATING & COOLING 16609 NE 80TH ST. VANCOUVER, WA 98682 REQUIRED INSPECTIONS Phone: 503 - 793 -0807 Cooling Unt Insp Final Inspection Reg #: LIC 150253 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. Issued By: 4 Z , ,, . d . ,_ _,,,e z , . Permittee Signature: _ j Call (503) 639 -4175 by 7:00 P.M. for inspections ne :J! he next bus' s day Mec cal Permit Application FOR OFFICE USE ONLY City O Tigard Received / By � Q jo rj (� LA , permit N. t T L ��i O4 dip Da :IF /MO 13125 SW Hall Blvd -, Tigard, OR 97223 Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 id r 9 „ • . D ateBy: Other Permit: Inspection Line: 503.639.4175 , " i Internet: www.Ci.6 ard.or.us - - -� Date ed /Met Ready/By: Juris: See Page 2 for g Notified/Method: 716 Supplemental Information • - TYPE OF WORK COMMERCIAL FEE* 'SCHED -- USECHECKLIST Mechanical permit fees* are based o the value of the work ❑ New construction Q Addition/alteration/replacement ❑ Demolition 4 ✓� Other: performed. Indicate the value (roun ed to the nearest dollar) of all mechanical materials, equipment, 1 bor, overhead, and profit. .CATEGORY OF CONSTRUCTION Value: $ A 1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES* Master builder For special information use checklist. Multi - famil ❑ Multi ❑ 0 Description Qty. 1 Ea. Total JOB SITE INFORMATION AND LOCATION • : Heating/cooling Job site address: 641 S'S neV s'9. ith 'NYJ Air ' ' ning or heat pump re utres site p showing placement) / 14.00 City/State/ZIP: i t' 0 /, P 0 7-2 22 3 Furnace , 00 BTU ( ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat 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 n (Cbo' Gas fir eplace 10.00 4 / , Cn./ +)F /n• CA/ J V C 1 de s Flue vent for water heater or gas it et c/ / coo {� /�) J d / 1�1_ 10.00 t�1 Loog g ligh ghter (gas) 10.00 / Wood/pellet stove 10.00 Wood fireplace /insert 10.00 ❑ PROPERTY OWNER ❑ TENANT ' • • Chimney/liner /flue /vent 10.00 -- Other: 10.00 Name: :7� Environmental exhaust and ventilation Address: a f 1 e J'/?` Range hood other kitchen K. equipment 10.00 City/ State/ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (3) 2 t3 (3 -79 Fax: ( ) toilet compartments, utility rooms) 6.80 APPLICANT - ❑ CONTACT PERSON - Attic /crawlspace fans 10.00 Business name: - PQ.c4 c j ) AG r Y W vie A ct vt,, �e®�„ Other: 10.00 U � g 4 t t�j Fuel piping Contact name: �Q � 'l / ( v / /// $5.40 for first four; $1.00 for each additional Address: / 6 ,c l 0 9 c - r f t t V 1, Furnace, ace, etc. l l ) C ©vifrk (/ '9 Gas heat pump City/ State/ZIP: v�l 4 � P2 WalVsuspended/unitheater Phone: (5C3 •7% 3 ono 1 1 Fax: : ( ) Water heater Fireplace E - mail: ci Qykte:3 1 7 ` t of 0 eel- v C O S Ile. I^ Range . CONTRACTOR . Barbecue Business name: 3,4-A- --- 4 IV---i Cli-Xf Clothes dryer (gas) Other: Address: . MECHANICAL PERMIT FEES* City/ State/ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) _ 4 -3 - 0 _ G� Plan review (25% of permit fee) CCB lic.: CC (3 % 4' c0 2.., `' 3 / _�` ,..(). State surcharge (8% of permit fee) ,,--,s--o ...... B TOTAL PERMIT FEE — 7 . _ Authorized signature: ` This permit application expires if a permit is not obtained within 180 / days after it has been accepted as complete. / Print name: L�tt s e / or Date: �,'2 4/ ®7 * Fee methodology set by Tri- County Building Industry Service Board i:\Building\Permits C- PermitApp.doc 12/03 440 -4617T (11 /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. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 06/24/2004 11:43 FAX 5035981960 CITY OF TIGARD fZ1001 * * * * * * * * * * * * * * * * * * * ** .. „. * ** TX REPORT * ** �. * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /R% NO 1339 CONNECTION TEL 5035572990 SUBADDRESS CONNECTION ID ST. TIME 06/24 11:42 USAGE T 00'33 PGS. SENT 1 RESULT OK • " • CITY OF T 71 MECHANICAL PERMIT : ; _. DEVELOPMENT SERVICES PERMIT #: MEC2004 -00403 �� �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 6/24/2004 PAARR ED: CEL: 2 2S 510 108AD -11200 SITE ADDRESS: 14510 SW CHARDONNAY AVE SUBDIVISION: YOUNG PARTITION /MLP2002 -00010 ZONING: R -7 BLOCK: LOT: 003 JURISDICTION: URB CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: ELE 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 > =TOOK BTU: < =10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: AC install. _ Owner: FEES GELLATLY, ERIK Description Date Amount 14510 SW CHARDONNAY ____ [VMECHJ P ermit F ee 6/24/200 $72.50 TIGARD, OR 97224 [UTAX] 8% State Surcha 6/24/200/ $5.80 Total $78.30 Phone: 415- 320 -0113 Contractor: A -TEMP HEATING & COOLING 16000 SE EVELYN ST CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Cooling Unt Insp Phone: 503-650-9602 Final Inspection Reg #: LIC 71878