Permit •` CITY OF T I GA R D MECHANICAL PERMIT
�� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00323
s `� °�� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/17/2006
PARCEL: 2S 112 D C - 00701
SITE ADDRESS: 15989 SW 72ND AVE BLDG - ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK III LOT: 038 JURISDICTION: TIG
Project Description: Replace HVAC & swamp cooler. Valuation $12,000.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: F1 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: WOODS UNIT
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 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 7/17/200E $258.50
[TAX] 8% State Surcha 7/17/200E $20.68
Total $279.18
Phone:
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 125815
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: /= Permiftee Signature: t .-- # .
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.
Mechanical Permit Auuli t>I n 0 .01g1,.. — I FOR OFI ICI.: 1)SI ( /Nl.\
City of Tigard d B Received I , _ _
`J g Date/By. e1 f' Permit No ) _- / ' ,,
n 13125 SW Hall Blvd., Tigard, OR 97223 — .
?
II 0 Phone: 503.639.4171 Fax: 503.598 r C Plan Review
�ooU Date/By. OlherPermit:
T I G n K i Inspection Line: 503.639.4175 / U Date Ready/By: Ell ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method Supplemental Information
y,, I I 1. v= ti. w ri
TY131RICr' �V. rouliTh COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction i kj 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, lab ve d and profit.
C TEGORY OF CONSTRUCTION Value: $ 1 L�'''
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
El 1 - and 2 family dwelling Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description j Qty. I Ea. 1 Total
57 l JOB ITE INFORMATION AND LOCATION Heating/cooling
Job site address' / / . L■ 7 Z - � , , w � ( / 4 4 J? . conditioning or heat pump
uires site plan showing placement ) 14.00
City /State/ZIP: I r � / �/ r � Furnace 100,000 BTU (ducts/vents) 14.00
/ I Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Ph/14i etkp) Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
n /` /1kt y� i R n t hot water system 14.00
C FOJ /''d Residential ential boiler r (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I 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
/0 / o CzGC / �� L z, #1/00 � Gas fireplace Flue vent for water heater or gas 10.00
�
fireplace 10.00
..'/ii .. i, / • ',di fireplace
lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
APF.RTY lL�xAiF 1 ENANT Other: 10.00
Name: /17/91/ l'/ /1 �/ / t rf '1i� — VA if /9I'.4 Environmental exhaust and ventilation
Address: `� +" Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
3 /, /6/l 3 �3 Single -duct exhaust (bathrooms,
Phone: ( ) 6 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: S5.40 for first four; 51.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State/ZIP: WalVsuspended/unit heater
Phone: ( ) Fax :: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: N.../47 -4 1i c_., Clothes dryer (gas)
C ANT Other: Address: '7 MECHANICAL PERMIT FEES*
City / State/ZIP: e ,7/1 j
pi4 /i4 Subtotal ,,,z 51 .,37)
Minimum permit fee ($72.50)
Phone: ( 5) S z { '-3 Fax: (3)131 2 4 7 _v Plan review (25% of permit fee)
CCB tic.: / z c$ / State surcharge (8% of perms fee) p. a
f,J TOTAL PERMIT FEE ,,.,,e/ -741, JR
Authorized signature: v This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: U � • Fee methodology set by Tri- County Building Industry Service Board
�
1:\ Building \PennitstMEC- PermitApp..oc 04/06/06 • 1 617T(II/ "" 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.
•
1:\Building\Permits \NEC- PermitApp.doc 12/30/05 2
'i
CITY OF TIGARD -.
BUILDING DIVISION PERMIT #: MEC2006-00323
• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/17/2006
Phone: (503) 639 -4171 tti�l
Inspection Requests (24 Hrs.): (503) 639 -4175 .— .. `__..
INSPECTION WORKSHEET FOR DATE: 7/19/2006 TIME: 7:00AM PAGE: 63
SITE ADDRESS: 15989 SW 72ND AVE BLDG -A CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 038 TYPE OF USE:
PROJECT NAME: DOMINO'S PIZZA
DESCRIPTION: Replace HVAC & swamp cooler. Valuation $12,000.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: OREGON HEATING + A/C INC PHONE #: 503 - 538 -2953
Inspection Request Scheduled For: Date: 7/19/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 033282 -01 503-849 -8162 Y
Corrections /Comments/ Instructions: CU Ca(
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00 cr - . 1 tor .
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'11 eat - 0
El P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ► L FOR NSPECTION ❑ ADDITI NAL EES ASSESSED
Inspector: L Date: 7 C� ® Phone #: (503) 718- 04-7 -
p ,..►
CITY OF TIGARD MEC2006 -00323
BUILDING DIVISION PERMIT #: 7/17/2006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 m'rootiIIl`
Inspection Requests (24 Hrs.): (503) 639 -4175
7/21/2006 7:01AM 66
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
15989 SW 72ND AVE BLDG -A
SITE ADDRESS: OREGON BUSINESS PARK I11 038 CLASS OF WORK:
SUBDIVISION: DOMINO'S PIZZA LOT #: TYPE OF USE:
PROJECT NAME: Replace HVAC & swamp cooler. Valuation $12,000.
DESCRIPTION:
PACIFIC REALTY ASSOCIATES,
OWNER: OREGON HEATING + NC INC PHONE #: 503-538-2953
CONTRACTOR: PHONE #:
7/21/2006
Inspection Request Scheduled For: Date: . .A Pour Time l (f
Cca # Irma ap mription [ t h qtgto41162 Mes + , I l - rA
Corrections /Comments /Instructions:
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633 VV9 --a/ —
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t
Inspector: Da te: i ` Pho #: (503) 718 1 1 Z
P )