Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00762 �� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/21/2005 PARCEL: 1 S135AA -AC001 SITE ADDRESS: 10450 SW 90TH AVE ZONING: R - 4.5 SUBDIVISION: ASHBROOK CONDOMINIUMS LOT: 001 JURISDICTION: TIG Project Description: Building 2: 4 townhouse units. Other units: (4) gas fireplaces Addresses: 10450, 10452, 10454 & 10456 SW 90th Ave. CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: 8 OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 4 STORIES: 3 BOILERS /COMPRESSORS HOODS: 4 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: 4 AIR HANDLING UNITS CLO DRYERS: 4 FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 4 > 10000 cfm: GAS OUTLETS: 20 Owner: FEES MATRIX DEVELOPMENT Description Date Amount 12755 SW 69TH AVE, SUITE 100 [MECH] Permit Fee 11/21/20C $442.80 TIGARD, OR 97223 [TAX] 8% State Surchar€ 11/21/20C $35.42 Phone: 503- 620 -2020 Total $478.22 Contractor: REQUIRED ITEMS AND REPORTS Phone: Reg #: 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: Permittee Signature: 42/1"/ !r- 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 completi• of the project. Approved plans are required on the job site at the time of each inspection. Permit Application ce FOR OFFICE USE ONLY 1 chanica1 ity of Tigard CP o By. ,1 /� Permit No.: / /A= CO 7 4 2. 13125 SW Hall Blvd., Tigard, OR 97223 -}�� t1o� . i 1. Plan Review Other Permit: Phone: 503.639.4171 Fax: 503.598.1960s / „ic)� p �.; <� Date/By Inspection Line: 503.639.4175 Pp°° \ , t ,. ' II p _ Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us 1 �d �� �n 'S\U, Notified/Method: Supplemental Information TYPE O'l 'QRK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST °V • M echanical permit fees* are based on the value of the work • ® New construction ❑ Addition/a1teration/replacement p performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ dwelling RESIDENTIAL EQUIPMENT/ SYSTEMS 'FEES* ❑ 1 - and 2-family g ❑ Commercial /industrial ❑ Accessory building IR Multi- family ❑ Master builder ❑ Other: For special information use checklist. Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating /cooling �® �J -IA Air conditioning or heat pump Job site address: i. .! 9 O tic. (requires site plan showing placement) 14.00 City /State /ZIP: Ti6.4,Ep Ore. 97223 Furnace 100,000 BTU (ducts/vents) 14.00 :5 6+ 1549 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: (3LD oq. Project name k CA_, n�i✓! tUrti heat pump 14.00 Cross street /directions to job site: `0 7 / A. #0 Duct work ` 14.00 ,, , Hydronic hot water system "1 14.00 o • Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: 4.5 0/< Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: / S 135A4 -AC co/ Other fuel appliances ` •� DESCRIPTION OF WORK Water heater 10.00 •[g[� Gas fireplace !-f 10.00 zip p Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 f • Wood /pellet stove 10.00 Wood fireplace /insert • 10.00 Chimney /liner /flue/vent 10.00 ' ist PROPERTY OWNER .0 TENANT Other: 10.00 Name: 4 iRi y v l,/eld ..)..i it/7- Environmental exhaust and ventilation Range hood/other kitchen top Address: 127 55 SA ' 91A AU4 / .50/7 �� dr9c � equipment 10.00 CO • City /State /ZIP: -T ie-A/W . ® 97223 Clothes dryer exhaust Lf 10.00 Q.O° Single -duct exhaust (bathrooms, Phone: ( 503) 626-2010 Fax: ( ) toilet compartments, utility rooms) 3, 6.80 S ' y0 ❑ APPLICANT ® CONTACT PERSON ' Attic/crawlspace fans 10.00 Other: 10.00 Business name: 4'C,17 N04-7/ -s Fuel piping Contact name: 634 I.S i $5.40 for first four; $1.00 for each additional Address: Furnace, etc. / Gas heat pump 0 City /State /ZIP: Wall /suspended/unit heater rp-0, � ( S'03) 7.31 ( g ( ) Wa ter heater yf ' Phone: b Fax: Fireplace 4 • E -mail: Range j {/ CONTRACTOR, / Barbecue Business name: ��G�/ T L' 71 - 72A/ /�/ � Clothes dryer (gas) 11 [ ~ ,/ Other: Address: �"5C2 �6 S' E, z2,4 l/ U!� MECHANICAL FEES* City /State /ZIP: C /4c/c� S on. g7ots Subtotal , - 466 Phone: ( 03) �� 6SS , -a // gJ/ Fax: (S - B3) ' 751/ Minimum Plan review ( permit feer of feeee) ) • CCB lie.: 7 C� permit ,([ State surcharge (8% of permit fee) ` TOTAL PERMIT FEE ?8 . P Authorized signature: l r This permit application expires if a permit is not obtained within 180 ,'`� days after it has been accepted as complete. Print name: C /Xe /S i L Date: //A50 • Fee methodology set by Tri- County Building Industry Service Board s i:\ Building \Permits\MEC- PermitApp.doc 12/03 4404617T (I I /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supple Information , Commercial ee Schedule: Total Valuati ' Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.10 $72.50 for the first ,000.00 and $2.30 for each additional 000.00 or fraction thereof, to and in . uding $5,000.00. $5,001.00 to $10,000.00 $141.50 for the st $5,000.00 and $1.80 for each . 4 ditional $100.00 or fraction thereo t, to and including $10,000.00.. $10,001.00 to $50,000.00 $231.50 for e first $10,000.00 and 1.35 fore. h additional $100.00 or fr: ction the eof, to and including $51 000.11. $50,001.00 to $100,000.00 $771. 0 or the first $50,000.00 and $1.25 :.r each additional $100.00 or fracti., iereof, to and including $100,100.11. $100,000.01 and up $1, '6.50 fo the first $100,000.00 and $1 0 for each : dditional $100.00 or ction thereof. Note: , All new comm cial buildings require • sets of plans. • i: \Buildin g \Permits\MEC- PermitApp.doc 12/03 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: IvIEC2005-00762 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2005 Phone: (503) 639-4171 _ i Inspection Requests (24 Hrs.): (503) 639-4175 t lL INSPECTION WORKSHEET FOR DATE: 6/2/2006 TIME: 7:08AM PAGE: 52 SITE ADDRESS: 10450 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 00 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Building 2: 4 townhouse units. Other units: (4) gas fireplaces Addresses: 10450, 10452, 10454 & 10466 SW 90th Ave. OWNER: MATRIX DEVELOPMENT, PHONE #: 503-620-2020 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 6/212006 Pour Time: Code # Inspection Description Confirm # Contact # ', essage 699 Mechanical final 031002-01 503-209•7386 Y Corrections/Comments/Instructions: kJ 6—kr \eq 0NA & r/ 2-1/die (DA4N9 — *.5•5,--uLk,s , / 091-6 /0 Cfcv( 1-0 -crt--2_ 196 J -.-- • 1 0 - . . , ‘ .- QtO Pqt- 54.3-c.S.- ate_ CceLs v2-&-i-v 6v(-2--- _ i oq '. 1\1 d Ai C. Teis \ - ... _ k / ; , / ' , , . Xik,ss 1 1 PARTIAL APPROVAL fl CANCEL NO ACCESS El FAIL I I CALL FOR INSPECTION [ I ADDITIONAL FEES ASSESSED ‘12 r. Inspector: - Date: 6 6 10 P 4-2 Phone #: (503) 718- r CITY OF TIGARD - -, BUILDING DIVISION PERMIT #: MEC2005-00762 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2005 Phone: (503) 639-4171 Afi II, ov Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET WORKSHEET FOR DATE: 5/24/2006 TIME: 7:12AM PAGE: 76 SITE ADDRESS: 10450 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUlvt3 LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Building 2: 4 townhouse units. Other units: (4) gas fireplaces Addresses: 10450, 10452, 10454 & 10456 SW 90th Ave. OWNER: MATRIX DEVELOPMENT, PHONE #: 503-6202020 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 5/24/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechallical final 030447-03 503-209-7386 N Corrections/Comments/Instructions: 1 .:1 4 = 2 ; 2 1. lia tc!" -.0 ---•;'-gr . - 1l, ). ' Aiti OAIA,' A g A ki . 41LCS gal 0 , ilmf,011r ri■ !Dv rrp.■, wriv e■ `- All l ip do , .. u -. A ..-- • tr.-- 1—• 0, klit--U, ...- .\\ • i I P S k 71 I PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS - FAIL ' El CALL FOR INSPECTION 0 ADDIT • NAL F ES ASSESSED Inspector: ka A3 AFJ, i A ■,, Date: '4 1 41' ••- /P Phone #: (503) 718- V . ____ CITY OF TIGARD .. ' BUILDING DIVISION PERMIT #: MEC2006.00762 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11121120(15 Phone: (503) 639 -4171 4iifit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 511//2006 TIME: 7 :00AM PAGE: 37 SITE ADDRESS: 10450 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Building 2: 4 townhefuse units. Other units: (4) gas fireplaces Addresses: 10450, 10462, 10464 & 10456 SW 90th Ave. OWNER: MATRIX DEVELOPMENT, PHONE #: 503 - 620 -2020 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 5/11/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 029709-04 503-209-7386 N Corrections /Comments/ Instructions: � c(- - 7 - kaa ( - - b.d40 )z /-, • 0 2_ 6 A-v - z17‘A c-- Pv ASS • I P PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ,_ Date: 5 / 1 Phone #: (503) 718 - CITY OF TIGARD ' r BUILDING DIVISION PERMIT #: MEC2005- 00767 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i1/21/2005 Phone: (503) 639-4171 A\ Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 212006 TIME: 7 PAGE: 3 SITE ADDRESS: 1060 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHI3ROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK IBROc K tx03�I OMiNIIIMS DESCRIPTION: F3uilding 2: 4 townhouse units. Other units: (4) gas fireplaces Addresses: 10450, 10452, 10454 & 1045E SW 90th Ave. OWNER: MATRIX{ DEVELOPMENT, PHONE #: S CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 2 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 027332 -04 51. *i-2[) 7386 1 S Corrections /Comments /Instructions: !/N r7- li -A* , ❑ PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Z —22--rr e.P Phone #: (503) 718- 24-1—S-- r CITY OF TIGARD = - ing6- BUILDING DIVISION PERMIT #: ?\005 DU /.7( A 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 .R Opp• (i Inspection Requests (24 Hrs.): (503) 639 -4175 ° _.... INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 0 U J V e) CLASS OF WORK: . SUBDIVISION: LOT #: TYPE OF USE: I PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: a — / q-6) e( Pour Time: Code # Inspection Description Confirm # Contact # , Message me L1VV1.✓1 - ( 1 I 2 ) © Corrections /Comments /Instructions: q 1/ c)k,-� s k it Co c L.; - 1-.-A- < A---- 4_,o a k . , X70 _ ie., s4— v .-(\■- t 1.t, - 4 0 CO 4 t S - Q s-1-- az 61 a l R: * 0- ,e., Jam✓ - ' S u . • � bf PASS V PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ` ADDITIONAL FEES ASSESSED /f� Inspector: 1 ' (/' Date: I i f Phone #: (503) 718- 2- ' f CITY \ OF TIGARD 'Y �- it i BUILDING DIVISION PERMIT #: IA ECt006- 007x32 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/ 005 Ph (503) 639 4171 �ii�El�I�I� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 2/7/2006 TIME: 7:02AM PAGE: 6 SITE ADDRESS: 10450 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASHBROOK CONDOMINIUMS DESCRIPTION: Building 2: 4 townhouse units. Other units: (4) ga.: fireplaces Addresses: 10450, 10452, 10454 & 10456 SW 90th Ave. OWNER: MATRIX DEVELOPMENT, PHONE #: 503.620.2030 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 2/7/2006 Pour Time: 4 114A Code # Inspection Description Confirm # Contact # M: -age 610 Gas line 026420 -04 503 - 209-7386 Y r / Corrections /Comments /Instructions: ' c iii e • �' txc -ei ds �4 (-/C-/-4 Ir--- g � ter! - a- d z o hi- -- 00a. Lt_, 7.1 `3 C l , / / / A-3 - s—" c 6 s l e_ --- ----- - --c--\, i i ' ' . . &- - I Oz.e_1 I, -------_____=---- -- y tiAl./ -. Cans (-L__;7.,9, (J )ac)- ° / / ;)--s -c '1� - `)- 1 L - -7 .- C I n PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` ✓4. (..---- Date: ?/-.2 D' r Phone #: (503) 718- -2-4-(7-Y 1 CITY OFTIGARD - *.. O GAR .: BUILDING DIVISION PERMIT #: MEC- 5.00762 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2005 Phone: (503) 639 -4171 : my /11411 s �lhl Inspection Requests (24 Hrs.): (503) 639 -4175 ��� :_.. INSPECTION WORKSHEET FOR DATE: 9/7/2006 TIME: 7 :O AM PAGE: 5 SITE ADDRESS: 10450 SW 90TH AVE CLASS OF WORK: SUBDIVISION: ASHOROOK CONDOMINIUMS LOT #: 001 TYPE OF USE: PROJECT NAME: ASH ROOK CONDOMINIUMS DESCRIPTION: Building 2: 4 townhouse units. Other units: (4) gee fireplaces Addresses: 10450, 10452, 10454 & 10456 SW 90th Ave. OWNER: MATRIX DEVELOPMENT, PHONE #: 503rG20 -2070 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 2/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Mess , Ct` 6 Mechanical rough 026420 -05 603. 209.7306 Y' Corrections /Comments /Instructions: . l - 4 - 71 - Q V2e,_./ \ 0 0.-J I.-%W. . T i \ i' e...„. i bletjte ( L‘--. c.,÷ - A -2- f — -C--: " - (•iteD 6 C" 4-7Z,,C A O re...- 5 L a J2 Q • k kfc.,-7 ,i 3 i .h0, r _ 4 46L/ / ia-"e4e■it< ..._ i _ � � 4. 1 `�, - hc � . . , . _ __ ____ .__"-____. Aiti 65/--QA-eA-u t r l./ CI-4-4-‘..,---1.,‘ _ _ -- r- ,,. , q r , N 6---e At-4*. ' v i ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS l' ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V 6 ` \ `° Date: ' ( 76-6 Phone #: (503) 718- 2'2t -- .. ,:_,. Inspections Required for: t11 _ 0076 L • ✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By J BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground/slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in • 805 MFG - Structure grading /footing 125 Wall cover 210 Foundation walls 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab __ 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post/beam structural 150 Hot tub /spa/pool 230 Underfloor insulation 195 Misc. inspection: 235 Shear walls /anchors 199 Electrical final _J 240 Exterior sheathing 245 Firewall 250 Roof nailing _ ELR - Restricted Energy Permit 255 Wtr proofing basement walls 135 Low. voltage • 260 Tilt -up panel 195 Misc. inspection: _ 265 Masonry 199 Electrical final • 270 Reinforcing steel (rebar) • 275 Framing _ MEC - Mechanical Permit 810 MFG - Structure set -up MIN 280 Insulation 605 Post/beam me anica,I. Mill 285 Drywall nailing J �� 610 Gas line 0u1T,v 4 A, cay ,Z— .% 287 Suspended ceilin? 615 Mechanical rough in 295 Misc. inspection: 620 H dronic .i.in. 625 Duct work 899 MFG Structure final 630 Fire dameer 498 Grading final 635 Smoke detector shutdown 299 Final inspection ■ 640 Exhaust hood - 695 Misc. ins section: • t 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit .,. 910 Sprinkler rough -in 305 Plumbing underslab __I • 915 Fire alarm rough -in 310 Crawl drain . 920 Suppression trip test 315 Post/beam plumbing _ • 995 Misc. inspection: _ 320 Plumbing rough -in 998 Alarm final _ 325 RP/backflow preventer 999 Sprinkler final 330 Water service t. _ 335 Rain drain 340 Storm drain SIT - Site Work Permit - 505 Sanitary sewer 405 Excavation 345 Culvert/catch basin 410 Fill 350 Septic tank 415 Grading 395 Misc. inspection: 205 Footing _ 399 Plumbing final 1 210 Foundation walls _ 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: _ 505 Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection 599 Final inspection I: \Building \IVR \InspCard- AOP.doc 06/17/2005 • CITY TIGARD - MECHANICAL. PERMIT -_ ' DEVELOPMENT SERVICES PERMIT #: ME.C2005- 00762 13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 DATE IPAARCELRCEL: 1'1121/2005 : 1 S1351 -AC001 SITE ADDRESS: 10450 SW 90TH AVE ZONING: R -4.5 SUBDIVISION: ASHBROOK CONDOMINIUMS LOT: 001 JURISDICTION: TiG Project Description: Building 2: 4 townhouse units. Other units: (4) gas fireplaces Addresses: 10450, 10452, 10454 & 10456 SW 90th Ave. CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: 8 OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 4 STORIES: 3 BOILERS /COMPRESSORS HOODS: 4 FUEL TYPES 0 - 3 HP: DOMES. INCIN: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: REPAIR GAS PRESSURE: 50 + HP: CLO DRYERS: 4 FURN < 100K BTU: 4 AIR HANDLING UNITS OTHER UNITS: 4 • FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS 20 > 10000 cfm: – — - - I Owner: - -- — FEES MATRIX DEVELOPMENT Description Date Amount 12755 SW 69TH AVE, SUITE 100 [MECH] Permit Fee 11/21/20C X442.80 TR ArRD, OR 97223 [TAX] 8% State Surchaq 11/21120C $35,42 - -+- - Total - - - � — $478.22 Phone: 503 -620 -2020 — __ - -._ Contractor: TIP REQUIRED ITEMS AND REPORTS 0 Phone: Reg #: O • 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 952-001-0103. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 -:i32 -2344. � i f t j Issued B Y: !- , a r = " Perrnitfe_ Signature: Call 503 -639 -4175 by 7:00 a.m. for inspections that business day. This permit card shall he kept in a conspicuous place on the job site until completiorio tt project. Approved plans are required on the job site at the time of each inspection.