Permit CITY OF TIGARD MECHANICAL PERMIT
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DEVELOPMENT SERVICES PERMIT #: MEC2005 -00415
., 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/27/2005
PARCEL: 2S109AC -02100
SITE ADDRESS: 14850 SW 132ND TERR ZONING: R -
SUBDIVISION: ALBERTA RIDER ELEM. SCHOOL LOT: JURISDICTION: URB
Project Description: Install refrigeration equipment for walk -in cooler and walk -in freezer.
Project Value: $5,800
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: E2 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
TIGARD - TUALATIN SCHOOL DISTRICT Description Date Amount
6960 SW SANDBURG RD [TAX] 8% State Surchar€ 7/27/200E $12.47
TIGARD, OR 97223 [MECH] Permit Fee 7/27/200E $155.90
Phone: 503- 431 -4003 Total $168.37
Contractor:
COMMERCIAL REFRIGERATION INC
5920 SE GLISAN STREET REQUIRED ITEMS AND REPORTS
PORTLAND, OR 972133790
Phone: 503 234 - 6445 •
Reg #: LIC 65271
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: . � s� Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections t at busing day.
This permit card shall be kept in a conspicuous place on the job -ite unti «. mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
. - _. ..
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Mechanical.Perrat Application ....,,,, :- - - - - -.- - FOR OFFICE USE ONLY ,..
City of Tigard ' Received
Mr" •
By: /ft
13125 SW Hall Blvd., Tigard Perrnit No.
Date/
, OR 97223 -../
Phone: 503.639.4171 Fax: 503.598.1960
1(6 litht. Plan Review
Date/By: 1
Other Permit: 4 ,040 ,
4 40 „Ai
Inspection Line: 503.639.4175 Date Ready/By: Suns. See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
0" :t -,:a.ii'tk'k4gM*,-A-ct-T 6,;:7-Ei :;•:.i.4`ita 7. PIP:PI\ 4° ,:„”,,,, , - R gt*' *-E "7-;,, ,, Cj E TPW -7 ' "It A E--6 f IE€435IST '
New construction 0 Addition/alteration/replacement. Mechanical permit fees* are based on the value of the work
1:2
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
-V• l '''''''' ' '4- r4. % 4 " ti'-::', 4-HittrAila t oltirATDR"SgffiWW I '' ' I ' l '''' *A411 Value: $ , /3 0
0 1- and 2-family dwelling "Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description Qty. Ea. Total
ible4 ,: iWOWAW0K ffctealibisV4 -Imni." Heating/cooling
Job site address: (73 ( 0 ) 1-32 kiiiE4ce„. . Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: " A4Azk 0 A_ q? 22, V Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg/apt. no.: Project name:11
111--Bek ( D.15/1- Gas heat pump 14.00
Cross street/directions to job site: sc..a. 04. ex.)-f _5 c t. 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
Flue/vent for any of above 10.00
Subdivision: . Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
Water heater 10.00
Gas fireplace 10.00
. 12e_r (2_< "A 1 d 41 14'0T vent for water heater or gas
i 2.V 4 L 0-1 LI- c'.- 4xr_1- Lei ACit -----00 fireplace 10.00
Log lighter (gas) 10.00
F7A(22.__-G1, Wood/pellet stove 10.00
. Wood fireplace/insert 10.00
It: - in A". =:,-0.r*.::': -•:, „;,;, frr..-A4-ygm. .r. :;.-,,,,,, : - , 11 Chimney/liner/flue/vent 10.00
:-,-,„-_,:„: ' ., 1 3: - M,...JEW Y 42, - „WAVAU,:k4 r IPI,.- , : 1.9„1-11rt t f-trAt.q.! - ... - oth 10.00 •
Name: Environmental exhaust and ventilation
. .
Range hood/other kitchen
Address:
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
• Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) : „ ' • toilet compartments, utility rooms) 6.80
44 1ArOW4k4-.•-'briWii -7 .: : .'''''',W41: A IR '•e< 4 -i'llywkweirpuvero".tiv Attic/crawlspace fans 10.00
,vat, % ,=',....cizi.U: 1 -1r, !via
• Other: 10.00
Business name: Co r vt _ m _ ift..4 (4 c p_
Fuel piping .
Contact name: d_e_a_rt.y ti_ e_ Co 11_y1/4,/c1(._. $5.40 for first four; $1.00 for each additional
Fumace, etc.
Address: -5a7 2 ) Ai :;__ 6-(25/cfrti
Gas heat pump
City/State/ZIP: Po (Lt- ,c) n_ 9 (3 Wall/suspended/unit heater
Phone: (9)3 ) - 2.3q_ 4 c(cec Fax: : ( ) . - _
it 06 6.?"-- Water heater
Fireplace
E-mail: Range
: W")- = “-= Barbecue
", ,`,%; .4 ':.7`..,' ..,. ': ,:".':' - TirZ:' IVL,,
Business name: 51 A.A A--s A 13d ar__, Clothes dryer (gas)
Other:
Address: . plaTkr f '''-'"
A ; '::' ';*,.r,,;•; ,-;',--- - -
City/State/ZIP: Subtotal
Phone ( ) Fax ( ) Minimum permit fee ($72.50)
: :
Plan review (25% of permit fee)
CCB lic.: 6 (,) .2_-- I . State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name _a_p_y "L c A", i circ_ Date: , 7 * Fee methodology set by Tri-County Building Industry Service Board
i:\Building\Permits\MEC-PermimApp.doc 12/03 440-4617T (11/02/COM/WEB)
, , )
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: 7/27/200�
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 AO :11V ....
Inspection Requests (24 Hrs.): (503) 639 -4175 - 10/24/2 00 7:02AM 55
1 INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
14850 SW 132ND TERR
SITE ADDRESS: ALBERTA RIDER ELEM. SCHOOL CLASS OF WORK:
SUBDIVISION: ALBERTA RIDER ELEMENTARY LOT #: TYPE OF USE:
PROJECT NAME: Install refrigeration equipment for walk-in cooler and walk-in freezer.
DESCRIPTION: Project Value: $5,800
TIGARD - TUALATIN SCHOOL DISTRICT, 503- 431 -4003
OWNER: COMMERCIAL REFRIGERATION INC PHONE #: 503- 234 -6445
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
I
Coda # 1
In �ection f �saclription SM Se 0g15159 8 # 559 Message
c anica p
Corrections/Comments/Instructions:
' A °P-jP-
immirmistir irri
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ASS I I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: pr Date: I Phone #: (503) 718 -