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Permit 4 X * m CITY TIGARD MECHANICAL PERMIT I t DEVELOPMENT SERVICES PERMIT #: MEC2004 -00113 r�" DATE ISSUED: 3/11 /04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 114A0 -01500 SITE ADDRESS: 17005 SW 92ND AVENUE SUBDIVISION: ZONING: R -12 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: UNK 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: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2 > 10000 cfm: GAS OUTLETS: Remarks: Grill and Fryer inspection. Owner: FEES TIGARD, CITY OF Description Date Amount 13125 SW HALL TIGARD, OR 97223 [MECH] Permit Fee 3/11 /04 $72.50 [TAX] 8% State 3/11/04 $5.80 Phone: Total $78.30 Contractor: OWNER REQUIRED INSPECTIONS Phone: Mechanical Insp Final Inspection 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 952-0014410 through OAR 952 -001 -0100. You may obtain copies of these rules or direct q esti. to OU ►,C •y calling (503)246 -6699 ' Issued By: : , •4 Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application, , FOR OFFICE USE ONLY City of Tigard Received "--// - p • Permit No.m l/ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 //y imu'gl i� Other Permit: �"NP d'I) Date/By: Inspection Line: 503.639.4175 Date Ready/By: Saris: H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: ./ ' i cl Supplemental Information c * srre�.tr� : q" } '�' .�5.�..� =i.:a- .s ve4i. ri.�.>'.s?�,+v °. -agrs, amt�`w.S`« =- " "s . -. y Y'.;„ °- `�;%n." - - c�;*:dr: :i ..; , ., -3. .. as " r - ';,r" gS lkat . . ` - - „a`•ii �% �+r "=ii =x. :' ' .x s �° • _ . , - °`' - ,TYPE QE WORK W. ' ' :: COMMERC F SC H E D ULE - - ` _ �- �.'��ia�`°` � . ��'.:� �_ ...u�- ara��...;ar .,€ r _ te a.., ,.. .� ...y i_ a,� . _. _�.. .. s� °�? i':•°s'�"-°' �� . ❑ New construction % 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, labor, overhead, and profit. ,, s }+�',,�,y s. ° ..� � �s:� : 'w . J y . . `zw �,* � .� & " 3 c �a"" - 4 , +'� ` Value: $ ' , .reds �. W x : .° - * ._ . , ', , h �' s 5, CATEGORY y OF C,QNSTRUCTIO ';_ .,..<. 4 ..e; x`..� , .„ ; 4 , R ESIDE N T IAL - : . .U th E /.`SYS°TEMS:FEES ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building "'� ' . '' ' ` " ❑ Multi- family ❑ Master builder J Other: For special information use checklist. Description Qty. Ea. Total =' ' : - �, >,�, JQB SITE; O I AT1 ,..;_ , r 'j Heatin coolin Job site address: b 0 yI Air conditioning or heat pump ( a 1 � (requires site plan showing placement) 14.00 F umace 100,000 BTU (ducts/vents) 14.00 Ciry /State /ZIP,: 7 6 d o R 9 � aa L i - — `� 3 0 ( > ) I, /� p l Fumace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Projectname: I G► CJYtUtSS 1 n� 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 ,` ° - ` l , ". s l Water heater 10.00 �DES OF WOR "' ,M, R� ,�t, r = '�� _r.. �, ». ,. J �a � Gas fireplace 10.00 a i q tit t Ci y, C 4 /; - Ii h (L' C a . ( Flue vent for water heater or gas (4 e V pl t' Dt 6X (. h fit Sty? o' S S It 0I, h oo c, fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 t v { ., ,bi : W : ::: i " 5: .,fir : :,, � -..:> "=T,V.,, Sail" Chimney /liner /flue /vent 10.00 », ".: 1 P :o.' 4co. « " v. T ENANT a z�•: .� �> „��a.:;��,...��,.. ��. �, � ,,,,,,,,d,:;-:_g,,,. �4�„� Other: 10.00 C f ' 1 Name: C 1 b 5 Ir A � 0 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 ,iii APPLICANT S ` 3 4 ' CON K 1 'P SON ') ; Attic /crawlspace fans 10.00 s. Other: 10.00 Business name: Fuel piping Contact name: :II v (� A p pi (rS Oh $5.40 for first four; $1.00 for each additional .�,�( t -�f Address: I f $ In4 ' L r l e l I /5/40e Fumace, etc. Gas heat pump . City/State /ZIP: ) i 5 AY ( 1Y 6 2 9 Ti a / Wall /suspended /unit heater Phone: �] v / J ( p tr SCE � _ C 3 �(_ Fax:: ( ) Water heater Range ^ Fireplace E- mail: 3r a h P r 9q Cu V 1 '1l C A S � vie Range ge ,_ ?`r .�- 'u s. :' f .,,� t `"&, .}ice Barbecue a „ .t - OlYTi2',,,,At -t `' + ` �� a3".: ' � 6 -ao-e. @ .,, , ...e. «YA. S. i.., �4 - 3.. u., e� E ?e:... ._3 ��`,; Business name: ©/V NG12 Clothes d er (gas) l Other: j( er Ahl p 6 li a Address : °.1 ., �b �.:-rt�i° > l ' -� :..; r..�� ., -�;* .: ,,. �:1VIECHA'1�TfGA=I; PEItlGI1aTKEEES €, �,;.��_ Via• sm. .�:x=y� �. - �wr:-,. =' ,City/State /ZIP: Subtotal Minimum permit fee ($72.50) '2a Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lie.: State surcharge (8% of permit fee) s, kO I TOTAL PERMIT FEE 7 g 30 Authorized s • . to : f ,! This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1 91111 A i I t Q • * Fee methodology set by Trt- County Building Industry Service Board i:\Building \Permits \MEC- PermitApp doc 12/03 440 -4617T (I 1 /02 /COM/WEB) Mechanical Permit Application - City of Tigard . Page 2 - Supplemental Information Commercial Fee Schedule: otal� aluat>�on ; . ; P t Fee s $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 CITY OF TIGARD BUILDING DIVISION 4 PERMIT #: MEC2004_00113 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3111/2004 Phone: (503) 639 4171�'pnypupVl�i� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/27/2005 TIME: 7 :10AM PAGE: 62 SITE ADDRESS: 17005 SW 92ND AVENUE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: COOK PARK DESCRIPTION: Grill and Fryer inspection. OWNER: TIGARD, CITY OF, PHONE #: CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 007865 -01 503- 880-3180 Y Corrections /Comments /Instructions: �k.)b---4tra0 1 . • PASS ❑PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO AL F ES ASSESSED • Inspector: Date: / l `� Phone #: (503) 718