Loading...
Permit C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 -00627 Ali- .,� I I 13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/17/2004 PARCEL: 1 S134AD -04800 SITE ADDRESS: 10765 SW BLACK DIAMOND WAY SUBDIVISION: BLACK BULL PARK ZONING: R -4.5 BLOCK: LOT: 031 JURISDICTION: TIG 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: 1 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: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: 1 FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: 1 Remarks: Replace furnace with like kind, add dryer vent and gas logs and assoc. piping. Owner: FEES CHRIS MONTY Description Date Amount 10765 SW BLACK DIAMOND [MECH] Permit Fee 9/17/200 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchart 9/17/200 $5.80 Phone: 503 - 312 - 0103 Total $78.30 Contractor: OWNER REQUIRED INSPECTIONS Phone: Gas Line Insp Mechanical Insp Reg #: Heating Unt Insp Final Inspection 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) 6699. Issu d By: ,� • �e cis _ _ i J Permittee Signature:/ )"Ie � CaII (503 .39 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application FOR OFFIC U SE ONLY'' - Received (; — , City of Tigard Date/By: 7 / 7 ex/ Permit No.:He /'io J �ao2 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit: 503.639.4171 Fax: 503.598.1960 /� e Datey: Inspection Line: 503.639.4175 o.'ll� B Date Ready/By: EI See Page 2 for www.ci.tigard.or.us W Notified/Method: Supplemental Information ` e 'a f- re , - : l c.�>� =. r..xx-. �.s. in , asM" 11 . 1 W ANN .. ; °.: : -r-a::e.�: it �:; , , ... .� -i , 1„TYP E OF ORK „� t ir . i�` •. ” :COMMERCIA *; S CHEDTJ T E "= I)SE <CHEC'KLIST s ,. _ �"_ . - ,�� � .r.. s- €�s,'�� Ek:F r � � � __.hnL'r..a. .. v� ,8 -r I . ,,;ue N:1,, _ _�'� - � _ ❑ New construction .ddition/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.:q.c .€< �, �,, - ?�' ,:..° : ;� �� � � .Rr` s xif;�i Value: $ a l u;A rCA*TE O CO NSTirieTI ON � k 4 ._..',- .:,, " .,-x. - g - z ..°« -. - % ,- ,a , �a,.; r .. aawu � S , W , rs- Y.,,^.<�z I, .. yt - 'scs � . ° ii .•�; mot 9 and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building it 1 Nri E ?,T FQUIPMEI�IT:/ SSSTEMS I EES El Multi-family ❑ Master builder ❑ Other: For special information use checklist. Description Qty. Ea. Total �y„+`k�>s,4x: • "::�'�' ^�3,�.� °�c,^,�; �`��. ^ w::�t :'., : ���,^.. ; >� „",_.,�,4:Y5.-Rr }��- .r'.��.a°�a�,^^.�`�� Yi, <, ,„ {,��,"„ JO , SI TE F®Ri1I N AND LOCATION- . �.> ,� ' Heating/cooling Job site address: ( Air conditioning or heat pump 0 76)5 SuU , " > �L\y- Dk pNO t„) (� _ (requires site plan showing placement) 14.00 City/State/ZIP: ^` c ,n + n r1 o (Z Furnace 100,000 BTU (ducts /vents) 14.00 ty : l Y',� " 7 ZZ 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 N .`>tA�,// r —e � Hydronic hot water system 14.00 i�Or'� 1 0 �n I 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 '� ` D ES` RIPTI ft j4 O RK ffi <-` 2 Water heater 10.00 ��tt Q rj t} J � Gas fireplace ent 10.00 � �� (,� Flue vent for water heater or gas t \ 1 0-eta + t O fireplace 10.00 �f ` "x`' Log lighter (gas) / 10.00 . v Wood /pellet stove 10.00 Wood fireplace /insert 10.00 - ii i -t1WN .::; `i n� y ; T ENAPI <.,. ' x:,,, Chimney/liner/flue/vent 10.00 i"� -4,-;,...,,,A.,',,,,,,,,,,;.,;,...0:4 RO$TY OWNER' : "':z . ;s „`'` Wk.. r, ' :��.� :� < � J:: ��.`'`' , �e �... �.w.� .��,�":�> a Other: 10.00 Name: C V\ r 1 5 t c , (\ Ty Environmental exhaust and ventilation Range hood /other kitchen Address: ` --z ( S _ aN IN J equipment 10.00 City/State /ZIP: TI [; , r �-iJ 1 Single -duct exhaust (bathrooms, n !1 D (L Clothes dryer exhaust / 10.00 Phone: (503) ( _ D / 6 3 Fax: . 1) toilet compartments, utility rooms) 6.80 1PPLICAN I � 1 g Attic /crawlspace fans 10.00 ® 'r� CONTACTS PERSON d Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/ State/ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range + ,'' ,$° to F �..a:,'ta"x<rss+ax."rzv„'"�# av —Ill , 1, i ' ....� . C R ” .s ' : a . ei,l ..:�_ `=: Barbecue Business name: llha©k)D ft .-- Clothes dryer (gas) I / _ Other: 1 h5 5 - No vpA� i 4� .� :� iti, - --.. _ Address: \ .? >, � � GHA �AL';�PERIVIIT�FEES * -- City/State/ZIP: r, ° 'T'' f� 0 -12_:c - q 7 2 23 Subtotal Phone: (o,) ( b � —G ` a/l5 Fax: ( 5 3) 0 0 -- (3 Minimum permit fee ($72.5 7,q , �� Plan review (25% of permit fee) CCB lie.: State surcharge (8% of permit fee) 6 9'o j - TOTAL PERMIT FEE 7 g, 30 This permit application expires if a permit is not obtained within 150 Authorized signatur. , days after it has been accepted as complete. Print name: L j - F t �j �]'L ../ Date: q� 7/0 Fee methodology set by Tr - County Building Industry Service Board is\ Building \ Permits \MEC- PerrnitApp.doc 12/03 440 -4617T (I1 /02 /C0M/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation , _< , 3 • = Permit {Fete. :.. , $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 - 24 -Hour BUILDING Inspection Line: (503 639 -4175 INSPECTION DIVISION Business Line: (51 639 -4171 MST / BUP / Received Date Requested / 7 PM BUP Location 0 - `� -= � L..� suite GO C Contact Person Ph ( )3/01- of v 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC — a 2 ?‘„ Footing Foundation ELC Ftg Drain Access: i ( U of 6o ELR Crawl Drain 1 O Slab Inspection Notes: F1 v-u o _ 0 0 „ ( „ . SIT Post & Beam l/ �-!� Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing L � � Insulation �" / / L®- - ` ' © L / °` Drywall Nailing 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 PAS---RART FAIL CAL Post & Beam ' Rough-In Line Gas Line Smoke Dampers 'ART FAIL . 4 grti - Service Rough -In UG /Slab Low Voltage Fire larm • •A PART FAIL fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reinspection RE: — Unable to inspect – no access Fire Supply Line ADA / 2- l Approach /Sidewalk Date I nspector Ext Other: Final DO NOT REMOVE this inspection record in the Job site. PASS PART FAIL •