Permit / CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -10046
��i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/27/2006
PARCEL: 2S 110BC -00900
SITE ADDRESS: 12475 SW BULL MOUNTAIN RD ZONING: R -1
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Install (3) exhaust fans ducting. Project Value: $2,400
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 0
OCCUPANCY GRP: U2 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: 3
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
TIGARD WATER DEPT. Description Date Amount
8777 SW BURNHAM ST
TIGARD, OR 97223 [MECH] Permit Fee 4/6/2006 $81.70
[TAX] 8% State Surcha 4/6/2006 $6.54
Total $88.24
Phone: 639 -4171 395
Contractor:
SCHNEIDER EQUIPMENT INC
21881 RIVER RD NE
ST PAUL, OR 97137 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 633 -2666
PRI 503- 633 -2666
Reg #: LIC 39265
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: !/ 4 111 ��� Permittee Signature: di-74 yi/j
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business da .
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 Perini aTig D FOR OFFICE USE ONLY .
City of Tigard' Received
R n
Date/By. Permit No. /00 0
13125 SW Hall Blvd., Tigard, OR 972 tl 2006 Plan Revie
4'7 O�
Phone: 503.639.4171 Fax: 503.5981°4 1° '
( i r v r o y ;zkl�i'`, Date/By: Other Permit:
I Line: 503.639.4175 ■ t.--- Date Ready/By: ® See Page 2 for 41 77 Internet: www.ci.tigard.or.us CITY OF TIGARD -- Notified/Method: Cy Supplemental Information
BUILDI DIVISION
TYPE NG OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
El 1 -and 2 dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ,Commercial /industrial ❑ Accessory building
❑ Multi-family 0 builder For special information use checklist.
Multi famil ❑Other: Description Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: i Z�'7s v � . �) / �/ , ti0 1 a*,( t ?'' Air q conditioning ho or heat pump em
a p l (requires site plan showing placement) 14.00
City /State /ZIP: �d a, O / 7 %23 Furnace 100,000 BTU (ducts/vents) 14.00
name:. � A Wed DuS l;rnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project
�a 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
4 C Gas fireplace 10.00
l � j � � , '7A, .5 ‘ Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER l ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: r ,, i 6 , 'n 6- + 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
❑ APPLICANT • ❑ CONTACT PERSON Attic/crawlspace fans 10.00
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
CONTRACTOR Barbecue
Business name: �)1 Clothes dryer (gas) r
�%1/1 N �Y� v' 'mil �i�� �—Y[ c Clothes dryer
gft T FM �f�(�T�°�
Address:
7..... / fv / ,.Y ` j MECHANICAL PERMIT FEES*
City /State /ZIP: ¢— fG</// ,/)' '9713 7 Subtotal gi .10
433 �, 6'33 / Minimum permit fee ($72.50)
Phone: () G. Fax: ) z4 Plan review (25% of permit fee)
CCB lic.: '53 1 65 `‘ \ n 1 y n State surcharge (8% of permit fee) rp."l
x TOTAL PERMIT FEE 9g, A
Authorized signature: This permit application expires if a permit is not obtained within 1 0
days after it has been accepted as complete.
Print name: �trN e /V/e yde7 y Date: 327406 " Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Pennits\MEC- PermitApp.doc 12/03 440-4617T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard c t ;
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.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD r7' E
BUILDING DIVISION PERMIT #:a e06 - I 60 14 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 o lfilpi ��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: I 't is v ` "`._ /72.------- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: CO T" PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: • Date: 3-d ? --.0 . Pour Time:
Code # Inspection De, cription Confirm # Contact # Message
6 9' ? //n !,--
,_ _.9'
Corrections /Comments /Instructions:
n 0--6r 0 (A) x .6 9 9 ,--k--a-
at i
�. . I , Irs�[ i 0 1 / 4 - / / .
i / Of
' a .114 .l�L .. - I / : �!�..._1_ / /_' ii ✓/L iLEI
0 e
•
h — 4a 1
11 rallaBirlffetr-
PASS I I PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED
Inspector: I D ate: T a, ! ' hone #: (503) 718-c �-