Permit CITY TIGARD MECHANICAL PERMIT
,I� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00349
I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/16/2005
PARCEL: 1S127DD-00100
SITE ADDRESS: 09730 SW CASCADE AVE ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Replace like to like heat pumps and gas packs. Value: $75,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
T MICHAEL + ASSOCIATES LTD Description Date Amount
ATTN: JOHN WEGMAN [MECH] Permit Fee 6/16/200E $1,084.00
9200 E MINERAL AVE, SUITE 200 [TAX] 8% State Surchaq 6/16/200E $86.72
ENGLEWOOD, CO 80112
Phone: Total $1,170.72
Contractor:
HUNTER DAVISSON INC
1800 SW PERSHING REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Phone: 503 234 - 0477
Reg #: LIC 01612
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 OUF C by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: ed C� ��� Permittee Signature: ,,e4
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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Pepz aVa° i� FO R OFFICE USE ONLY
City Of Tigard Received � Air 2005 Dat / 05 PemnitNo i = ` ,0
13125 SW Hall Blvd., Tigard, OR ,97223 Plan Revie
Phone: 503.639.4171 Fax: 503 Ang,, > tir e, � ! a I Date/By: Other Permit:
Inspection Line: 503.639.417 OF TIGARD a!/ II Date Ready /By: 1u Hl See Page 2 for
Internet: www.ci.tigard.or: " t2J
eUILDING DIVISION Notified/Method: Supplemental Information
£•qtr - t ,U E+CHECKLIS"T
�.� , - '�FEE .:r SCHEAULE" S
''z '•, -- ��6� - v11IlYtERCIAI, -
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❑ 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 fit.
".;i �:l`''.: : :? " +e `.3 m< : M- 47.4c iabir3ilt - rN_ ...r«, -•a f: °; }Y:;C Value: $ 75 Y
i y t w 3 � . z CATEGORYY QF, CONS1'RTJGTION %'f , ^ .. ., , . , / ....
RESIDENTIAtEQUIPMENT /SYSTEMS FEES*
❑ 1- and 2- family dwelling ,(Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea, Total
='>- i �r.-:. v�•- r : „�' �.F'���^!1- .;�is -�,: ��t�.�xa-°,., r� = „ i .r #rs�i s1_ws >:.�� «: �. 4� - �� ; .�..'.:,� -t- - _
- �> :: - + :;TOB = ° eE. _ . . .. .: Heating/cooling
=r .. €Y' _ - > -, T INFOMA- IO1V' . "TA A'I:IU -. , ,<<; y ^ i , , - :,,, ,,.. . • , -.
,-, s., t..; +. "..,. €A':`. .:. >e•,�,v.: «- 5....�- «.a.,. -ar.: _a.^�� +,r �:3 "u,. �� '�rw ,..r• 1 '" .,aa�?,:�.nc .,
Air conditioning or heat pump
Job site address: 3 0 9 C Q � � ��� ( requires site plan s placement) 14.00
Ci /State/ZIP7 Fumace 100,000 BTU (ducts /vents) 14.00
tY :e / 1 � Z � ®� Fumace 100,000+ BTU (duets/vents) 17.90
Suite/bldg. /apt. no.: Project name: ge CO' i3 /ciq , 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
hydi - onic) 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
ta`V - °-' -> F' , . ?ara 3 - .t €"`�:''= ° ��`=:,is::c.ar.� "' 7 .,:€€ .fa: "€'«� -�:� o-°�: d '.tP" i fign =: a,€ . ' Water heater 10.00
i t�:1 ,: , ,s,r.�, e.s; ' t DES QN O rWORT�� :>� - . , .. ii. • ? q• �, .,y. a
e zt�yw�.> s;; v- : a* a.;. r,,;'- '< :4:se <:- >;ax,?.� �n�":».'s...?�: "'. " .. ,, : N. _a, .>
Gas fireplace 10.00
e i t ' ;a/Pap P ,'- ? amp 5 -w 1 . }� Flue vent for water heater or gas
i fireplace 10.00
V / Q, &'4. tekJ Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
10.00
< ,.rwa b.,... *�, ; xf ., p„ 1 �ti' ifs;. $ W:: :<. Chimney /liner /flue /vent 10.00
j Iii , ,P�ROPER Y O WNER p "1. s' 0 ;, A a r ' ®w t
. , T ;. ,. .. �� _ *W , .� :.r: a ; ..... . .... _ - Other:
�„
Name: S li (' 0141 f a h Environmental exhaust and ventilation
Range hood /other kitchen
Address: g 73 D S ia- a1) mit A.
_ equipment 10.00
City/State/ZIP:T `9 ,,A OR Clothes dryer exhaust 10.00
1 (q(hJ' Single -duct exhaust (bathrooms,
Phone: ( ) J Fax: ( ) toilet compartments, utility rooms) 6.80
;;c; -�r ' "' : ;,w„ "'''"$'cg`s =.. :'ti t ' C' - w >;"% .s
" ,„ d, „- Attic /crawlspace fans 10.00
'1:, = gi : y; • u ' ; >, -i IC :i :; : ! .. ,S. ,, . , .' �; i;;:
:=s-: " ® ,O '; . _
,,.� ..APP ..,.. �", c
::� �� ss
Other: 1 0.00
Business name:
Ntaa��er ``�aut' Sena j.ht' , Fuel piping
Contact name: r_ ��,® /i $5.40 for first four; $1.00 for each additional
1 e� �� Furnace, etc.
Address: 1tp- 111 s'�' j e/f )_ 1 .7% Gas heat pump
City/State /ZIP: -/- i ` 9 72 � . Wall /suspended /unit heater
Phone: (sag) 9 7 j ``1 '96'2 vvv Fax: : ( ) Water heater
/ Fireplace
E -mail: Range
-'G-3 - ;' , n rt.. ;ii "= .; ;1 «:: - . T C 'rr.:sl'':' ti: K„ y.y ; i } s;e; s,- '+i2.°.- �
�.`t:� #" ,� =� � �� � � _ s �°`4 CONTRAGTCjR � � .,� - .
is <s
. _ Barbecue
(� Clothes dryer (gas)
Business name:
rQ fY+J` Other:
Address: MECHANICAL PERMiT;FEES*
City/State /ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) 1 Fax: ( ) Plan review (25% of permit fee)
CCB lie.: ) 4 it 47 / ./ 0? State surcharge (8% of permit fee)
TOTAL PERMIT FEE
T his permit application expires if a permit is not obtained within 180
Authorized si ature: /� days after it has been accepted as complete.
Print name: 4 s �' n / Date: r/ $ .-®5 * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp doc 12/0 / 6 440-4617T ( I /02 /COM/WEB)
• Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
•
Commercial Fee Schedule:
WatitttraMONSI*. PPIEMATCP:,:g,15mT:7;:;
$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.
•
iMuilding\Perrnits\MEC-PermitApp.doc 12/03 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00349
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/1&2005
Phone: (503) 639 -4171 / iid Hry a
Inspection Requests (24 Hrs.): (503) 639 - 4175' °'f l.
.
INSPECTION WORKSHEET FOR DATE: 9/13/2005 TIME: 7 :05AM PAGE: qf.,
SITE ADDRESS: 09730 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: SHANE CO. BUILDING
DESCRIPTION: Replace like to like heat pumps and gas packs. Value: $75,000
OWNER: T MICHAEL + ASSOCIATES LTD, PHONE #:
CONTRACTOR: HUNTER DAVISSON INC PHONE #: 503.234 -0477
Inspection Request Scheduled For: Date: 911312005 Pour Time.
Code # Inspection Description Confirm # Con - Message
699 Mechanical final 015510.01 503. 793-9802 Y
Corrections /Comments /Instructions: 01-41 . )
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P. ASS PA RTIAL APPROVAL CANCEL
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FAIL CALL FOp INSPECTION I I ADDITIO AL FEES ASSESSED
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Inspector: 1 � �� Date: ` Phone #: (503) 718-