Permit CITY TIGARD MECHANICAL PERMIT
f' , DEVELOPMENT SERVICES PERMIT #: MEC2005 -00009
�'` "� �I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/6/2005
PARCEL: 1S135BB-00600
SITE ADDRESS: 10380 SW CASCADE AVE
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Furnace replacement. NO HEAT Value: $5,000
Owner: FEES
FOURIER, GEORGE PER Description Date Amount
FOURIER, JAN JACOB [MECH] Permit Fee 1/6/2005 $141.50
CARSON, ALAN W [TAX] 8% State Surchar€ 1/6/2005 $11.32
PORTLAND, OR 97217
Phone: Total $152.82
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone: Heating Unt lnsp
hone: 692 - 1565
Final Inspection
Reg #: LIC 5193
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
952-001-0S I • e eh OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions 7UNC by calli ng
(503) • . -6699.
Iss ed By: � i, ��� � �:! � Permittee Signature: 1 �/ 'I
Call ( 50 •39 -4175 by 7 :0 0 P. M. for inspections needed the next busi -ss day
MEdtanical Perin:MC EjtVED FOR OFFICE USE ONLY •
City of Tigard 1 Date/By: > - / - O i l 44/ Permit No. 4 /- -0000
13125 SW.Hall Blvd., Tigard, OR Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 " 2005 / ,„lll ,, + t s Date/By: Other Permit:
Inspection .Line: 503.639.115; 641 Date Ready /By: gni El See Page 2 for
Internet: wwvv.ci.tigartr I F TIGA D T Notified/Method: Supplemental Information
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: �,{ �ti��a: �"` ��; s' S�' �H.' �.`. t+7 �;, rli �„: �, �., N:B ��. � «xa� y, ix�S.0 ��a =_,.���v,.:.�: �='�.4,-!,, . �. . .. ��Eti �`' >�'.,, M..�ur.�r=;,_,.. �,.. �.. ,. :_�.. , .r. , . - ... °N __ .., -. -.:. � _
Mechanical permit fees* are based on the value of the work
El New construction g Addition /alterationEeplacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
`., ".". ;ist :�, ;,� �%�45': " + " }t: 2Y ° :i".. :� .,_ .,,,�:.. ,, .h+=u'.,:, ,x •. - - - , g ; ''.; ; . - 45 - 0; r ° ri,; ?,77 ' f=l1W, Value: $ : l �
k ;. ,,'..1 ., . 4141 i as 3 , , CA TE GORY t OFL CON STRUC „'ITO N 1% : :- , ,,l'o r ! ,W , . i ., _ , L ,„ -,
` RESIDENTIAL EQ / TEE S*
❑ 1- and 2- family dwelling ®(Commercia}'industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family . ❑ Master builder ❑ Other: Description Qty. Ea. Total
�r =�, .tX z ?w..' >.::s. v =sr,:: w.er.; ;,.�x , =.;s�; t + . r . . - -
* s� - 'JOB'SITE INFORMATIONi;rAND4LOCATION 4 y ) „I Heating/cooling
a t
b� a� 1 i�.n �.
Job / Air_conditioning or heat pump
ob site address: 14.00
� � 3 8o Sv..S Clse,rc a e.. B \Y� (requires site plan showing placement)
City/State /ZIP: 1 Q Q� 15 9 9 3 Furnace 100,000 BTU (ducts /vents) 14.00 ,
J `/ / Furnace 100,000+ BTU (ducts /vents) 17.90
' Suite/bldg. /apt. no.: Project name: 1 ioiJ . _ Y° ' ✓l G Gas heat pump 14.00
Cross street/directions to job site: ectsc X 6 r b url Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
a ic) Unit h 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
4, . : :- . ? ,. ',' «� ' "'I' w ^'I >,; .. .t > ' - t ,r� .,i,°= `.sr <:i r°;?a :s= Water heater 10.00
.� � �� - r� -r � 4 t � � r - , r t,
, f (4, 8 e DESGRIPTION� =OF WORK ' . ' w,.,: '.
Gas fireplace 10.00
I Flue vent for water heater or gas
PteP�u�o 0(12 �71PiC t1Al • fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
. Wood fireplace /insert 10.00
SpF .; .. - z.4�-.4.. , v ,
�.
.,, ,. x s . ; tr- l (ty ;. .-, ti, a)» ,,,. 3,,E1 Chimney /liner /flue /vent 10.00
1 rl.t: FR O
OPE REY WNE> ..r r:o.1lifl �� .. i .�.„ TE NA +.ir_ .,_
N, ..° H :�.:4 :,l
Other: 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 •
x z az =. ;,: 3 y" :C., A",` MIII-- 14',V;t: .:r. , S o ='tit; . ,,Q t A tt i c / cra wls ace fans 10.00
r , n. o "'APPI=:IC T r `" oat t ® CO NT' AC � T . P at r p
' ` ^.�.®. i... -rt„ C' ' ° , * 7 S?
Other: 1 0.00
Business name:
Fuel piping
Contact name: 5,„-4 Se_ -4 $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State /ZIP: Wall /suspended /unit heater
Phone: (Sa3) 713 _ 5-6 2_8 Fax: : ( ) Water heater
Fireplace
E -mail: • Range
. .� r,�,��� �w:xa�,ei� "y, °aa.w:: . = �.- 'z"�g ``?� -�3'i � "" �'�.; $s:�3'yi = d�r�'>± "fez?. ":
a WA, ".. '.1 =.. i<,. 4 ;. I. _,,;4 ;�s�> : � ' i`' ;t, : T. 1 .,.. , Barbecue
;i ^ i Mr %a ,.='tt ECONTRACTOR ),Ng,_:: ,., 7r. ,:r
3,,
m...:.� * �:�:M�����;� »t�.,i, =�c �,��;51,� - e� . .. a ��4 ._��.,. . , = z!.ayt�vx:+7�ss ... .. .. ...... .., 3,.E.. ere ter, z"n��; R.':k. r.,: ;
Business name: Clothes dryer (gas)
R 1 - rou1 ( M e( Con . other:
Address: 1 3 3C sw - u 0.a0.� ( Q
t
City/State /ZIP: T UQIAT I ► b g_ 9)062_ Subtotal
Minimum permit fee ($72.50) /1"/„17„)
Phone: (503 )( is l e s- Fax: (So3 )(01/. /971 Plan review (25% of permit fee)
CCB lie.: Qs` c 3 \' -V1' State surcharge (8% of permit fee) / /, 3
TOTAL PERMIT FEE / 52. -
Authorized si atllre: This permit application expires if a permit is not obtained within 180
gn �� <��m �� �// ff j L days after it has been accepted as complete.
Print name: Date:. /. 6 .O5 * Fee methodology set by Tri- County Building Industry Service Board
i:\Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (I I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
'otal Valuation : V "Pe nu Feet--
$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 (y / •
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and / (-7/ .6
$1.35 for each additional $100.00 or -3 g
fraction thereof, to and including •
$50,000.00. •
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and /52
$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.
•
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CITY OF TIGARD 24 -Hour ,. , . ,.
_
BUILDING - Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 d oau lST
P
Received Date Requested / 1 1 AM PM BUP
Location / 2 8e Suite i 00 S " c ?
Contact Person Ph ( ) '793 f -5 O c PLM
Contractor Ph ( • ) SWR
BUILDING Tenant/Owner Ai ELC
Footing
ELC
Foundation Access: t 1 D /0v—fi»-t (Mt- y
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear -
- 1 Int Sheath/Shear i ,I •
Framing A �`i � `
Insulation i
Drywall Nailing •
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING 1 i
Post & Beam A / ' . ,
Under Slab
Rough -In I .
Water Service _
Sanitary Sewer
Rain Drains NAM tr
Catch Basin / Manhole —A alrA I IF ' _
Storm Drain
Shower Pan WAWA T A
Other: air
Final
P T FAIL � '
ECHANiG`i_`
Pos eam AAV
Rough -In
Gas Line
Smoke I - mpers
ma
4 � PART FAIL
y TRICAL
Service
Rough -In .
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE Unable inspect — no access
Fire Supply Line r / t D ADA 1 /l o VOt
Approach/Sidewalk Date > Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL