Permit CITY OF TIGARD
MECHANICAL PERMIT
I� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00713
All
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/29/2004
PARCEL: 2S 113BA -00400
SITE ADDRESS: 07632 SW DURHAM RD 125
SUBDIVISION: SW CENTER SDR1999 -00020 ZONING: I -
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of fans, ductwork & grilles.
Valuation S 7000.
Owner: FEES
OPUS REAL ESTATE OREGON IV LLC Description Date Amount
1000 SW BROADWAY [MECH] Permit Fee 10/29/20( $177.50
1130 [TAX] 8% State Surcharl 10/29/20( $14.20
PORTLAND, OR 97205
Phone: Total $191.70
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222 REQUIRED INSPECTIONS
Phone: 462 Duct Inspection
Misc. Inspection
Reg #: LIC 50897 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)246 -6699.
Issued By: Lt � Permittee Signature:
Call (503) 639 - 4175 by 7:00 P.M. for inspections needed the next b3siness day
10/22/04 FRI 09 : 55 FAX 5034626555 HVAC INC • Ft1 0 0 2
Mechanical Permit Application - . - . 4.....- - . FOR OFF.1111:- USE ONLY - -. .,... - -..--..,,,•, ... ' ,.,,,
,. Citl of Tigard , . Received _ V/ '• -
1 DateiByl 1 ez 2f -- '0 ./ , 7 Pennit No.\\,\C r/
13125 SW Hall Blvd., Tigard. OR 97223 ?Ian Review
Other Percnit!
Phone: 503.63.4171 Fax: 503.598.1960
E . ._ .7•460111
Datealyt
inspection Line: 503.639.4175 RECEN " 0
; .: $. :....:, , i1L,.. Date Ready/By: Sum: fil See Page 2 for
Internet: vtww.ci.tigard.or.us Natified/Method: - if ( Supplemental information
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,, , • 1 ) Mechanical permit fees* are based on the value of the work
0 New construction . • 411:54473',,, • tacement
performad. Indicate the vainc (rounded to the nearest dollar) of all
0 Demolition 0 't ter owiSION mechanical materials, equipment, labor, overhead, and profit,
, gltst,:.g.IF,Nvi , 70401 , ft , 41 , 4911 . MNizr,t'q
Vaue
*4 .IklAWArpliet i ....r ,i: ct„ . izIMMOW.Sai,v-A-,A.,..1011111:y,.5..00c,; l: $ .7 ()CV. C
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0 1 and 2 dwelling iDrierci 1 dustrial E] Accessory building
For special lnformatto a use cheeklis‘.
ID Multi-family 0 Master builder 0 Other: Description Qty. I Ea. I Total
tip2 ri„6, .
. , 1,.. '1,4: i,!■40,,,W4i, ,■ r '4f7W.1 , 41r
Air conditioning Or heat pump
Job site address: 7 ( 3 Q 5 co ....., k c44r1 kd
(requires site clan showing place:neat) .
1 14.00
CityiStateIZIP: ---ri._61,rd (' r Furnace 100,000 BTU (ducts/vents) I 1.4.00
I Furnace 100,000+ BTU (ducts/v:11o) 1 17.90
Suite/bldg./apt. no.: /..2 .r `'-} I Project name:CA , ort La. C in C
, . Gas heat purnn I 14.00 -I
Cross street/directions to job site: 1 Duct work I 14.00
Hydronic 1aot water system 14.00
Residential boiler (radiator or
hydronie) 14
•-1
Unit heaters (fuel-type, not electric.),
in-wall, in-duct, suspended, etc. 1100
Fluelvent for any of above 10.00
Subdivision: Lot no.:
• Other: , 10.00 I
Tax Map/parcel no : Other fuel appliances
8•4. qp,..mmpJ
?j 14, tf,i104/1041,11,05.; ii Water heater _ moo
,,,,.,,,,,,,, 1,01 , r,;:i --.W.:', ',PI ,,,,,,„ .,„,• :11,,,,F ,i ' P,V4- 1,,,,,,,,, -. , 1 , ... , • • • .■• 1 •■• I, ••` .
Gas fireplace 10.00
(.4 ..214; 4 . Ms ,..;... .• Ai - .6 1 4. q--• e^ Ct, C _ Flue vent for water heater or gas i
_place 10.00 .
• .
Log lighter (gas) 10.00
Woodioellet stove 10.00
Wood fireplace/insert 10.00 _
10.00
chimneyliz.rifiLevent
vco,04, ,„,.,,,, .,,,,,„,.... ,„,...,, y, ,.4,i,ir ,0:3,1AI ,:' ..a ' Vii, ;■tti,i'!.., „A/o , I), ;,,,,,, , , AE , • ,I -. , ,,; , :,,I, o t h er: 1 10.00 I
Name: Environmental exhaust and ventilation
Range hood/other kithen
Address: 10.00
equipment
CityiState/ZIP: Clothes dryer exhaust 10.00
1 Single-duct exhaust (bathrooms,
Phone: ( ) Fax ( ) toilet compartments, utility rooms) 6.80
PRilipliVOIT,10,1#01VORRAYinil0I,Rapottlitotkivo..--iplirpwa,,*14,1ii,q.),1,i,?, AtticktawlsPace fans 10.00
, ,,, we: .".7 .4 .1. 1,..:,, ' 'Ind .'1..',.', ' , ..0.4 11 ' i'lii",*1 -.. • , '`.. , ..,- 11Ai.i...}}A :.1 ,... x.1 . 4 .1 , , , ',F>5,.1) i,: i. :r0,,;,
Other: 10.00
Business name: - ._ Fuel piping
Contact name: $5.40 for first four, $1.00 for each additiona
Furnace, etc. I
Address: O heat Dump
City/StateqfP: Wall/suspended/unit heater '
Phone: ( ) I Fax: : ( ) Water heater
I Fireplace
E-mail: Range •
M
4 `11.1l.1,9,
111 Ba7becue _
W,toik Mi 1(;'ilitIfiA'-... i...:.2.:fr .. ■•,;. , 7M , ...,i(' (4
Clothes dryer (gas) _
Business name: t+04c z,,,
Other:
Address: 115.3 s E ,...\_,,,,,42.4 (../
vaikpooli:..,R,0,..0.,, :,--t-, ..,..:, ,,,,, ;.•-•,---- .
Cit)/State/ZIP: rA.L j tu2.... `, o sci ..„. 1 q D, I Subtotal /7 7 0
I L..... Minimum permit fee ($72.50)
Phone: (503) it( Li S- Fax: (5)a, ) Ci ( 6 .S53
I Flan review (25% of permit fee)
CCI3 Ito.: 50 gq --7 1 State surcharge (3% of permit fee)
TOTAL PEILMIT FEE I /1 /, '7 t
r---, , .„, Thi permit s application expires if a permit is mot obtained within iso
Authorized signature: A , ,,,,,.. , d\ days after it has been accepted as complere.
Print name: S/18/r C it- Qz\o vrt s or I Date: P:',)La d-) 04-1 . Fee methodology set by Tr-County Building Er.dualry Service Board
i: ZwildingtPurrits 1 MECTerrnitApp.dee 12/03 440-4E 17T (11/02/CO:NWEB)