Permit C ITY OF TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2004 -00078
'' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/27/04
PARCEL: 2S114AA -00100
SITE ADDRESS: 09000 SW DURHAM RD
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: El VENTS W/O APPL: VENT SYSTEMS:
STORIES: 2 BOILERS /COMPRESSORS HOODS: 4
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 1,350,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: Y 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 3 <= 10000 cfm: 4 OTHER UNITS: 16
> 10000 cfm: GAS OUTLETS: 5
Remarks: Science remodel, rooftop units, fume hood and ductwork. $200,000 Valuation
Owner: FEES
SCHOOL DISTRICT 23J Description Date Amount
13137 SW PACIFIC HWY [MECH] Permit Fee 4/27/04 $2,496.50
TIGARD, OR 97223 [MECPLN] Plan Rev 4/27/04 $624.13
[TAX] 8% State Surchar€ 4/27/04 $199.72
Phone: Total $3,320.35
Contractor:
OREGON CASCADE PLUMBING & HEATING
PO BOX 12127
SALEM, OR 97309 REQUIRED INSPECTIONS
•
Phone: 503 - 588 - 0355 Gas Line Insp
Mechanical lnsp
Reg #: LIC 127 Heating Unt Insp
Shaft Inspection
Hood Inspection
Fire Suppr Insp
Duct Inspection
S.D. Shut -down inspection
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 f• yw rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 00' 0 through 0 R
952 - 001 -0100. Y.0 may obtain co•ies of these rules or direct ques ion • t■O . : r ailing
(503)246 -669•
Issued By: P i I % Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 7 IV 27 0 11
irs
i
1000 Sw wRH4n AP
H �� be(i, ,dc kf iKA e- ;fit
T ,c V}m O R i ��t�iu ` S R`� 'y?M't `.z A a x a «x{ $US tx r k , ' 1 + +, 'K�F�..'. #, "�"�..' x
/ Ii_eclaamca1 Permit Application mg. y =1.OR O FFICE ;E ONLfI : > .�. ,,� y t4„,, "�,:,,, ';?} ,g
City of Tigard d Date /By —06) 0 1
EI` l �D � a-��L/ �
� PernutNom�G�vD
13125 SW Hall Blvd , Tigard�E � \ V / Plan Revic n�
Phone 503 639 4171 Fax 0 60 + , tLi Date/By ^ . .0
Received
g Other Permit
Inspection Line 503 639 4175 2 004 '� a I
rl'I ii ns 0 Sec Page 2 for
g w ��r t, Date Ready /By Ju i 1
Internet www.ci.d and or us FEB 2 5 Notified/Method Supplemental ilementul information
� � . - -CITY TICARD . 0 • _ C O I V ME tFE SCHEDULE . CHECKLIST
" ' ' _ ' ' 1' � '' „ ' B i t , D [ - ,,.v �, a, , .� •"
Mechanical permit fee are based on the value of the work
❑ New construction LN Addition /alteration /replacement performed indicate the value (rounded to the neat est dollar) of all
❑ Demolition Il Other. /Pit)2.1 D kL. %' tf$Qt'3'@ mechanical materials, equipment, labor, ovei head, and pi oft t
Value: $ -2,00 ODD —
y r - •- -i CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
❑ 1 and 2 family dwelling rS, Commercial /industrial ❑ Accessory building 4
For special information use checklist t,
❑ Multi family ❑ Master builder ❑ Other Description Qty Ea. Total
';': •)''` JOB; SITE' INFORMATION` A LOCATION Heating/cooling
Air conditioning or heat pump
Job site address
D 0 0 5 14.) ( ?.)1 2 t,A* l p b (requires site plan showing placement) 14 00
City /State /ZIP. ` i - LG .. /4 L.17 b Vt. q 2 2 4- Furnace 100,000 BTU (ducts /vents) 14 00
—�- Furnace 100,000+ BTU (ducts /vents) 17 90 .
Suite/bldg. /apt. no . NA, Project name 't 6,8„1en t 0 5t r
4.. Gas heat pump 14 00
Cross street/directions to job site: Duct work 14 00 lo
L..) RA-LA, 0 'ID Sw OUW-11A114 lab9, R esiden i hot water system 14.00
eC Residential boiler (radiator or
hydronic) 14 00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 10,00 O '
Flue /vent for any of above - 10 00
Subdivision: Lot no.
Other 10 00 \'
Tax map /parcel no : 2 C it 4. AcP 00 1'D D Other fuel appliances
=, , " ` ' Water heater 10 00
?' ° - `DESCRLPTION ' ' ' _ ..._
:.. •�. ,. ' ' : Gas fireplace 10.00
I NYTIGt tDt< 0-0-4 0 4 12 tM0 'of G 0P F-2etS'i"fc.4. Flue vent for water heater of gas
fireplace 10 00
2 r STa'—� ��'� 6- N ¢ � y 40 t Log lighter (gas) 10 00 lirli
GIA��,S F20 t lit /tJi.Lo Ii-oDf . ` 9 .JAL ( ) A ' L i Wood /pellet stove 10 00
pX f-papal cTG Wood fireplace/insert 10 00
IILL `"''�y { Chimney /liner /flue /vent 10 00
.'.PROPERTY,OWNER °_ - '"I'" '; w '. ®. TEN A NT,°
.. . Other I 10 00
Name: IA l - A. 1 4) "TuA -LA'CI .) '4tbL c- sa -r Environmental exhaust and ventilation
Range hood /other kitchen
Address. G G L c P 0 1 , j 5A'a.1 YJ Y3ui4 c3- equipment 10 00
City /State /ZIP: LL &Makj O 9.1 ZZ-5 Clothes dryer exhaust 10 00
Single -duct exhaust (bathioorns,
Phone (s 43 - 4 Db0 Fax. (S'63 431 r 4041 toilet compartments, utility rooms) 6 80
,,, -..; .`= . A : , , _,. , "
APPLIC "e " 4 ' ', ': ^i :4 r A4'4 . (• ) CON'TA'CT 'PERSON Attic /crawlspace fans 10 00
" � _ Other 10 00
Business name: 0u LL 01.S b (J 1,0atq. 1, ��} -4j, 1 fctS Fuel pip
1�(�t t4
Contact name: rc - ' o/t) $5.40 for first four; $1.00 for each additional
Furnace, etc
Address 3 (9 ' (.v4•s+41?- ST. . 1 Zoo Gas heat pump
City /State /ZIP: rote-11,p4....09 i Ok!_ l-i Z o 4 Wall /suspended /unit heater
Phone. 6.b .)) ZZ(v 6 is- D Fax. • (6,b3) z--7 i - 5 ( q Z Water heater
Fireplace
E -mail: �� i AA, 3 d D wa, , cn,,� Range
-7 ,r ., , t ,. r i ' ONTR "€ n. '1,:-!''',I
`- .,. :r�a ,.v �,: ..;� .� '" v .- Barbecue
.� 'C : , Clothes dryer (gas)
Business name: O� 6_04) 044 p lye Z /1j�� Other
Address: ?0 (ic)( / 2,-/ 2-7 t MECHANICAL PERMIT FEES*
City /State /ZIP n '), -0/11 3e 9 �J Subtotal vi �f�,SC)
�� LC , r( ��� ���yv Minimum - mit fee ($72 50)
Phone: ( 3) �` � _ 0 , S Fax' ( )
CCB lie.: 42 7 Plan review (25% f permit fee) 2! (>
it
State surcharge (8% of permit fee) 9 1.72..
TOTAL PERMIT FEE 3 witlun 180
3 20.35
Authorized signature �_ C (�� 1 1J� This permit a pdj
days application after it ex has pi been res it accepted ermit is as not com
Print name.. _ �w✓` Date 2I 2410 Fee methodology set by Tn- County Building Industry Service Board
.,.i.,.....u.- .....,n.0 o_....., e.,..a.- im 440 - 4617T (I I /02' /COM /WEB)
Mechanical Permit Application - City of Tigard
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.
\Building\Permits\MEC-PermitApp doc 12/03 * 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested —.— AM PM BUP
Location C ID DO 1) C.vat -G� 4'?C Suite MEC a O V -60678
Contact Person �h� Ph ( ) l3a - S 5 PLM
Contractor ��PP ( ) SWR
-t
BUILDING Tenant/Owner S 6.Ji $" . t/A fir'& --- ELC
Footing
Foundation ELC
Access:
F
•
tg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear I if Int Sheath /Shear ;,-, / 1 1 3CD t l _ - F Framing iC �1 /6--P U�l (!� yr �,
Insulation Ni. – ' �" j `°
Drywall Nailing CO- �-�CJ - r - i
Fi rewal I
Fire Sprinkler
Fire Alarm gFAV 6:51 MC,--3 �S5
Susp'd Ceiling �( p�
Othe —" S ' ( Cam-' e s Fr 6 '° F
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab �' -
Rough -In
Water Service ��
Sanitary Sewer _ / • '
Rain Drains ' �_'
Catch Basin / Manhole Mil
Storm Drain
Shower Pan
iUI ' �i�f
Other:
Final IlinaffiV ✓ _ ,
PASS PART FAIL �''I / �%
MECHANICAL iti: � . ,� ∎
Post & Beam
Rough -In 1 \
Gas Line
S,; ,.., ■ ampers
ark
-ASS PART FAIL
E 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 _ ri Please call for reinspection RE: El Unable to inspect – no access
Fire Supply Line
ADA Date Inspector Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL