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Permit CITY TIGARD MECHANICAL PERMIT Qf��l DEVELOPMENT SERVICES PERMIT #: MEC2006 -10017 DATE ISSUED: 3/8/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 BB 01400 SITE ADDRESS: 12070 SW GARDEN PL BLD5 ZONING: C -G SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG Project Description: Modifications: HVAC /Thermostats. Valuation $5,900. CLASS OF WORK: OTR 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: 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 RREEF Description Date Amount 720 SW WASHINGTON ST STE 630 PORTLAND, OR 97205 -3508 [MECH] Permit Fee 4/1/2006 $157.70 [TAX] 8% State Surcha 4/1/2006 $12.62 Total $170.32 Phone: 503- 224 -9450 Contractor: AMERICAN HEATING INC 1339 SE GIDEON ST, STE. 1 PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 239 -4600 FAX 503- 239 -7038 Reg #: LIC 33135 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: "TZ Permittee Signature: _ S�e - , Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day. This permit card shall be kept in a conspicudus 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 Permits FOR'OFFICE USE ONLY ' City of Tigard Date/By: 3 7 1 6 1 j Pernut No. -, ( la) , 716) 13125 SW Hall Blvd., Tigard, OR 97223 q kg 8 700E} Plan Review e � 1 tH Phone: 503.639.4171 Fax: 503.598.1960 �/�/� /�dNjr,��'�I ;t� Date/13y: Other Pernik: Line: 503.639.4175 11' airy r ; : + 1 6; J t O1 iV Noti6ed/Method: Supplemental Information TS. -�� .x. ,. i`:€:r- r'US IELIST -,,... - -rc'�;:s ��EESCHED.UIsE'•- �`,. C = i�nvaERcial:� "F " .. �. :tar. �,. .. •u. .'�: .. .xx� ,. ,:;�'<: :�;... :..,. +.,�E .. " .,. .IU s . 1.4 ^ ? ':ry '� = - ter_. : , 1b � "' 3.2 a ,..v� ':r.,sa a 1� `.. ;o- ... „ .-- .... -. ...- `- . i ". New construction Addition/alteration/replacemen 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 profit. :,:1:'= I , . Value: $ 4.0 D TI Nvl ,. ; r ; <. £; ,;x : ,i: - v , w4 -.,.. },�.. i .... <, 4 .n. .,. = "; . ,_ t �. ,, • a._ : K• ., ., . , NIS FEES • " , RE$IDENTIAI;; E QUIP�NTENT °/ YSTE S ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For specinl information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. Total .t' � N =e" Heatin ��)`'` ti;;. <. FO TION ^,:ANDA =TiO coolin Air conditioning or heat pump Job site address: p! '�II -� ''� ti l l:x I .pv !f �L ±�, y ,:•.,.,.. :... r / \ ��� vV (requires site plan showing placement) 14.00 City/ State/ZIP: It S (,u -� oft q DD3 Furnace 100,000 BTU (ducts /vents) 14.00 J ( Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Nk_Se Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 10.00 Subdivision: Lot no.: I Other: 10.00 Tax map /parcel no.: Other fuel appliances sy .: .-. z >hs;= z sMr'.air'.r.n *.:t ia;. : = y ..tte . 'K. «:.j4r,`F;p ::: ':a ',t »u `4,y r,2 TR ri, -,, ear';: r, igyirs:' °} i:' ,;z' =: a . >,.,<l v:;�4 `s: �E�",,,,�.:r Water.heater 1000 €u;' a ia:, .,- r'.4,1 +.' 4.41 -.. . =,s, a RIP.gTIQN1 t F:lt OIiK : � `` „,, ., .. t : ,,. ; 41.. „r n. >.;, .., , 4;2:;5 �'�.�o.: =: i�ir! iu: f :''s.'h�;�, ��, ;.;.`�ter ll .' �pES�.��>•.. +t;3 r,s s r.£z,;3�,.t,• � .� i � s. :vfi;d. � ,,:.,:$: .. �. _.: E'�it,.,. ,. et':'��s' N'YrtC OeV a `1 W r l / Gas fireplace gas 10.00 � � Flue vent for water heater or as fireplace 10.00 Log lighter (gas) 10.00 • Wood /pellet stove 10.00 . Wood fireplace /insert 10.00 <, ;: Y S; a ;,,., n1 . ; . x: r , ; `; ... Chimney /liner /flue /vent 10.00 r5.. :- b',,,r, .. 7.': wa,: sF;r, .IR, {ei� , > "+..�s �.,- °' i. ", :'i: "�: , ,�'w,l ".o�l.p" OPERT,µ WNER r,,, L -A mec , rAl i: ,lal _ ��<��;�rJ.� .�.1;� r ��,:.. �e. �". ��, krKl:, mra ,,.:'�,;�r:;ir';� *..> ohs ^,,...:�:, � ".: °r�r �.,. ...�.,>;._'.�:g,,.�r. =: "_:. , ..�t Other: 10.00 Name: • Environmental exhaust and ventilation • • Range hood /other kitchen Address: equipment 10.00 City/State /Z1P: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 • ; . f s 10.00 4;.1:`,: ,.; ;;:1!- ,_.r.:>.. *.- o ., n .: �..,�, , =. r;i;x::;u; °• .` i;-.`i';11: MORE .x. ;I >.. ,,/ ' Attic /crawls fans s1.e l lgft; s ; ..a.E., t .,,7 , , ftl, ,:. ,, r :RLIC AN1''Iv: "s "fi; -rr ..r.,r K ! liP , : ..COIV;T•AGT''pi!,,,,,, , Attic/crawlspace ; 5T ,..a ,,.. , .. ;.5..�. <.,:� :" yr "si 4;sri3, , ..�.. s, ace 10.00 ". �� .._, _ � „^ Other: Business name: C � �-� t �_0 _ Fuel piping PP Contact name: cox c l ` 1l�\ $5.40 for first four; $1.00 for each additional Address: 13 S rckP < O 1 Furnace, pum etc. Gas heat p City/State/ZIP: -'C ( 1 . \ 0 q a Q Wall /suspended /unit heater • Phone:1 ' Lt( 6 Fax: : (� 5 a-301,2D �� -� Water heater Fireplace E -mail: Range +'act - . "s n,>n, .t�: .x ; .::;:a;.. - ,s.,t.;, .p,. Via, :5�; ; c :t tr e C:` .�' >;.;;- .r _ :,:,' ,' ,n°>. »6 =i'�" w� , n;.w =.d:»s „,2: �'aJ� ,% .:li,'- ��, = p, ` ». ,:' 3 .s,5: ; °.e... ,i`i" f�:; .'���. -, �. `tz-a; �,., ,.an:.pi�• ��r.,- =a: fi=r s ,K,i��,�. ; :.?r" 7�� !r� �� °�w::;'�*�'^'ws �E'1, a ��'e�;s €w - i, l Barbecue ,:,�,:(Cr ,lf, i -ti � (' a '�'# " k 3 O` :a t„','C v . 4. "a Ns,, !, . 1. - n R�Yi..� k r .. .c.2i:f!l�r;,d. Fpt'� "q.4 ;�,.t�.:‘ °, N. , �nR' irr:. N. t::; t ?+' I, s ...;. .' r�; isr ....',r. .'�°• ".., ":�vK�.d�; J�i�:hR!?1,��.�k..S- &rcm �r : >ari;,oa.a „- , .- ,i. °..- ,�1r,.. X °. sl'_v:. .,.:;R.y T, ': ,.. .�- - Clothes dryer (gas) Business name: Y (�(� - ,� 1A � • Other: Address: 'U ?'+ `x` _. = ```MEEC Ei`A_iNICAIL'; P ERMiT - F . " s h Sf&I ".i'.YS�st ,f .,.31t 3sA'k City/State /ZIP: - '� /1�r �� 0 Q 61�`) -6 Subtotal V r ( Minimum permit fee ($72.50) Phone: �ct.(1J 00 Fax: ( ) Plan review (25% of permit fee) CCB lie.: . t 3 State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized si ature: This permit application expires if a permit is not obtained within 180 gn p days after it has been accepted as complete. 1 Print name: a ' ON . vvv 111 �" Date: 6 * Fee methodology set by Tri- County Building Industry Service Board y c i:\ BuildinglPermits \MEC- PemutApp.doc 12/03 440 -4617T (1 I /02 /COM/WEB) CITY OF TIGARD RECEIPT DEVELOPMENT SERVICES RECEIPT DATE: 3- -3; _ ,Novoili.;\ 13125 SW Hall Blvd., Tigard, OR 97223 JURISDICTION.: 503-639-4171 www.tigard-or.gov CASHIER DATE: CASHIER RECEIPT #: LINE ITEMS: Case No. Fee Description Revenue Acct. No. Amount Due 76 4-- • Total Due: $ „z Li SEE ATTACHED FEE SCHEDULE. PAYMENTS: Payer: Method Initials Check o. Confirm No. Amount Paid ‘ ,•c2-e Total Paid: $ I: \Building\Forms\ManualPermitForms\ManualReceipt.doc 03/01/063/7/2006 CITY OF TIGARD E& BUILDING DIVISION PERMIT #:a ©Q , - f° o l 7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 /mn1101 Inspection Requests (24 Hrs.): (503) 639 -4175 p i ll.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 0 - 7 0 ✓ a " A—d CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 ) 0 b (P Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: m EL H- F7fU P-L aK PASS ❑ PARTIAL APPROVAL I I CANCEL n NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: OaAA. / Date: 3 / 0- 0 ( Phone #: (503) 718- . `T J3 I