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Permit CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 -00190 V I I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/22/2004 PARCEL: 2S101 BB -01500 SITE ADDRESS: 12256 SW GARDEN PL BLD.1 SUBDIVISION: CROW PARK 217 ZONING: C -G BLOCK: LOT: 003 JURISDICTION: TIG 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: 1 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: 270,000 BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 _HP_ _ WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 4 AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Add one new unit, replace 3 existing units and structural support. Project Value: $16,100 Electrical permit required. Owner: FEES SPIEKER PROPERTIES LP Description Date Amount 4380 SW MACADAM AVE STE 100 [MECH] Permit Fee 4/14/200 $313.85 PORTLAND, OR 97201 [MECPLN] Plan Rev 4/14/200 $78.47 [TAX] 8% State Surcharl 4/14/200 $25.11 Phone: Total $417.43 Contractor: HVAC INC 5188 SE INTERNATIONAL WAY MILWAUKIE, OR 97222 REQUIRED INSPECTIONS Phone: 462 Gas Line Insp Mechanical lnsp Reg #: LIC 50897 Duct 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 follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 4 : • thr.i. , OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)2 / _ Issue • By: &2,4 ' Permittee Signature: 4116,L • Call (503) s • -4175 by 7:00 P.M. for inspections needed the next business day /2 SC So 6. *taw e-- Mechanical Permit Application :'.7 ".'''' ` FOR;OFEICE ONLY` '1':7 ::' e Received Mechanical �� .a "� 'PAenr'r DateBv 7 O Permit No : � ,. (/Z)/ 4 0 City of Tigard r® Planning Approval Building / A �, 'ps Date/B • Permit No :'� �� /M 13125 SW Hall Blvd. Plan Revie,w� Z Other Tigard, Oregon 97223 © Ik Date/B `f �2 '�� Permit No Phone: 503- 639 -4171 Fax: 503 -5 8 -� Post - Review Land Use r Date/B Case No . Internet: wtivw.cr.tigard.or.us Pe f��I 24 -hour Inspection Request: 503-639460% "r1 L Contact El See Page 2 for G`, 4 . Name /Method• MI Su .. lemental Information. � • TYPE OF WORK - •-' -COMMERCIAL FEE* SCHEDULE - USE CHECKLIST .• .• . . ❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work ®'Additio alteration/Aplaeement ❑ Other: performed Indicate the value (rounded to the nearest dollar) of all C RY OF CONSTRIi( TON mechanical materials, equipment, labor, overhead and profit. ❑ I & 2- Family dwelling e rr l / / Industrial Value: S (O / 0O. C1 O See Page 2 for Fee Schedule ❑ Accessory Building ❑ Multi- Family • RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE Description Qty Fee(ea.) Total [1] Master Builder 11 Other: Heating/Cooling JOB SITE INFORMATION and LOCATION Furnace - add - on air conditioning ** 14 00 Job site address: /A„),56, SLv C d/ i,t P(Gt.d_e— Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 Project Name: e. c - 644400(c_12 Hydronic hot water system 14.00 Residential boiler Cross street/Directions to job site: _(for radiator or hydronic system) 14.00 Unit heaters (fuel, not electric) (in wall• in -duct, suspended, etc ) 14.00 Flue /vent (for any of above) I 10.00 Subdivision: 1 Lot #: Repair units 12.15 Other Fuel Appliances Tax map /parcel #: Water heater Pp 10 00 DESCRIPTION OF WORK . ' ' Gas fireplace 10.00 t apo_ sic ($ w. C� (,�, ; i 4xiry - . Flue vent (water heater /gas fireplace) 10.00 l�jr'as ( 10c,' J Log lighter (gas) 10.00 Q 9 ' Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 0 PROPERTY OWNER • ' 0 TENANT Other. 10.00 _ Name: ' 1 £a � Q ppg , r £b 14) Environmental Exhaust & Ventilation Address: 1.1,8,0 ...t.) ythel}D A1)6 � /00 Range hood/other kitchen equipment 10.00 Clothes dryer exhaust 10.00 City /State /Zip: P - 0 p., q 7j/ Single duct exhaust Phone: Fax: (bathrooms, toilet compartments, ❑ APPLICANT • - - ❑ CONTACT PERSON , - • utility rooms) 6.80 Name: Attic /crawl space fans 10.00 Address: Other: 10.00 Fuel Piping City /State /Zip: * *(55.40 for first 4. S1.00 each additional) Phone: Fax: Furnace, etc. ** Gas heat pump ** E -mail: WalUsuspended/unit heater ** . CONTRACTOR - Water heater ** Business Name: .Uiy Fireplace ** Address: S X S V el Range ** Cit /State /Zi BBQ ** y p: Ak L kt E t l )i'-& a a� Clothes dryer (gas) ** Phone: 1 -1-(p)-4D.)_- Fax: a - ( Other: ** CCB Lic. #: --T ' ] Total: Authorized (' i Mechanical Permit Fees Si �k L . lovi4.00AJ Date: (4Al2`i Subtotal: $ &I , gS �* /YI Minimum Permit Fee $72.50 S C : Cn °l it r � t ��06.SOY\ Plan Review Fee (25% of Permit Fee) $ , g i 4 (Please print name) State Surcharge (8% of Permit Fee) S tj , // TOTAL PERMIT FEE S j i , _ Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry ervice 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forrns\MecPermitApp.doc 01/03 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 S5,000.00. $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. $100,001.00 and up $1,396.50 for the first $100,000.000 and $1.10 for each additional $100.00 or fraction thereof. All New Commercial Buildings require 2 sets of plans. i:\Building\Permit Forms \MecPermitAppPg2 09- 01- 03.doc CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 6 ° 3 AM PM BUP Location / ' S P' Suite MEC 0 ( Contact Person .' ! ► � h ( ) 4 a _ t- ( S 2 L PLM Contractor - -211 Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab In e_ctij►�j ote {, SIT Post & Beam ��XX 1 v Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Fi rewal I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL r PLUMBING ` f == r r Post & Beam Under Slab '.' l J Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL _ 'MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers 1 PASS PART FAIL • ELEC ICAL _ ervice a♦ / Rough -In =il 1 .ice � UG /Slab A � 40 . ' � a . /�- �� . Low Voltage Fire Alarm Final ❑ Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: E Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL