Permit CITY TIGARD MECHANICAL PERMIT
1 1 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00419
e1lll 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/12/2005
PARCEL: 2S109DA -04500
SITE ADDRESS: 15412 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 022 JURISDICTION: TIG
Project Description: AC install.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 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:
Owner: FEES
DON MORISSETTE COMMUNITIES LLC Description Date Amount
4230 GALEWOOD ST # 100 [MECH] Permit Fee 7/12/200: $72.50
LAKE OSWEGO, OR 97035 [TAX] 8% State Surchar€ 7/12/200E $5.80
Phone: 503 387 - 7538 Total $78.30
Contractor:
GAS HEATING &APPLIANCESVC CO
PO BOX 174 REQUIRED ITEMS AND REPORTS
WEST LINN, OR 97068
Phone: 503 235 - 3301
Reg #: LIC 32508
0
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.
C A.
/
2.--
Issued By: „ // Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous 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 Permit Application - -= '' ` roan OF VI USE ON IA ____, ..
City' ia-1,tiga rd Received 7 %J Permit No.: . _ Q
ase
13125 P. Hall Blvd., Tigard, OR 97223 Plan Revie rw /
Phone /ncr..
503.639.4171 Fax: 503.598.1960 y ;:h]-•, „r . Date/B
Other Permit:
Inspection Line: 503.639.4175' ri•. Y
_ ^ _I_� ' Date Ready/By:� ®See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK " COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
• ❑ New construction ❑ Addition /alteration/replacement 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.
- CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL.EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building -
❑ Multi - family El Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. Total
" JOB SITE INFORMATION AND LOCATION, Heating /cooling
Job site address: 1 5 /2_ S.__ r� . Air conditioning or heat pump
G �. ( // bn (requires site plan showing placement) / _ 14.00
City /State /ZIP: r - Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 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
Subdivision: SJ.ti.,.,. • 4-- 2 ,A 7 Lot no.: 2 Z Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00 •
//�� Gas fireplace 10.00
P`t r r- (,, y t `{-. e r.e_ r Flue vent for water heater or gas
fireplace 10.00
• Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10.00
❑ .PROPERTY OWNER , ❑ TENANT
Other: 10.00
Name: 0 m !'4 T 5 .e. , ..�w ................... w.f , S 1,..Z 6.,.. Environmental exhaust and ventilation
Address: a TO , ,•, G K 1 ` Range hood/other kitchen
equipment 10.00
City /State /ZIP: 4 � Q f,� L f F: a d K ('7 Clothes dryer exhaust 10.00
aft/ a Single -duct exhaust (bathrooms,
Phone: (So)) 3$ 7 - S 3g ( 5b,) 1p 7- -76O l C., toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑, CONTACT PERSON . ' Attic/crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
• Fireplace
E -mail:
Range
CONTRACTOR' • . Barbecue
• Business name: G A Clothes dryer (gas) -
Other:
Address: P, D * R o� (7 4 MECH L, ANIC PERMIT FEES* •
• City /State /ZIP: .t,- LS 1 2 `M / n to ( l ` 8 ' ' Q 6 U Subtotal
/ Minimum permit fee ($72.50)
Phone: ( 5 ) (o /
5 - l (o 6 3 Fax: ( 5 p) ) 65-6 - /643
Plan re (25% of permit fee)
CCB lic.: /ti .3 . 5J t State surcharge (8% of permit fee)
v TOTAL PERMIT FEE
Authorized signature: a r-z----- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 0 14-7 .4 L ti l •„ f Date: 7- 7.2 -QS * Fee methodology set by Tri- County Building Industry Service Board
i:\BuildingTermits\MEC-PermitApp.doc 12/03 440 -4617T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard • .r.
Page 2 - Supplemental Information
Commercial Fee Schedule:
, Total Valuation:, .Permit Tee:
$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.
•
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i:\Building\Permits\MEC- PermitApp.doc 12/03 2
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,, D ON ° MORISSETTE OBE: 3435
HOMES INCORPORATED
4 2 3 0 G A L E W O O D S T R E E T L OT: 22
LACE OSWEGO, OREGON 97095 DATE: 02/03/2005
(6 0 9) 9 8 7 - 7 6 9 8 T A X (6 0 9) 9 ,(3 � 8 z __ „ ____ ,,,. _ 7 - 7 6 1 6 PROPERTY• SUMMIT —RIDGE
X dz b CITY: TIGARD
,�_� SCALE: 1" =20
PLAN No.: 197
STANDARD ELEVATION
X i 60,r„� , .4--I-e-- q - s - c i s
5' -0' 6'
MST �Obs - 00
5' -0' -\ 21' -6'
■■ 406 404 T.OlU.396
0 402 400 398 B.O.W. 392
406- '" 11036' f)
A Water —.. I - n 71 EL ■32'
400 I ! r ' 1. ��j^a� , %I' 4 � 6 . � /�1 r; : i 20' , - 398 o
.� •� � �� 662 s • � 1s'
ot
0. �' - 3 Car 2 32'- ri
do r; FP. ** R al
•;404• 2,594 6C1, ft. 6 A 402 ° 3 3 bdrm. 4)
IA
2 bath illi
PPE. 4049'
V .1 Pi
Sewer Q' " _v Y
21400 -
00 ':,N,• I ' I D
d ) • : 400 396 �dlon caMroi / ;
Y/ y; turd bw•wg. and h.y I 1�}
e 11035 -- Os') EL•3eb
N 0` T.0.1.11. 391
11- IL-
�' — '� 398 396 394 I
392 w I 3 I 18.0 .11). 386
xi va CO
it
IT-0' !Q
PRELIMINARY SALES ¶ 36' -4' ■
COPY ONLY
NOT TO BE
USED FOR
CONSTRUCTION
•
NOTE:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
THEY MAY VARY AND BE SUBJECT TO CHANGE.
LEGEND LOT COVERAGE
LOT AREA 6,621 5Q, FT.
0 STREET TREES: BUILDING AREA: 2,105 5Q. FT. LOT *22
- FRAXINUS PENNSYLVANIGA PERCENTAGE: 40.5
URBANIT ASH' 6,621 act. ft.
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CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MEC2005.00419
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2006
Phone: (503) 639-4171 „\
:441 I
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/15/2005 TIME: 7:11AM PAGE: 73
SITE ADDRESS: 15412 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 022 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: AC install.
OWNER: DON MORISSE! 1E COMMUNITIES LLC, PHONE #: 503
CONTRACTOR: GAS HEATING & APPLIANCE SVC CO PHONE 503-235-3301_•'
Inspection Request Scheduled For: Date: 7/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 011455-01 503-679-5137
Corrections/Comments/InstrUctions: • agi t-- e Wa 4 .0 S
6
•
•
•
[ PASS LAPPROVAL 0 CANCEL 0 NO ACCESS
0 FAIL 1111 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: f Date: Phone #: (503) 718-