Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00017
� f l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/12/2006
PARCEL: 2S 101 AD -00400
SITE ADDRESS: 06655 SW HAMPTON ST 110 ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 034 JURISDICTION: TIG
Project Description: Install fan, move 2 grilles. Value: $1000
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: 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
HAMPTON OAKS LLC Description Date Amount
6665 SW HAMPTON [MFCH] Permit Fee 1/12/200€ $72.50
2ND FLOOR [TAX] 8% State Surchaq 1/12/200€ $5.80
TIGARD, OR 97223
Phone: Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Contact #: PRI 503 - 538 - 2953
FAX 503 - 537 - 2172
Reg #: LIC 125815
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.
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Issued By: i�� ..Tl`�� Permittee Signature. // v.
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 A I � E = FOR OFFICE usE,oNI Y
City of Tigard. RDeactee/Biveyd (` ix ot. Permit No.: . _ 440 of ._. (
13125 SW Hall Blvd., Tigard, OR 97223 JAN 11. 2 2006 AionolA Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Oth er Permit:
Inspection Line: 503.639.4175 " r' . . I
p CITY OF TIGA e. I Date Ready/By: H SeePage2for
Internet: www.ci.tigard.or.us g BUILDING DIVIS101 Notified/Method: mp Supplemental Information
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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: $ leva/^—
,�,{ RESIDENTIAL EQUIPMENT /;SYSTEMS FEES*
XJ
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
�J 5'1.-41 /1 conditioning or heat pump
Job Site address:
t1 44 rin (requires site plan showing placement) 14.00
City/State /ZIP: % /14- Furnace 100,000 BTU (ducts /vents) 14.00
/ Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: / /4 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: Lot no.: 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
Cle.4.✓ 6/.44.- Wu/J. 1 I> Flue vent for water heater or gas
1 l fireplace 10.00
_Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
V. 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
® N4 /1-16- Clothes dryer (gas)
Business name: Other:
Address: Pt) 14 MECHANICAL PERMIT FEES*
City/State /ZIP: 6 Jam« CT 9 S Subtotal
Phone: ( � 3) S 3't — IA3-3 Fax: (5 ) 537— v i Z Minimum (25% fee rmit fee)
2 Plan review (25% of permit fee)
CCB lie.: I ZS S (5, —' --a' - - �, I.) Al State surcharge (8% of permit fee)
/ TOTAL PERMIT FEE
� � 1 � ' `' This permit application expires if a permit is not obtained within 180
Authorized signature: C days after it has been accepted as complete.
Print name: (......G/ " L Date: 1/ JO/ QC ° Fee methodology set by Tri -County Building Industry Service Board
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information ' ti
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.
i:\Building \Permits \MEC- PermitApp.doc 12/03 2
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CITY OF-TIGARD
, BUILDING DIVISION PERMIT #: MEC2006-00017
I 13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 1/
Phone: (508) 639-4171 A
i a ntillitiiir
Inspection Requests (24 Hrs.): (503) 639-4175 ,„_tql 1.L.
INSPECTION WORKSHEET FOR DATE: 1/20/2006 TIME: 7:00AM PAGE: 11)6
SITE ADDRESS: 06655 SW HAMPTON ST 110 CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS . LOT #: 0 TYPE OF USE:
PROJECT NAME: GREENSPAN
DESCRIPTION: Install fan, move 2 grilles. Value: $1000
OWNER: HAMPTON OAKS Lie, PHONE #:
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503.53a 29
Inspection Request Scheduled For: Date: 1/20/2006 Pour Time:
. Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 025295-01 603-849-8162 Y
Corrections/Comments/Instructions: aL.Atur
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t....‘s I I PARTIAL APPROVAL El CANCEL pi NO ACCESS
I I FAIL , CALL FOR INSPECTION 0 ADDITI NAL FEES ASSESSED
4 ) i tifi d
Inspector: sr I .4• 7i Date: ( Phone #: (503) 718-