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Permit - CITY OF MECHANICAL PERMIT DEVELOPMENT T SERVICES PERMIT #: MEC2004 -00574 - -! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/24/2004 PARCEL: 25101 AB -01200 SITE ADDRESS: 07275 SW HERMOSO WAY SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM 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: LPG 3 - 15 HP: COMML.INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Replace oil furnace with gas furnace. Add AC. Value: $2,000.00 Owner: FEES KEYWAY CORP Description Date Amount 14820 SE JOHNSON # 101 [MECH] Permit Fee 8/24/200 $72.50 PORTLAND, OR 97267 [TAX] 8% State Surcharl 8/24/200 $5.80 Phone: 503 654 - 6223 Total $78.30 Contractor: BELL HEATING 15550 SE PIAZZA AVE CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Phone: 503 Cooling Unt Insp Heating Unt Insp Reg #: LIC 447 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 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -6699. By: ■0 Issued B / Permittee Signature: 1 y � Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day •__ 1 chanical Permit Application FOR OFFICE USE ONLY o; Tigard Received Permit No.: P a n Re , 3 Aid �� m so -00 1312> SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 / / „ fl , ,„ ' D�te/By a " OtherPermit: Inspection Line: 503.639.4175 , . � � J Internet: www.ci.ti ard.or.us _.. Date ed/Me Ready/By: / Supplemental See Page 2 for g Notified/Method: i Supplemental Information Vitgli4,4„,, = � g 11 �. � 7 ° t� ,_ : ';. ,, 1 1 , - 1 64, 0HgeICLIST' • tom :w a ... Mechanical permit fees* are based on the value of the work ❑ New construction [ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, ( \ o � v ) e e e rrhead, ` an t and profit. r a . _ , F � . ti t'1 1'd�',`.. �a.. ' ' , . %s ,..a r., ; Sc... � n. r Value $ _a . 6 . t) 1,,,.,,t e"i1® a,,4.t!, . SY STEMS FEES* [ 1- and 2- family dwelling ❑ Commercial/industrial 1=1 Accessory building ` ❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist. Description Qty. Ea. Total «ter. �a x� _ . Heating/cooling Job site address: - r Air conditioning or heat pump 2 _ 1 _ (requires site plan showing placement) 1 14.00 14,00 City/ State/ZIP: Is C MI Q Furnace 100,000 BTU (duets/vents) 1 14.00 114,OC Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (ducts vents) 17.90 • ;MIME Gas heat pump 14.00 • Cross street/directions to job site: I. , Duct work 11, 14.00 Hydronic hot water system 14.00 r-, L 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 � ,' t z: , „ 2 S r �,,, s`ri ',4-11L I -, s a '` �: Water heater 10.00 .. ::.'..1. } h. . ...1 ,, -�, . j ilia a _. 4' +: Gas fireplace 10.00 • P.E .-1't-ALC- e i I I. Fi4 * #CE tel q H 44 5 F(1112_1.1:46_ E Flue vent for water heater or gas �� D Al fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 si7 r rr 7 r may; : L, . -,:> Chimney/liner /flue/vent 10.00 'e' x ,. . ' _ a .. 4• :.., ,z'..-. 1 . t.3 3 Y N ' N Other: 10.00 Name: C Environmental exhaust and ventilation Address: (LA S c - g' , -50,0 P.A. Range hood /other kitchen equipment 10.00 Ci / State/Z1P: 1 ^ 1 Clothes ty QC��� f'�tJ� 1 0�0� dryer exhaust 10.00 ) n Fax: Single -duct exhaust (bathrooms, Phone: ( (�. J_( ( Q7s ( ) toilet compartments, utility rooms) 6.80 f . y f y , vz _ a j 8 . 8 , , g c, , 17, :F Attic /crawlspace fans 10.00 Business name: , 1- Other: 10.00 ��.+L� kA \ _ i1r n+� Fuel piping Contact name: (ft «t... ink et.m. tC-..s.‘ $5.40 for first four; $1.00 for each additional Furnace, etc. I 5. , 4 a Address: l Sj S SO 5 ?Z 22A (4v ) Gas heat pump City/State/ZIP: C...1,.." C��./� W�S C r� 1C) LS Wall/suspended/unit heater Phone: 0.03 446 ( - - ( , tack F a x : ) )( ( j L �G"�'(... 1S t ` Water heater Fireplace E -mail: Range ia Co 1 w. _ . t' ;ter a ; ; 4 F t ..x: � = '', , . *1 " ' - . i Ba rbecue Business name: 4t Clothes s dryer (gas) Other Address: L S 560 C ? r fit- _P P' ' :,,-,t- r , 4 PM. s i,r, .1 - Di a t City/State/ZIP: es„,.. P nj C 1 O `c Subtotal 4 vtit Phone: (gj3 C 5 C 4t Fax: ( 5 3 6 S4 .-- /S 4 I Minimum permit fee ($72.50) ` Plan review (25% of permit fee) CCB lic.: c ( State surcharge (8% of permit fee) 1 TOTAL PERMIT FEE '�$ Authorized si •a a e: • STEVE DR t 5 This permit application expires if a permit is not obtained within 180 ■ • • days after it has been accepted as complete. Print nam : �• .Y, V ^ ` Date: j t ®C: i * Fee methodology set by Tri- County Building Industry Service Board i;\ Building \Permits∎MEC- PemiltApp.doe 12/03 440 - 4617T (11t02/COM/v'EB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information . . Commercial Fee Schedule: t d i irk!! ,n F ,7 '"'! 9F rt "Y _, `c" Y j. 3x _ . $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 $1.3.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 $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\ Building \P.ermits\MEC- PermitApp.doc 12/03 2 �� . r ,, - ''' ''''‘I't '1''I''' ' -. •a ? '; ' • l '' TE p 'AN „ 0° , a ay t.&dt .,.., .E' i g i - r l'' A]ORTH FOR INSPECTOR " .L.. .. , . . R. cr ; . CONTRACTOR ��1� A A! C- 1iEATPlMP UNtT SITE PLAN a j ;� BELL MI.$NC. , ' .- 4 c s T o-., l `� t t' V . r� EMI ff ? I , � . y t • „ , • . - 6 - W Q � Ickfl i e- IL-1 j - �p C il ‘ 1331 g .1. 1 To STREET ci) , . - \ ( L C . I o ,, <; ink +1'i , .;¢ x A a a CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTIQN DIVISION Business Lrne: (503) 639 - 4171 MST BUP Received Date R q ested 5 7 -/ 3 AM PM BUP Location x - 7.5 it Suite MEC 4f70 c f -06 7 Contact Person ( /1Y`- Ph ( ) “- I l t f PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation (� 644\-6 7 �Z\ Drywall Nailing �� l Firewall Fire Sprinkler �� (�% Fire Alarm f ©�� 7 Z— ( k Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING ' ► • Post & Beam Under Slab Rough -In WI �� Water Service ( a r Sanitary Sewer • Rain Drains Catch Basin / Manhole t , , Storm Drain '' Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rou • h -I n Smoke Dampers / J PART FAIL 'te RICAL 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 ❑ Please call for reinspection RE: 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