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Permit CITY TIGARD MECHANICAL PERMIT , ,,,.I� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00050 A O JII 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/1/2005 PARCEL: 2S1 10 D D -05600 SITE ADDRESS: 10640 SW HIGHLAND DR SUBDIVISION: SUMMERFIELD NO.4 ZONING: R -7 BLOCK: LOT: 156 JURISDICTION: TIG CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 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: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Gas furnace install. Owner: FEES JOHNSON, BOB Description Date Amount 10640 SW HIGHLAND DR [MECH] Permit Fee 2/1/2005 $72.50 TIGARD, OR 97224 [TAX] 8% State Surcharl 2/1/2005 $5.80 Phone: 503 649 - 1744 Total $78.30 Contractor: PIONEER GAS FURNACE 3615 NE BROADWAY PORTLAND, OR 97232 REQUIRED INSPECTIONS Phone: 503 Mechanical rough -in Mechanical final Reg #: LIC 36102 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -6699. 7 � Issued By: j' _ jpr Permittee Signature: (1).1 4 _A Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 'Mechanical Permit A , , �Ii.:' \� r(l.R (h i lt. I. l •l:: (l\,.l l ' . CI Of Tigard L ', r _ Received Permit No �"� g DateBy,2 _` "OS '�j`g • 13125 SW Hall Blvd., Tigard, OR 97223 ' Phone: 503.639.4171 Fax: 503.598.1960 a 01 `tQ! „� ;,t, fi Plan Review Date/By: Other Permit: 'Inspection Line: 503.639.4175 = n I i Date Ready/By: turfs: ® See Page 2 for Internet: www.ci.tigard.or.us - 'f - - Notified/Method: . Supplemental Information ....1 . A � 1V j�l�� ,:. r ,�'��'�`� +,.ft� , ... •.,(>1FK COMMERCIAL FEE*.: • SGHEDULE'�- �JSE t �i It . .L .o n. � i�z _v �„ -. ii New construction A ddition/alteration/replacement Mechanical permit fees* are based on the value of the work _ performed. Indicate the value (rounded to the nearest dollar) of all • - ' ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. "'�•;i:$c''°°: a ,j, , Value: $ .� � - ��•�� i �r l`' °''' ' ��i ~CATEGORY.• OF CONSTRUCTION - {: :: RESIDEIVTIAI: wEQUiPMENTVSYSTEMStFEiii . 126- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. `: , '0 Multi-family 0 Master builder ❑ Other: Description Qty. 1 Ea. 1 Total '' . lafi JO�,SITE; ,1ND LOC/ MON . Heating/cooling . 'Job site address: / /� �^ A ir conditioning or heat pump �b(Q 'g0 c� 4 � �l I I Q 'l D r • (requ site plan showing placement) 14.00 . :City/State/ZIP: ! I ,-- c i q Z 21- Furnace 100,000 BTU (ducts/vents) / 14.00 / Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldgJapt. no.: v Project name: T`J O TO Pi 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 t. 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 • - r Tax map /parcel no.: . Other fuel appliances w3. ��f�'��'ra,��i- ,t:�,•'., ''DESCRIPTION OF WORK Water heater 10.00 Gas fireplace _ 10.00 . i � f gas , -/ Flue vent for water heater or gas fireplace 10.00 Log Tighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 Chimney/liner/flue/vent 10.00 S ” _ PI;Oftft d.OWNER•' I ❑ TENANT Other: 10.00 1. . , 1 , ..,-• 'blame: /96 6 Do n s fr.) Environmental exhaust and ventilation , . ��Yrl.e Q S Range hood/other kitchen Address: i.oh equipment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (33 ) (,L - 1 7 L1-q- . Fax: ( ) toilet compartments, utility rooms) 6.80 w i w • fi ' ; : ;. f 'APPL ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Other: 10.00 Business name: Fuel t m p g • Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State/ZIP: WalUsuspended/unit heater Phone: ( ) I Fax:: ( ) Watt!' heater I 6 s.4.'7 Fireplace . E -mail: Range '�� ° — '"` "'p `` ;^ CONTRACTOR Barbecue Business name: a pion e eta s r" 24,,,nQe C lothes dryer (gas) . 3 / - �f � Other: Address: J ( O S t/tF roan ,f Gt.X.i y ,. , MECf1ANICAL`PERMPP�FEES`' � `�-� , �' '�+° City/State/ZIP: 6fl �/ and OR 97 Z Subtotal /9.9 -0 ( 5 0 3 2195600 f Fax: ( 503 2 _ ^'2 �� Minimum (25% of fee ($72.50) m tfee - -- 249 � Phone: Plan review (25%ofpetmit fee) •�-- CCB lic.: 310 /D State surcharge (8 %,of permit fee) 5. 2' w _ TOTAL PERMIT FEE 7 R',o30 . Authorized signature: i / "This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. Print. name: e„/6.79'e I (/ 1 / 1 Date: l — 3 / ) 5 1 • Fee methodology set by Tri -County Building Industry Service Board F■114, . Mechanical Permit Application - City of Tigard p Page 2 - Supplemental Information Commercial Fee Schedule: To�falYalu%atio'n: r 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 $1 00,000.00 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 • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested ° AM PM BUP Location 0 • • ■• !AI 01is .I ►� Suite _ MEC 25 d oa56 q Contact Person Ph ( )a t"9 -,S000 PLM Contractor � �Q� ) Ph ( ) SWR BUILDING Tenant/Owner Footing Foundation ELC Access: Ftg Drain -1 ,•�� (Z ELR Crawl Drain >LJ Slab Inspection Notes: SIT Post & Beam Shear Anchors E /� ' l n O U E P a / q / / O S Ext Sheath/Shear (� G Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling • Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain - Shower Pan ' Other: Final PASS PART FAIL p MECHANICAL. 6, ).' Post & Beam Rough -In Gas Line Smoke Dampers i SS • PART FAIL ELECT CAL .- rvic 5, \ gr: n •:b Lo `, tage Fir:: A d i) Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. "ASS PART FAIL SITE . Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date Inspector /W Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: * (503) 639 -4171 MST BUP Received Date Requested -f AM PM BUP Location /0 ( ( 7 Z / N.? .s Suite MEC (9 005-600L_50 Person v Ph (S C 3) c PLM Contractor '1e � SCE Ph ( ) o M' J =S 0 SWR BUILDING Tenant/Owner 6, ` � ELC :2605 "e Footing �— !o t i q / 7 2 /Y - ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing d , • + , � /� Insulation R\t ?1--A CA . a Y N Y W ■ \ ' A\-1 l Drywall Nailing �_/ i �(� Firewall Fire Sprinkler n ` CY `wy iz�� l V l U '.', uu � Fire Alarm A Susp'd Ceiling Roof Other: Final PASS PLUMBING FAIL r "\ \` 1 ` (0 J C� `T `�1 Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL �ECHANICA, Posh & Beam Rough -In Gas Line Smoke Dampers Final • PASS PART ELECTRICAL ice Roug W` ab Low Voltage Fire Alarm l Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SIT ._ Please call for reinspection RE: Unable to inspect - no access Fire Supply Line / / L'r'`'� / ADA Approach /Sidewalk Date �- � �� Inspector Ext Other: Final DO NOT REMOVE this inspection record fro the job site. PASS PART FAIL