Permit hJe "h.
•
CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2006 -00096
DEVELOPMENT SERVICES DATE ISSUED: 2/17/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110DC -01000
SITE ADDRESS: 11075 SW MEADOWBROOK DR 1 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 014 JURISDICTION: TIG
Project Description: Units 1 & 2, install dryer vents.
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: 2
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
>
GAS OUTLETS:
10000 cfm:
Owner: FEES
SUMMERFIELD ASSOCIATES, LLC Description Date Amount
HSC REAL ESTATE [MECH] Permit Fee 2/17/200E $24.25
1500 SW 1ST SUITE 1020 [TAX] 8% State Surchar€ 2/17/200E $1.94
PORTLAND, OR 97201
Phone: 503 - 546 - 5712 Total $26.19
Contractor:
SKYWARD CONSTRUCTION
15908 NE 10TH AVE REQUIRED ITEMS AND REPORTS
RIDGEFIELD, WA 98642
Contact #: FAX 360 -546 -1630
PRI 360- 546 -1625
Reg #: LIC 158289
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.
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.
• •02,'10/2006 11:50 FAX 5035981960 CITY OF TIGARD al003
t '
Mechanical Permit Application FOR OFFICE USr ONLY
City of Tigard Date/By. / B y y. . . �� Per mt No.: . , �l/v0 6
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.598.1960 41111k ft�; Date/By: Otherp it In ection Line: 503.639.4175 `' Dote R B t • • 88 See Page 2 for
Internet www.tigard- or.gov Nod ficd/Method: 1 0. Supplemental Information
• TYPE OF WORK ;...: ;•.;COIMIIMIERCIAL ;:FEE1 OfilikILE - VSECHECKLIST
[] New construction. ❑ ition/alteration/rep]acement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) oF all
d Demolition Other mechanical materials, ermipment, labor, overhead, and profit. • • CATEGORY OF CONSTRUCTION. _ Value: $
RESIPEN� 1ALBQUIPMENT /SYSTEMS FEES* .
El lad 2- family dwelling El Comrnorcial /industrial ❑ Accessory building For: special information use checklist.
IgAulti-family ❑ Master builder ❑ Other.
Description I Qty, I Es. I Total •
.. : JOB SITE INFORMATION .AND: LOCATION • • .... H.eating/cooling •
• Job site address: 7 " n _ _ / I1 • 1 ma y, Air conditioning or heat pump •
1O �. I. gyp( "DL. �N i 1 / (t site plan showinpplace ea0 14.00
City /State/ZiP: �> ( ' j {� � � ' ei) Furnace 100,000 BTU (ducts/vents) 14.00
.-\ /1 Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. '
Suite/bldg./apt. LT I Project namc,51,1 `�}.Mry�� Gas heat pump 14.00
Cross street/directions to job site: .r' - i+4N( /4„ ( SX .a Duct work 14.00
fjjjj Hydronic hot water system 14.00
0 O C I C 1 't =S i Residential boiler (radiator or
• hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00 •
Flue/vent for any of above 10.00
Subdivision: Lot no.: Other 10.00
Tax map /parcel no.: Other fuel appliances .
DESCRIPTION OF WORK ... _ . W ater heater 10.00
1 Gas fireplace 10.00
11 5` lUNi ( - ki C Flue vent for water heater or gas
fireplace 10.00 •
D "- t 1 F% Log lighter (gas) 10.00
Wood/pellet stove _ 10.00
-
• Wood fireplace/insert 10.00 •
Chimney/liner/flue/vent 10.00 •
PROPERTY OWNER . • .. I: ' :: ❑ 'TENANT. • ... .' 10.00 •
Other:
Name ; _ e. - • ' 1 (i l' . + Environmental exhaust and ventilation
d
Range hood /other kitchen
Address: E-'STA, -r`;
,G, �Ca ��'� �(R.`aT -Aga- ?� u tT '� 1� • � equipment 10.00 •
City / State/ZIP: 7 0 ' q720 ( Clothes dryer exhaust y 10.00
Single-duct exhaust (bathrooms,
Phone: (03 • . - l 2 _ Fax: (. ' CG) 5, . -6 3c, d toilet compartments, utility rooms) 6.80
: . . Ft' APPLICANT • ' V .. ONTACT':PERSON Attic/erawlapace fans _ 10.00
Other. 10.00
Business name: 6ld; �>, et-0_ ,, LT , C . � . e ___- , pa Fuel piping
Contact name: C ° ,� 55.40 for first four: $1.00 for each additional •
Furnace, etc. I 1 1 .
Address: Gas beat pump •
City /State/ZIP: Wall/suspended/unit heater
Fax: Water heater
Phone: �r:) 4. " ( ) Fireplace
E -mail: Range -
.
CONTRACTOR • • ... :: ,...•::: . . : _.::.; Barbecue
•
Clothes dryer (gas)
Business name:5 y 4 7 tom - t - ti 1 :_ ; ,.. - t ci' i L IC, Other. •
Address: (C41-09) CU/`t 4V ., H .: : - MECHANICAL .PER nTFEES• .. • City / State/ZIP: r el .+ y Subtotal
��"tEl ' lt " x 'Minimum permit tee (572.50) AI • /Z } /
Phone: (�,O) 51‘. - .{c 2.6 Fax: (34 5 4, - (4 23Ce Plan review (25% of permit fee)
` CCB lic.: I i J B9 State surcharge (8% of permit fcc) • .•
� �1 ^ TOTAL PERMIT FEE •
G.� 0"'t A ., Ut)A'G f2 i This permit application expires Ifs permit is nut obtained wit in ISO
Authorized sign
) �� L i days after it has been accepted as complete.
Print name:
� ` / / '�� L-Z Date: , Mc) ; • Fee methodology set by Tri- County Building tadueoy Service Board
CITY OF TIGARD r m e - G p
BUILDING DIVISION I PERMIT #: Z !��<o OUP / �o
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171 h � ' I
Inspection Requests (24 Hrs.): (503) 639 -4175 _ '!!+� `'� I..
INSPECTION WORKSHEET FOR DATE: E PAGE:
SITE ADDRESS: _ 7 Evuo CLASS OF WORK: 4 SUBDIVISION: r LOT #: TYPE OF USE:
PROJECT NAME: (/ d 7 5
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - 6 D(o Pour Time:
Code # Inspection Description Confirm # Contact # Message
(o /$ Vim,, ...y, 31e)
Corrections /Comm is /Instruct ns:
154,E ,
(1 i
‘ ) ) . ) - -/' ,
I ii,f16 - S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Ins VC 4‘1-L---------
Date: 74 A to Phone #: (503) 718-