Permit CITY 00 TIGARD MECHANICAL PERMIT
r� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00098
" c � I I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/17/2006
PARCEL: 2S110DC -01000
SITE ADDRESS: 11270 SW MEADOWBROOK DR 5 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 014 JURISDICTION: TIG
Project Description: Unit 5, install dryer vent.
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: CLO DRYERS: 1
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
SUMMERFIELD ASSOCIATES, LLC Description Date Amount
•
% HSC REAL ESTATE [MECH] Permit Fee 2/17/200€ $24.25
1500 SW 1ST SUITE 1020 [TAX] 8% State Surchar€ 2/17/200€ $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: �% .v Permittee Signature: ,77
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.
u2/10/2006 11:50 FAX 5035981960 CITY OF TIGARD l 003
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Deceive. , i m — Tiz Pe rmit No.: II Ulm - 049 i n
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 k+*.;r.,• I (t N DatrlBy. Other it •
In Date R /B r. eetion Line: 503.639.4175 ` J • •: El See Page 2 for
x11 `
Internet www.tigard- or, gov Nutitled/Method: Supplemental Information
• TYPE OF- WORK 1 °`COMMERCIAL ::FEIC SCHEDULE - USE• CHECKLIST
I2 New construction on/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, Tabor, overhead, and profit.
CATEGORY OF CONSTRUCTION, Value: S
:. RESIDENTIAL' EQUIPMENT'/ SYSTEMS FEES* . •
0 1- d 2- family dwelling ❑ Commercial /industrial ❑ Accessory building •
For speciainformation use chr ck/Ist.
IDAulti-family 12 Master builder 0 Other Description Qty. Ea � Total •
.. • JOB SITE INFORMATION .AND LOCATION . ! Beating/cooling •
• Job site address: Ai conditioning or heat pump
h alt) . p. �� 14 f dro Le ` p _ . (MOMS site plan showing placement) 14.00
City /State/Z)p:T& ock. e-4) 0p., 9 72 24 Furnace 100,000 BTU (ducts/vents) , 14.00
■
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldgfapt no.: (1 if 5 Project narns5WM4F- La.1-1) Gas heat pump 14.00
Cross street/directions to job site: "D')9..1...) l ' -t •i . * v4„a t kc Duct work 14,00
• Hydronic hot water system 14.00
DP ( q q k4 t1"- 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 Water heater 10.00
I Gas fireplace 10.00
1IV6 ► .L-,rf.C> ^>,) Cjam- C f j E,, Flue vent for water heater or gas :
lace 10.00 •
D 1j t`2 i 1 — ki _ Log lighter (gas) 10.00
Wood/pellet stove 10.00
— Wood fireplace/insert 10.00
Chimne /liner/flue/vent geFROPERTY OWNER :. ;TENANT Other. 10.00
Nameak , -- • ' 1 •:. s C., ' (iY � '' • Environmental exhaust and ventilation
A Er ys Range hood /other kitchen
Address:' 500 8• 1l i eery ) 6u rrE (o'2) e 10.00
Cit /Sttte/ZIP:p N D ' q 7 2 0 7 ) 1 Clothes dryer exhaust ( 10.00
Single -duct exhaust (bathrooms,
Phone: (.)3 4 S 71 Fax; (fi) ,q46_,,-6 3C% a toilet compartments. utility rooms) 6.80
' : :Ci1" - APPII',ICANT • .. ' ONTACT PERSON Attic/crawlspace fans - 10,00 • Other. 10.00 •
Business name: 61,C� i 7 l 6 c r13� -t; 4 ._-- K ---, tf, ,,,..a Fuel piping
Cont name: � . � A.,i 55.40 far first four; 51.00 for each additional • •
Furnace. etc. •
Address: G heat pump •
City/State/ZIP: Wall/suspended/unit heater _
54Z - j > I Fax: Water heater
Phone: t,) ( ) Fireplace
E -mail: s Range ,
•CONTRACTOR ::.. • , :., Barbecue
• Clothes dryer (gas)
Business name:$ t j �y - r7p -- 451' --i L 4 Other.
Address: t c 9-0 i i V � - • • : MECHANICAL :PERMIT FEES` •..
City/State/ZIP: 12_t De ;E4=- L-t ') ice$ 14 2-- Subtotal ... /
Minimum permit t h e (S72.50) , 9j
Phone: (fir) 5 Ic i c 2.5 I Fax: (??) ,..16 — i 4 30 Plan review (25% of permit fee)
CCB lic.: ` State surcharge (8% of permit fcc) 1. 9 q
TOTAL PERMIT FEE a(t
c.4-4-4:. 4. £t f -74' •' 1Ii This permit application expires Ira permit is not obtained within i on
Authorized sign. / 4 � days after it has been accepted as complete_
' ' 4 "' � Date; Mc) y
• Fee methodology set by Tri Cotmty Building utdustry Service &nail
Print name: -
CITY OF TIGARD I
._
BUILDING DIVISION - PERMIT #:
G ISION E 24 ` 0009 d ,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: d
Phone: (503) 639 -4171 11i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TI E: PAGE:
10 SITE ADDRESS: / / / T L OF WORK:
SUBDIVISION: V LOT #: ' 4 TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - (0-0 (' Pour Time:
Code # Inspection Description Confirm # Contact # Message
G) I me c...4 • 3/0 -7/ F7
Corrections /Com nts /Instr ions:
pcq '
. ( y , f \
,-
V 7
tv: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t; V Date: ��� W Phone #: (503) 718 `7 2