Permit � MECHANICAL PERMIT
CITY OF TIGARD
� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00097
" A II . 13125 SW Hall Blvd., Tigard, O R 97223 503 - 639 -4171 DATE ISSUED: 2/17/2006
PARCEL: 2S,110DC -01000
SITE ADDRESS: 11240 SW MEADOWBROOK DR 2 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 014 JURISDICTION: TIG
Project Description: • Unit 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: CQMML. 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 2/17/200E $24.25 '
1500 SW 1ST SUITE 1020 [TAX] 8% State Surchari 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: /J� / / Ca a
, Z( .. e . .d e = . ______
• 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 Il 003
Mechanical Permit Application FOR O11 USE ONLY
City r ea lved
y . g t3' of Tigard DateB I'1 op egg Permit No.: & . 00)077 13125 SW Ball Blvd., Tigard, OR 97223 Plan Review •
Phone: 503.639.4171 Fax: 503.598.1960 k r. ;d,'•�t � i1 4 '\ Date/Br Other permit
Inspection Line: 503.639.4175 ,1 1 i Date Ready/Br r , .: ® See Page 2 for
Internet www.tigard•or.gov Noti lied/Method; sire. Supplemental Information
• TYPE OF:VVORK ;
- ' .tOMMERCIAL ;ZEI11.`!..SCHEDULE - USE CH ECKLIST
❑ New construction ❑ ition/alteration/replacement Mechanical permit fees an based on the value of the work
performed Indicate the value (rounded to the nearest dollar) o I all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
• CATEGORY OF CONSTRUCTION: . • Value: $
• ; R ES I D E I'TtA L E SYSTEMS FEES*
❑ 1 -dad 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ;1,,'(ulti- family 0 Master builder ❑Other. Description [ Qty. I Ea. I Total
: • JOB SITE INFORMATION .AND' LOCATION Beating/cooling
1 a �i1J ' bao 64 - 1)12.
Air h heat pump • •
Job site address: - (requires site plan site plan n showing wing placement) 14.00
City /StateZIP :T6y &Cs.') G 1 912- 2ft Furnace 100,000 BTU (ducts/vents) 1 4.00
Furnace 100,000+ BTU (duets/vents 17,90
Suite/bldgJapt- no.: L)J Ir aZ Project namr.5V ;t„ .0401 t=�
0 -1) Gas heat pump 14.00
Cross street /directions to job site: '�,,� IN,kte( /it,( ' , * C,> Duct work 14,00
j
• Hydronic hot water system 14.00
a p a F C I C I 1 / 41 `•/-S, i Residential boiler (radiator or
• hydroni) 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 . • • . Waler heater , 10.00
• I Gas fireplace - 10.00 (I 5 1 • • A LO 'NJ , a , J _Aitl a ft . Flue vent for water heater or gas •
fire 10.00 •
V i. — Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/linet/tlue/vent 10.00 l
(4ROPERTY OWNER .. . I: :: ❑ :T .. T ... .: Other 10 00J .
Name. ' . — — • - - - . ( �T ' _� Envir ex haust and ventilation
!� _ .. �" ���a Range hood /other kitchen
Address: 1, •
y � �4 rrr t� u U ° e q ui pment 10.00 .
•
City/State/2 P; 0� � C>(�• 9 720 i Clothes dryer exhaust ( 10.00 __ �`-``�_ I Single-duct exhaust (bathrooms,
Phone: ( )4L . Fax: ICJ) 554 6 / - 6 3c,.1 toilet compartments, utility rooms) 6.80 •
' .CF•API'LiCANT .. : 1 Pt PERSON Attic/crawlsp ce fans . 10.00 •
Other. - 10.00
Business name: 61:4, , 3) j 4- l ') C d45 e..- — L ti - Fuel piping
: C
Contact nacrie $5.40 for first four; $1.00 for Each additional •
Furnace, etc. .
Address: Gas heat pump _ •
City/State/ZIP: Wall/suspended/unit heater _
Fax: Water heater
Phone: ed.)) 5[( 4, - ( ) Fireplace
E -mail: Range •
. •CONTRACTOR : Barbecue
Clothes dryer (gas)
Business name:S -� Cos. � re L Other.
Address: (C ct 0 p4:: Zj'—ti A v&....- • • .... - MECHANICAL PERMIT FEES:
City /State/ZIP: :iv ( 0 _ g17.4 I � —u) t f 6 1 e .1- Subtotal /
'Minimum permit tee ($72.50) ,
Phone: () r�` ,c, Fax: (34, ) -a " ((r:.` Plan review (25% of permit fee) •
CCB lie.: , jci State surcharge (8% of permit fcc)
C-1- .O TOTAL PERMIT FEE , I ,
" / . tit .),41144:2 Ai This permit application expires WC permit u nut obtained within Ian
Authorized sign • F f days after it has been accepted as complete_ I
Print name: -
� e- ' r _ ai ► /�r Date: . U :" • Fee methodology set by Tri•Cotmty Building Industry Service Board
CITY OF TIGARD _'' qh _ m Ec
BUILDING DIVISION PERMIT #: ZOO G — d OO 9 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 1 '" 11 fl
Inspection Requests (24 Hrs.): (503) 639 -4175 "I I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
v
SITE ADDRESS: / / ), 7 O CLASS OF WORK:
SUBDIVISION: / LOT #: I [ f TYPE OF USE:
PROJECT NAME: 'T
DESCRIPTION: I
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date:3 — 6 -040 Pour Time:
Code # Inspection Description Confirm # Contact # Message
IS , 3 8 7
Correcti s /Comments /Instru tions:
P
j
) ° . - / -
• _thy
i trA . S 3 S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�z
Inspector: - `J` `�` Date:/ ' / Phone #: (503) 718 - 1