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Permit q CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00709 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/6/2007 PARCEL: 2 S 102 D B -00500 SITE ADDRESS: 08815 SW O'MARA ST ZONING: CBD SUBDIVISION: FANNO CREEK PARK LOT: JURISDICTION: TIG PROJECT: SENIOR CENTER Project Description: Replace gas piping to water heater and range. Project Value: $2,800 2/15/08, adding gas stove, new value: $5,550 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: A3 VENTS W/O APPL: VENT SYSTEMS: STORIES: 2 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: NAT 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: Owner: FEES CITY OF TIGARD Description Date Amount 13125 SW HALL TIGARD, OR 97223 [MECH] Permit Fee 12/6/2007 $90.90 [TAX] 8% State Surcha 12/6/2007 $7.27 [MECH] Permit Fee 2/15/200E $50.60 Phone: public works 503- 718 -25' [TAX] 12% State Surch 2/15/200E $3.53 Total $152.30 Contractor: PROGRESSIVE MECHANICAL INC 9123 SE ST HELENS STE 100 CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 654 -0303 FAX 503- 654 -4969 Reg #: LIC 140856 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. Is ed 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. Mechanical Permit Application _ FOR OFFICE USE ONLY 'City of Tigard Received / ©e Permit No.: U PI ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review m Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit: - r I G A R D Inspection Line: 503.639 Date Ready /By: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: I_M Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (roun.m o the nearest dollar) of all ❑ .Demolition ❑ Other: anic. • - . , _ ... em, labor, overhead, an. pro t . Value: $ 2 E30tJ, C CATEGORY OF CONSTRUCTION // RESIDENTIAL E@HII'I!1lENT / SYS�MEr EES -- ❑ 1- and 2- family dwelling rei Commercialindustrial ❑ Accessory building \, special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other. Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION - Heating/cooling Job site address: ,�/ a Air conditioning or heat pump / ' • LJeiXjt�. Sr (requires site plan showing placement) 14.00 City/State /ZIP: T 6 0 . 10 ._ g 7 Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: P roject name:1T6 A4t 5avi6z Oo i t o . 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 • hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: I Lot no.: Flue/vent for any of above 10.00 Other. 10.00 _ Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 �ts�4sf'Ce Flue vent for water heater or gas fireplace 10.00 ar 1 - - , /■• — e. ' - ki� %��� Log lighter (gas) 10.00 A) Q , ,CA )G Wood/pellet stove 10.00 Wood fireplace/insert 10.00 Chimney /liner /flue/vent 10.00 SLPRO ERTY OWNER ❑ TENANT ether. 10.00 Name: Environmental exhaust and ventilation Address: 1 Range hood/other kitchen equipment 10.00 City/State /ZIP: Clothes dryer exhaust _ 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility moms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other. 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additiona Address: Furnace, etc. Gas heat pump City/State /Z1P: WalUsuspended/unit heater `! Phone: ( ) Fax:: ( ) Water heater �{ Fireplace E -mail: Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: 6 A,., , Air '/ � �Xj /� ,../ �.e .. Other: Address: 9/ , ce- ST. //dgeexAs• Si e /o MECHANICAL PERMIT FEES* City/State /ZIP: Ce44 nAS o 9 70/S Subtotal 9,!% 9 Phone: (,5a 3) 63.7.11/.... 0.2 0 3 Fax: (S03) Minimum permit fee ($72.50) S r�a.s� — �{ �7 V'o Plan review (25% of permit fee) ;.61—x' CCB lie.: /46 g .„.24 DI State surcharge (8% of permit fee) ,,Z7 • TOTAL PERMIT FEE 9 Q. / 7 Authorized signature: This permit application expires if a permit is not obtained within 180 � � j � days after it has been accepted as complete. Print name: ep,V Ad ‘ersL40dZ I Date: / Z /4 'o 7 • Fee methodology set by Tri-County Building Industry Service Board 1:\ Building\ Permits\ MEC- PermitApp.doc 04/06/06 440-06171'(11 /02 /COM/WEB) Range. Hood Systems Report SERVICE COMPANY DATV OF SERVICE TIME A.M. PM, Z - i Z - be. q %06 u ii `` ANNUAL SEMIANNUAL RECHARGE INSTALLATION RENOVATION I {� < ,/ I LOCATION OF SYSTEM CYLINDERS UL 300 � - - 1 `1 3 Z`I ?. C - J C- R LC �C �N1� 1 i T:�[� J�YES 0NO � MANUFACTURER MODEL NUMBER WET DRY CHEMICAL 1" �2 li�D 042 / ,.t s 0 L R -102_ X CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE 'SD3 Z31 - z i9ci 3 .o6,-.4c FUSE LINKS 360 F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER CUSTOMER O Name , 19 /tb -2 • f;'.E,f - FUEL SHUT-OFF -. ELECTRIC GAS - - r SIZE Address i3 6 15 5,w • O Mil a2A • X _ X ) • SERIAL NUMBER LAST HYDRO TEST DATE - LAST RECHARGE DATE City ` �, Arz_IN State OR . ZIP ?1223 5 z T1 a ac.1 • MANUFACTURER'S MANUAL REFERENCE Telephone R ot`t itt E Store No. - PAGE NUMBER: DRAWING NUMBER: DATE Owner or Manager R . r COOKING APPLIANCE. LOCATIONS: LEFT TO RIGHT: . - • . -. . . - _ 3 uRN • ��► DA I E FILE COPY • 1. All appliances properly covered w /correct nozzles l 20. Replaced fuse links -. • . - _. 2. Duct and plenum covered w /correct•nozzles • ' -" 21. Check travel of cable nuts /S -hooks . • 3. Check positioning of all nozzles. - . / 22. Piping & conduit securely bracketed . 4. System installed in accordance w /MFG UL listing • • = 23. Proper separation between fryers & flame , M/4 5. Hood /duct penetrations sealed w /weld or ULdevice " 24. Proper clearance -flame to filters __ 6. Check if seals intact, evidence of tampering - . . 25. Exhaust fan in operating order _L__ 7. If system has been discharged, report same M IA . 26. All filters in place . _� 8. Pressure gauge in proper range (If gauged) • .Jllk 27. Fuel shut -off in on position _L 9. Check cartridge weight (If applicable) . 28. Manual & remote set/seals in place . / 10. Hydrostatic test date . 01 29. Replace systems covers / 11. 6 year maintenance date NIA '30. System operational & seals in place 12. Inspect cylinder and mount •/ 31. Slave system operational 13. Operate system from terminal link / 32. Clean cylinder & mount 14. Test for proper operation from remote / 33. Fan warning sign on hood / 15. Check operation of micro switch - 34. Personnel instructed in manual operation of system _Z__ 16. Check operation of gas valve • 35. Proper hand portable extinguishers / 17. Clean nozzles / 36. Portable extinguishers properly serviced 18. Proper nozzle covers in place • 37. Service & Certification tag on system 19. Check fuse links and clean" V Ikif NOTE DISCREPANICES OR DEFICIENCIES BELOW COMMENTS: RWAcx. w Z- Dal Lta kS RECEIVED FEB 2 1 Z008 CITY OP flUARD On this range hood fire suppression system' was inspected.and operationally e e - m with the fire . suppression syste :requirements of NFPA17 or 1-7A, 96 and the Manufacturer's' - manual; with the'results indicated' above. - . . X • A - % 5 -,,,.-- i z -ig-ogl 9 \ n r . SERVICE TEC CIAN- .. PERMITNO. -; DATE'. - TIME: • .AM - 9: PM - UST•MER'S A - ORIZ di The above. servicetechnician: -certifies':that the system was personally inspected.and conditions to be. as indicated o _report. • ... AUTHORITY HAVING JURISDICTION { ®Brooks Equipment Company. Inc. . CITY OF TIGARD . BUILDING DIVISION PERMIT #: MFC2007 -00709 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 17/612007 Phone: (503) 639 -4171 14 '"�4 �r�� III& Inspection Requests (24 Hrs.): (503) 639 -4175 - _- INSPECTION WORKSHEET FOR DATE: 2/19/. sA9 TIME: 7 :01AM PAGE: 28 SITE ADDRESS: 08815 SW O'MARA ST CLASS OF WORK: SUBDIVISION: F CREEK PARK LOT #: TYPE OF USE: PROJECT NAME: SENIOR CENTER DESCRIPTION: Replace gas piping to water heater and range. Project Value: $2,800 2/15/08, adding gas stove, new project value: $5,550 OWNER: CITY OF TIGARD, PHONE #: public works 503-7' CONTRACTOR: PROGRESSIVE MECHANICAL INC PHONE #: 503- 654 -0303 Inspection Request Scheduled For: Date: 2/19/2008 Pour Time: Code # Inspection Description Confirm # Contact # Mes -_- ri 610 Gas line 065170 -01 503-881 -5364 Corrections /Comments /Instructions: etgi- 0 i x 1 I . . AA be Ar i 4P, - PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED Inspector: Date: ; �� p (503) v Phone #: 503 718 P h T CITY OF TIGARD • • BUILDING DIVISION PERMIT #: MF C20o7 -00709 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 ?I612007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/16t2008 TIME: 7 :00AM PAGE: 39 SITE ADDRESS: 08815 SW O'MARA ST CLASS OF WORK: SUBDIVISION: FANNO CREEK PARK LOT #: TYPE OF USE: PROJECT NAME: SENIOR CENTER DESCRIPTION: Replace gas piping to water heater and range. Project Value: $2,800 OWNER: CITY OF TIGARD, PHONE #: public works 503-7' CONTRACTOR: PROGRESSIVE MECHANICAL INC PHONE #: 503 -654 -0303 Inspection Request Scheduled For: Date: 1/16/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 063301 -01 503-881 -5364 N Corrections /Comments /Instructions: — �8c�2_ i ? S a 4 _ . M PA IAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL • ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718 - - '/