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Permit ale CITY OF T MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 -00593 - _`- ' �J �! P 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: AR E CE L: : 1S135DD-03301 04 ARL 1 S135DD -03301 SITE ADDRESS: 11945 SW PACIFIC HWY 248 SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM 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: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Change out HVAC Value: $5775.00 Owner: FEES TIGARD PROPERTIES INC Description Date Amount 2106 SE OCHOCO ST [MECH] Permit Fee 9/3/2004 $90.90 MILWAUKIE, OR 97222 [MECPLN] Plan Rev 9/3/2004 $22.72 [TAX] 8% State Surchart 9/3/2004 $7.27 Phone: Total $120.89 Contractor: ROTH HEATING & COOLING P.O. BOX 1265 CANBY, OR 97013 REQUIRED INSPECTIONS Phone: 503 - 266 -1249 Mechanical lnsp Heating Unt lnsp Reg #: LIC 14008 Final Inspection • 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. /� _s/I Issued By: Qi1/ 4��f.i.[% Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day r . Mechanical Permit Application- , , ' l OR orrice USE ONLY City of Tigard t and . y ' / Re A l Permit No (� Ca , it 5 . ` / LjI C � Dte/B 13125 5 SW Hall Blvd., Tigard, OR 97223 -IQ : Plan Review Phone: 503.639.4171 Fax: 503:598.1960 u a Date/By: Other Permit: +naty f Inspection Line: 503.639.4175 _J,l I�'`�K _ Date Ready/Sy: ^ : ® See Page 2 for Int et ZL1 Notified/Method: /4 Supplemental Inf rmatlon l � C.C.. E OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work El New construction 'ddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. : CATEGORY OF CONSTRUCTION Value: $ s77�j - , ©O RESIDENTIAL-EQUIPMENT / SYSTEMS FEES* ❑ 1 - and 2 family dwelling MS ❑ Accessory building ❑ For special information use checklist. E] Multi- family ❑ Master builder Other: Description I Qty. I Ea: I Total JOB SITE INFORMATION AND LOCATION Heating/cooling ■ Job site address: ° � Air conditioning or heat pump 1,� �� Pc CZw� (requires site plan showing placement) 14.00 City/State/ZIP : `Y) 2-1"--, 3 Furnace 100,000 BTU (ducts/vents) r 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: l Project name: I - s k 1'H t Gas heat pump 14.00 4, Cross street/directions to job site: 9 / Al l E VC , 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: 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 Flue vent for water heater or gas C + y _ y C m ()7 pet � � _ / L l igh 10.00 N V U (%� (� Log lighter (gas) 10.00 . 111(-e - D-R. I; r....._ 0M) [ f Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ROPERTY OWNER ❑ TENANT Chimneytiner /fluelvent 10.00 1. Q Other. 10.00 Name: � ( L-I- ` wn Environmental exhaust and ventilation 3 O` 11 vO PO v t_ c (� U 1- Range hood /other kitchen Address: 1 ( J( equipment 10.00 City/State/ZIP: 'P Q/rNokl 1 2-21-'. Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (505) to t- 3 -59S I Fax: ( ) ((Z 6 () (pd- ! toilet compartments, utility rooms) 6.80 2,APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 (( Other. 10.00 Business name: Rm. Fuel piping � r� P P g Contact name: IR., 5 I ,12 n $5.40 for first four; $1.00 for each additional - Address: Pr) &(Pr ' Furnace, etc. / Gas heat pump City/State/ZIP: It, ! - r� 9 L0_ � Wall/suspended/unit heater Phone: ( , -- • , i & ! ( -1 I Fax: : ( ) -6l. l ^ 31.f7 Water heater Fireplace Range CONTRACTOR Barbecue n / : QC - , 7 " C` Clothes dryer (gas) Business name: U / � �// ( / - r � 5 lt` / �J l� I Other Address: l�O MECHANICAL PERMIT FEES* City/State/ZIP: C zki f t �j 70/3 . Subtotal - 5 ( ) 2.1.0&) -( 2 /q ( /� 2,41a 2,41a - 3/,‘w Minimum permit fee ($72.50) L10 AO Phone: � T ! Fax: U , Plan review (25% of permit fee) A-1..7 CCB lic.: / q Of State surcharge (8% of permit fee) ? • Al �� TOTAL PERMIT FEE with This permit a expires if a permit is not obtained ed within (80 Authorized signature: days after It has been accepted as complete. I Print name: f �� e Mat. Date: R 1 9- 104- • Fee methodology set by Tri - County Building Industry Service Board : ri.a,1:..oAP...., :bursar v...., :r Am. .1,.,. I//Ai 4 4 ( 7 1 ( llmi- rmrrwcml 1 c %FICE COPY ' N: ® - c I Ili °o Q "' �c.sn o I CITY OF TI4ARD 1 ui p o Z Approved ( ) Pt"Jnditionally Approved [ 1 I LJAB W m Fir R onMly IT the wigs � d cri4d — in: e �s4 _ N U PE NO 3 3 %/'� N., si- _I < ;vt4 IJ� I See Letter to: Follow ( ) I _ a r ., Attach . - - Job Ad re , 4445 SG • Q C ; b rim t4v$ 3/yq. Y: Date: a -3 y 0 7-7e6-7 I p (oce Melt if -- B OS. -A-1 .SScS C I U h : f` Ore a {-id cti4 t tA9 I e 1 vas . e f ��I ' S t 15 tM t c. X t C IA a rlit f' I i deeig(5 RTui t • • ari Act nif Pk4- Umi A ' - ;6--14, 1 l (r Z A — F is <, /d' kE' '...29s- L ILE cjr Li Kt / /y'Y5 Scv . 3q,j: ,L /)iv, , — , 6z � ,.D/2 1721; • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECT>'ON DIVISION Business Line:. (503) 639 -4171 BUP Received � / 1 Date Re este i e �� 1� OS\ 0 PM BUP Location i q S-3 Suite rJ MEC )- 4 -0-0 C93 Contact Person Ph C J O3) 5 1 – 7 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ` 1 i l Y ► Gx-Zc—_1 ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam N Q.. iftet.c. ¢- Shear Anchors U , Ext Sheath/Shear ' Int Sheath/Shear I I �- Framing _ ! r Insulation Drywall Nailing Fi rewal I Fire Sprinkler Fire Alarm Susp'd Ceiling ; =- / Roof Other: Final PASS PART FAIL PLUMBING i` Post & Beam Under Slab 04 "PPP- Rough -In Water Service ; MP!■ Sanitary Sewer Rain Drains Catch Basin / Manhole Uffile Storm Drain - .�lilaNIW Shower Pan Other: ,/ MP _• — Final PA T FAIL CHANIC P earn R.. • Gas Li Sit. Dampers • S PART FAIL LE - ICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE fl Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL