Permit . CITY OF TIGARD MECHANICAL PERMIT
n 1r DEVELOPMENT SERVICES PERMIT #: MEC2005 -00546
9%J II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/15/2005
PARCEL: 1 S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 250 ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT: 002 JURISDICTION: TIG
Project Description: Rooftop unit. Value: $65,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 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: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: 8 < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
TIGARD PROPERTIES INC Description Date Amount
8320 NE HWY 99 [MECH] Permit Fee 9/15/200f. $959.00
VANCOUVER, WA 98668 [MECPLN] Plan Rev 9/15/200f. $239.75
[TAX] 8% State Surchar€ 9/15/200f. $76.72
Phone: 360 - 574 - 6255 Total $1,275.47
Contractor: -
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS •
TUALATIN, OR 97062
Phone: 692 - 1565
Reg #: LIC 5193
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: 1 , _�'j'�' ✓'1J r � '
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.
/fb5 ca) 5RG% a o *Y
Mechanical Permit Application ,.9 FOR OFFICE USE ONLY
Received �/ r' , I ,
City of Tig 2 4° Date/By:
13125 SW Hall Blvd., Tigard, OR 97223 / V Plan Revie `j1�
Phone: 503.639.4171 Fax: 503.598.1960 U / /a;-� v � Date/By: �/
j > 9/ / Other Permit:
ti1' ll �
Inspection Line: 503.639.4175 r l� O � ■ cal j % Date Ready/By: J/+6'�' 10 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Metliod: .' / 1 Supplemental Information
� COMMERCIAL FEE
TYPE OF WORK //
FEE* SCHEDULE — USE CHECKLIST
❑ New construction ddition/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, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 4 g "
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building
For 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: // ,, I 44,2.4-0 Air conditioning or heat pump {
19 7� 5 ��� �j" / C- 4.1 (requires site plan showing placement) 14.00 I
City/State/ZIP: T int , 9`'' 2 3 Furnace 100,000 BTU (ducts/vents) 14.00 v
7� �" Furnace 100,000+ BTU (ducts/vents) g 17.90 v
Suite/bldg. /apt. no.: Project QQ 10
Q�lY�i f/�IJiI 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: 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
(S) /1, - I r_ Al cm-c_ v- tr C'7 Gvwfr Flue vent for water heater or gas
1 fireplace 10.00
C / / Log lighter (gas) 10.00 '
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
•
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 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 additional
Address: __ Furnace, etc.
' Gas heat pump
City/State/ZIP: / u,.(,�,,, Wall/suspended/unit heater
Phone: (s Fax: :s
5.3 ) 6 g/ /�7 1 Water heater
d
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name:��,e /�'Ch/ .0_,,,,,--,e7"-- Clothes dryer (gas)
Other:
Address: / D 3 3 o S v Ti y - T j,' MECHANICAL PERMIT FEES*
City/State /ZIP: 7� cp•-e_ y 70 e, Z Subtotal
l Minimum permit fee ($72.50) $9 .
Phone: ( cps ) !o EI.Z�-/�`45._ Fax: ( )) 1 9/ /,'7 0 2 . _
Plan review (25 /o of permit fee) 3 eil
CCB lic.: ,FT l . 9 . ? State surcharge (8% of permit fee) 7g
y / TOTAL PERMIT FEE I � � • y
I '
Authorized signature: This permit application expires if a permit is not obtaine within 180
days after it has been accepted as complete.
Print name: .7frif r Date�. • Fee methodology set by Tri -County Building Industry Service Board
I
Mechanical Permit Application - City of Tigard - -
Page 2 - Supplem Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up .$1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
t..
i:\ Building \Permits \MEC- PermitApp.doc 12/03 2
CITY OF. TIGARD
BUILDING DIVISION PERMIT #: MEC2005 00546
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/15/2005
Phone: (503) 639 -4171 41111
Inspection Requests (24 Hrs.): (503) 639 -4175 —
INSPECTION WORKSHEET FOR DATE: 9/29/2005 TIME: 7 :08AM PAGE: 92
SITE ADDRESS: 11945 SW PACIFIC HWY 250 CLASS OF WORK:
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE:
PROJECT NAME: JO -ANN FABRICS
DESCRIPTION: Rooftop unit. Value: $65,000
OWNER: TIGARD PROPERTIES INC, PHONE #: 360 - 574 -6255
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 9/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 016969 -01 503-692 -1565 Y
Corrections /Comments /Instructions: G,te l tC1---
1 2',
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ia 1. 111 WI
Vf 1 int.."
1 111111i "NM/ MI f- - ■--
p AS III PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
I , Alp&
Inspector: Date: at Phone #: (503) 718-