Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00462
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/23/2008
PARCEL: 1 S135DD -05106
SITE ADDRESS: 11995 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: BRUNO DENTAL
Project Description: Replace roof mount heat pump with like kind. Project Value: $9750.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: • BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: 1 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
WEIREX CO INC + Description Date Amount
CCC PROPERTY MANAGEMENT LLC
14001 WILLAMINA CREEK RD [MECH] Permit Fee 9/23/200E $227.90
WILLAMINA, OR 97369 [MECPLN] Plan Rev 9/23/200E $56.98
[TAX] 12% State Surch 91231200E $27.35
Phone: Total $312.23
Contractor:
APOLLO AIR, INC.
16088 SW FLAGSTONE DR. •
BEAVERTON, OR 97007 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 348 -8554
Reg #: LIC 156907
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.
I �
Issued By: A ,/11/ /1 Permittee Signature: - - 1j
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
I' • it 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 pplication FOR OFFICE USE ONLY
II ee ,/y
City of Tigard 13125 SW Hall Blvd., Tig Nes) �'9'l Date/ Receiv : y // �E Permit No.: Hft��OB-DOy(��
• �:' "s�t�.,
III ' Plan Revi •• 4 . �.
C Phone: 503.639.4171 F• "0d, t'.'" Date/By ) II �' I/ 0 Other Permit:
TI G A R D Inspection Line: 503.639 `5 Date Rea. y :y: / t Juris: ® See Page 2 for
?
Internet: www.tigard - or.gov C�' PRU Notified/Method: L9 l( "TO" Supplemental Information
t1G k4 r ikt -
TYPE (,!: 1 O O %3 S COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
❑ New construction AddttlWtt o n / 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: $ 97 57)
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling gCommerciallindustrial ❑ 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
(1 5 S � � Q r i �G Air conditioning heat pump
Job site address: / ( (requires site plan showing placement) / 14.00
City/State /ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: C' fi Gas heat pump 14.00
Cross street/directions to job site: Hydronic c hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
• in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater • 10.00
l / r Gas fireplace 10.00
fi -' /f /GP� htP��w/ / / � - 1-�/ Fue vent for water heater or gas 1 C — , D n r fireplae 10.00
V I .� 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: GOe f 2 €x Co , roc.._. 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: WalUsuspended/unit heater
Fax :: ( ) Water heater
Phone: ( ) Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: t / / c i / / , /t r �� Clothes dryer (gas)
Other:
Address: /(i F/ 5 a MECHANICAL PERMIT FEES* •
City/State/ZIP: /� fn ��/' Q 'roc 7 Subtotal
Phone: ) y 3 y6....8 cy Fax: ( ) Minimum permit fee ($72.50)
f Plan review (25% of permit fee)
t
CCB lic.: /5 7 7 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
'2/ `
Authorized signature: . (r,�/ This permit application expires if a permit is not obtained within 180
diys after it has been accepted as complete.
Print name: iii, � f Date: ?%/ v (J • Fee methodology set by Tri�ounty Building Industry Service Board
B
I:\ uilding\PermitsC- PemiitApp.doc 01/19/07 �- • 440- 4617T(11 /02/COM/WEB)
•
Mechanical Permit Application - City of Tigard •
Page 2 - Supplemental 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.
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I:kBuilding\ Permits \MEC- PermitApp.doc 01/19/07 2
CITY OF TI,GARD .
BUILDING DIVISION PERMIT #: Mf:.C200f300167
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/23/2003
Phone: (503) 639 -4171 � : „ p A I
Inspection Requests (24 Hrs.): (503) 639 -4175 "I —
INSPECTION WORKSHEET FOR DATE: 9/26/2008 TIME: 7 :00AM PAGE: 10
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 11995 SW PACIFIC H�IVY LOT #: TYPE OF USE:
PROJECT NAME: 13RUNO DENTAL
DESCRIPTION: Replace roof mount heat pump with like kind. Project Value: $9750.
OWNER: WEIREX CO INC +, PHONE #:
CONTRACTOR: APOLLO AIR, INC. PHONE #: 503-348-8554
I'
Inspection Request Scheduled For: Date: 9/26/2003 Pour Time: l° Pour
Code # Inspection Description Confirm # Contact # Message I
0�
699 Mechanical final 075983 -01 503 - 348 -8554 Y
Corrections/Comments/Instructions: tions: o
.A
Q\t4 S
X
C. 4 =e ms`\
i8 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Z-S Date: .926 i? Phone #: (503) 718- 02 '3