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Permit . f. CITY TIGARD. MECHANICAL PERMIT � � DEVELOPMENT SERVICES PERMIT #: MEC2004 -00745 ' VIII 13125 SW Hall Blvd., Tigard OR 97223 (503) 639 -4171 DATE ISSUED: 11/15/2004 , PARCEL: 2511 : 2 S 110A6 -00200 SITE ADDRESS: 14355 SW PACIFIC HWY SUBDIVISION: CANTERBURY PLACE ZONING: C -G BLOCK: LOT: 1-3 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: 1 DOMES. INCIN: 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: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: Replacement of roof top HVAC, hooking to . existing duct work. Owner: FEES KOLVE, G C Description Date Amount 14389 SW PACIFIC HWY [MECH] Permit Fee 11/15/20( $72.50 TIGARD, OR 97224 [TAX] 8% State Surcharl 11/15/20( $5.80 Phone: Total $78.30 Contractor: NW COMMERCIAL HEATING & A/C 18620 SE VOGEL RD BORING OR, OR 97009 REQUIRED INSPECTIONS Phone: 503 939 - 6928 Final Inspection Reg #: LIC 59375 • 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. Issued By: Permittee Signature: IL,. Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application FOR OFFICE USE ONLY • , Received /, / City of Tigard �� � J DateBy:�� I�V7 I, � PermitNo� �O 7 y 13125 SW Hall Blvd., Tigard, OR ��wN� � � Plan Review Phone: 503.639.4171 Fax /r�a,;dr ,. Date Other Permit: Inspection Line: 503.639.4 - � \ 7 a r:• Date Ready/By: t ® See Page 2 for Internet: www.ci.tigard.or.I1 Notified/Method: .17a- Supplemental Information ' - .;ICE ©1.lar COMMERCIAL FEE* SCHEDULE ° USE CHECKLIST 1:1 • a n/alte New construction ► ration/replaeement Mechanical permit fees* are based on the value of the work 1. ' performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition -■ Other: mechanical materials, equipment, labor, overhead, and profit. ' CATEGORY OF CONSTRUCTION Value: $ -:'p RESIDENTIAL. EOUIPM:ENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling %Commercial/industrial ❑ Accessory building - - For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. I Total . JOB SITE INFORMATION AND LOCATION. ' ' Heating/cooling /1/5 6-'4,- . - 9 Air conditioning or heat pump Job site address: � S / �/ �� ' /�G/e /7 . (requires site plan showing placement) / 14.00 City/ State/ZIP: ‘•94 2 , em Furnace 100,000 BTU (ducts/vents) 14.00 Fumace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: 6 Sep 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 /QEPG/ivGxICx/1" 06 / gyp/ ?> i/vi9 G Flue vent for water heater or gas /�/J`4,t/A/i 72 WAS 7 /i✓4 17/>G% Ge,0,_�� L l igh 10.00 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: Gs�l� ✓ /J / Te�r��I /Z s Environmental exhaust and ventilation Range hood/other kitchen Address: f ,Sin y,, r4S" �./V.l 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 �I ��i1.D Other: 10.00 Business name: Q'EGe Aw/i6 l � //7y� e, mi7ZZ l / Fuel piping Contact name: AiZ4e.. / / L / / ‘u�/OJt $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump I City/ State/ZIP: Wall/suspended/unit heater Phone: (57a3 9s 9 _d y° S Fax: : ( ) Water heater Fireplace E -mail: Range - CONTRACTOR • - Barbecue Business name:�� �f,4�(/f'� /�G /�ig ,yid./ Clothes dryer (gas) 7 Other: Address: ,��O.td ...5-6. Uz i z_ A? MECHANICAL PERMIT FEES* City/State/ZIP:.%l i+e/.1/ d, 917"�e:29 Subtotal Phone: e2 / Fax: (, 3 10.E /� / 2 Sri/ Minimum permit fee ($72.5 ) �� 7i e20911 O�Io �J go 7' Plan review (25% of permit fee) CCB lic.: 5 Li / , _ 29 State surcharge (8% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: ���4y��J� j/ days after it has been accepted as complete. Print name: Date: //r .. ei • Fee methodology set by Tri- County Building Industry Service Board i:l Building \Pertnits\MEC- PermitApp.doc 12/03 44046 (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. i:\ Building \Pemrits\MEC- PermitApp.doc 12/03 2 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION- ' Business Line: (503) 639 -4171 MST BUP Received Date Requested I AM PM BUP Location / 435 P Suite MEC O 2 q OU 7 Contact Person Ph ( ) S/ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner lL/� ;I G �2- / ?l� ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final - ` ." PASS PART FAIL PLUMBING Post & Beam / Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: _ Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Smoke Dampers S PART FAIL - CTRICAL 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 Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date � i 7 ` Inspector. Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL