Permit ..A CITY OF TIGARD MECHANICAL PERMIT
e PERMIT #: MEC2004 -00323
DEVELOPMENT SERVICES DATE ISSUED: 6/1/2004
JI
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110AB -00200
SITE ADDRESS: 14345 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: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
• Remarks: Replace cooler with smaller cooler.
Owner: FEES
KOLVE, G C Description Date Amount
14389 SW PACIFIC HWY [MECH] Permit Fee 6/1/2004 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchari 6/1/2004 $5.80
Phone: Total $78.30
Contractor:
ARTIC HEATING & REFRIGERATION
BOX 83795
PORTLAND, OR 97283 REQUIRED INSPECTIONS
Phone: 503 - 735 - 2808 Cooling Unt Insp
Final Inspection
Reg #: LIC 152332
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 quest ens i • C by calling
(503)246 -6699.
Issued By: )6 ,dez Permittee Signatur
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical PeriatApplication FOR OFFICE USE ONLY
City of figard DateBy -- / -wr 3 . Permit No. :/nEG o� - t 0 .
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ,, ,, II
Phone: 503.639.4171 Fax: 503.598.1960 beiss. Other Permit:
; 'y I i
Date/By:
Inspection Line: 503.639.4175 ■ a I �� Date Ready/By: Suns: El See Page 2 for
Internet: www.ci.tigard.or.us " " "�' "
g Notified/Method: 7--/ G Supplemental Information
. 'TYPE OF WORK COMMERCIAL_ FEE* SCHEDULE - USE CHECKLIST' - •
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/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: $
' 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: n � r G Air conditioning or heat pump
�'� aL UT� N ( `� ) 6 � (�- (requires site plan showing placement) 14.00
City/State/ZIP: \ L 6 \J "i'- j 4; 6 ( S _ 1 ( 1 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: - Project name:
Gas heat pump 14.00
Cross to job site: Duct work 14.00
(x(11 C lG- (2 6 0\ Residential is hot water system water � 6�T d v t `��V Resid 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
DES OF WORK Water heater 10.00
Gas fireplace 10.00
L Y^rk
LPF- Pc ` k.\&) Flue vent for water heater or gas
C..— fireplace 10.00
�- Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chirrmey/liner /flue /vent 10.00
❑ PROPERTY OWNER ❑ TENANT
Other: 10.00
Name: l_d t..-. ( - C� Environmental exhaust and ventilation
Address: l 9, 3 S Cjlj 'P A-c_- 1- - j cf Range hood /other kitchen
equipment 10.00
City/State/ZIP: 1 ( �� d 9 - 749. tS \-k. Clothes dryer exhaust 10.00
r Single -duct exhaust (bathrooms,
Phone: (5 G..$0 PO L7 Fax: ( ) toilet compartments, utility rooms) 6.80
.0 APPLICANT (( ❑ CONTACT P ERSON Attic /crawlspace fans 10.00
p / �+ Other: , 10.00
Business name:
Q Lt C- \ CD Fuel piping
Contact name: 4\ 1 � (C-10 S $5.40 for first four; $1.00 for each additional
I
Address: 3 C 'J S �l . l - 1 1C Furnace, etc.
Gas heat pump •
City/State/ZIP: C Pra... � 0 1 1 l `_ Walt/suspended/unit heater
Phone: ( 5.93 6 20 so -] Fax: : ( ) 1 Water heater
r Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: lta l ' � C.7 t ` 0 C. Clothes dryer (gas)
f Other:
Address: t" Jt g 3-7 a 5 MECHANICAL PERMIT FEES *, -.;::.
City/ State/ZIP: TDA 77 --R3 Subtotal
Phone: //�� 3) v Fax: ( ) Minimum permit fee ($72.50) 2:„1 ,, 9U 7 35 � O Plan review (25% of permit fee)
CCB lic.: / 5 2 ?..(p • 0 State surcharge (8% of permit fee) 62P
TOTAL PERMIT FEE 75. 3D
)(Authorized signature This permit application expires If a permit Is not obtained within 180
I days after it has been accepted as complete.
Print name: J� t I ∎ • te: 0 • Fee methodology set by Tri County Building Industry Service Board
i:\Building\Permits C- PennitApp.doc 12/03 440 -4617T (i i O ./COM/WEB)
Mechanical Permit Application - City of Tigard ". of •
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\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTIGN DIVISION . Business Line: (503) 639 -4171 MST
BUP
Received Date Requested b ✓ 2, AM PM BUP
Location j (9'C— Suite MEC 7_''6032!3
Contact Person °'"P V14 Ph ( ) 73s 8 Q PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner1 tij ELC
Footing
Foundation ELC
Ftg Drain Access: �/ � /�'� ELR
Crawl Drain w v"
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation �(J ,n A , -�P.�' c�� . S �f ; CDCE--
Drywall Nailing 1 1�h ` ` *�
Firewall
Fire Sprinkler
Fire Alarm y t F ail
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 '� r
Shower Pan 11111
Other:
Final
P FAIL
IIECHANICAL
Post & Beam
Rough -In
Gas Line V
Smoke Dampers
Fi
ACV PART FAIL
TRICAL
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 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL