Permit CITY TIGARD MECHANICAL PERMIT
l'� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00186
`� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/13/04
PARCEL: 2S112DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 180
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 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:
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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:
Remarks: Relocate ducts & grilles for TI. Project Value: $1,200
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 4/13/04 $72.50
[TAX] 8% State Surcharl 4/13/04 $5.80
Phone: Total $78.30
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: 233 - 6911 Duct Inspection
Final Inspection
Reg #: LIC 38868
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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 -00
Issu d By: ' 1 / Permittee Signature:
Call 50 •39 -4175 by 7:00 P.M. for inspections need t e ne business day
Mechanical Permit Application FOR OFFICE USE ONLY
City .of -Tigard / Permit No.: DatDate/By: 7 Os/ rl �, + iv / g.4
SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /�, r el Y:
Date/B Other Permit:
Inspection Line: 503.639.4175 . , *. 67 � Date Ready/By: fur' ' El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: / ((j, 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: $ i Zi9Q
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I and 2 family dwelling 2rCommercial /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
_ Air conditioning or heat pump
Job site address:
S .3 Lt.J PE D MOOD (requires site plan showing placement) 14.00
City/ State/ZIP: � D PAZ, 72? V Furnace 100,000 BTU (ducts/vents) 14.00
7� Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: rico Project name: 5 0 1.1 F 7' 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
delf Qr /" S ...ippd- v of ) g FF (0 7 x 4.4.0 £ '1Z" Flue vent for water heater or gas
fireplace 10.00
A)'12 cm_ / Li. Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Ot y/liner/flue/vent 10.00
Other: 10.00
Name: l� c ;TA 4 , 5 7- Environmental exhaust and ventilation
Range hood /other kitchen
Address: 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: Fuet t to
P g
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater
Fax ::
Phone: ( ) ( ) Water heater Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name:
niCc 7 fr7P Assoc.. C . Other:
Address: 9 78 8 5/,.. / 7t , „ 4 MECHANICAL PERMIT FEES*
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City/ State/ZIP: iTN
L0eD Subtotal
/ Minimum permit fee ($72.50) 7. JZ>
Phone: (Sol) „23 i Fax: (Sal) RSV 4 77‘ 7 Plan review (25% of permit fee)
CCB lic.: 3 g e d „,v State surcharge (8% of permit fee) S JO
TOTAL PERMIT FEE 78. )
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: JI CpEIhy !„, • Fee methodology set by Tri -County Building Industry Service Board
" t Date: y�i3 o3
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1:\ Building \Pernits \MEC- PemtitApp.doc 12/03 4404617 (II /02ICOM/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:\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 6 • 175
INSPECTION DIVISION Business Line: _ (503 , 171 MST
BUP
Received Date Requested — 2• PM BUP p
Location /0(D 50 d 07JT, Suite � �� 7 ' 07� `
Contact Person (0) 0 Ph ( ) 5(' — tb/ c l 9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing r!
Firewall
ci te t /9 1.1111°
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 1 / 4 171 /Q (r)
Other:
Final
PASS T FAIL
CHANI"CA
Post & Beam
Rough -In
Gas Line
Smoke mp
• S •A • F IL
ECTRICAL
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date d Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL