Permit A CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2005 -00455
�y�, DEVELOPMENT SERVICES DATE ISSUED: 7/28/2005
. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25101 DC -03800
SITE ADDRESS: 07190 SW SANDBURG ST 20 ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Mechanical TI, gas packs and duct work. (2 -new) Project Value: $4,800
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:
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:
Owner: FEES
MCCORMACK, WILLIAM L + DARLENE T Description Date Amount
7415 FAIRWAY LOOP [MECH] Permit Fee 7/28/200° $91.30
WILSONVILLE, OR 97070 [MECPLN] Plan Rev 7/28/200E $36.52
[TAX] 8% State Surchar€ 7/28/200f. $7.30
Phone: Total $135.12
•
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 t• OU;} by calling 503 - 246 -6699
or 1- - 32 -23
I
Is ed By: Permittee Signature: • At.-
Call 503 -639 -4175 by 7:00 a.m. for inspections that bus' := s.y
This permit card shall be kept in a conspicuous place on the job site u : .• mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
•
. -- i.•
Mechanical Permit Application FOR OFFICE USE ONLY
City of Ti and Received ..
`'f g Date/By: / Permit No.: R 62 ,„ 0 , 5 --,2::, NS -,2::, S --3- - '
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 • //yal /r; 11 + %i +\ Date /By: Other Permit:
Inspection Line: 503.639.4175 ._ .. . a / y
,,,�► ` � B Date Ready/By: J H See Page 2 for
Internet www.citigard.or.us �
Notified/Method: //(�." Supplemental Information
- .. , �-L4. 9005' -0O /6 3 •
TYPE OF WORK COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
❑ New construction - . • - 2- Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
• performed.•lndicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑Other: ' mechanical materials, equipment, labor, overhead, and profit.
• CATEGORY OF CONSTRUCTION Value: $ 48 0
• - . RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling ® Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family. . - . ___ ..__❑ Master builder ❑ Other: Description Qty, I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: q _ _ __ _ • Air conditioning or heat pump
• - / s F t ),3 J C. D ' / E 7 (requires site plan showing placement) 14.00
City/State/ZIP: - i . Q 5 , 7 u3 Furnace 100,000 BTU (ducts/vents) 14.00 •
^^ Furnace 100,000+ BTU (ducts/vents) 17.90
., _Suite/bldgiapt -no.:. _ - ._ ._ ...... -- . - -._. Project name:14a CO lt/AC /C 3 C-1-.1 Gas heat pump 14.00 . .. .
.Cross street/directioiis to job siie: - -__. -- . - " Duct work _ 14.00
• Hydronic hot water system 14.00
et,J- .a.6 i:./eiC -�S ",0-,01-5 t�of 7 £Jog Residential boiler (radiator or
•
- q) t, /, J hydronic) 14.00
_ ._ .. _ -_ _. Unit heaters (fuel -type, not electric),
.. . . in -wall, in -duct, suspended, etc. 10.00
• • Subdivision: . _ . .Lotno.: 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
• Flue vent for water heater or gas
fireplace 10.00
- - Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
OPERTY.. O WNE R —_. _ _ .. _.
I - ..• ❑ TENANT Chimney/liner /flue/vent 10.00
me: .. _ ..
Other. 10.00
"Na
l �, w l L.-Li 8#-1 Environmental exhaust and ventilation -
`� n Range hood/other kitchen
Address:
741, 5 - 'C 14 a -t _,Aq �O r equipment 10.00
City/State/ZIP: Lot 1.50A) ` VL. - 0 2 97070 Clothes dryer exhaust 10.00
� Single -duct exhaust (bathrooms,
Phone: 63, G a, C� 4w � 9 0 Fax: ( ) . toilet compartments, utility rooms) 6.80
l ❑ CONTA PERSON space fans 10.00
_ - APPLICANT Attic/crawlspace
10.00
Business name: �
F�� 0 _ . 1 Vjj &4013,11�_
�1�! ' " l - Fuel piping .
Contact name:. Jo Cii/ zua1)L-) $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
/e3�3a 61.3 I iJi4 ¢TlA-) Itc /4D Gas heat pump
City/ State/ZIP: -7-0 /.) / �g 9 706 7_ Wall/suspended/unit heater
. . P h o n e : ( , , ) •
4 e) _ ,! 5G 5 : . Fax:: ( 503 ) 6/ / - /871 Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: ."5.:-.1 Clothes dryer (gas) •
! , r• Other
Address: - MECHANICAL PERMIT FEES*
City/State/ZIP: - Subtotal
Phone: Minimum permit fee ($72.50)
( ) Fax. ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)_
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: I Date: • Fee methodology set by Tri-County Building Industry Service Board
CITY OF TIGARD ' -
BUILDING DIVISION PERMIT #: MEC2005 -00455
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005
Phone: (503) 639 -4171 Ure 4Pi�l ,,
Inspection Requests (24 Hrs.): (503) 639 -4175 = _ '
INSPECTION WORKSHEET FOR DATE: 8/4/2005 TIME: 7 : 06AM PAGE: 72
SITE ADDRESS: 07190 SW SANDBURG ST 20 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCCORMACK BUILDING
DESCRIPTION: Mechanical TI, gas packs and duct work. (2 -new) Project Value: $4,800
OWNER: MCCORMACK, WILLIAM L + DARLENE T, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 8/4 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 012799-01 503-692-1565 N
Corrections/Comments/Instructions:
I
4_ AINIENNIETBMTAIVW
-...,
a w ■ IP r 11 (XI I W' - U -
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL F. INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I Date: 6 ` ✓ Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00455
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005
Phone: (503) 639 -4171 p ill
Inspection Requests (24 Hrs.): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 73
SITE ADDRESS: 07190 SW SANDBURG ST 20 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCCORMACK BUILDING
DESCRIPTION: Mechanical TI, gas packs and duct work. (2 -new) Project. Value: $4,800
I
OWNER: MCCORMACK, WLLIAM L + DARLENE T, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 8/29!2Q05 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 014468 -01 503-692 -1565 Y
Corrections /Comments/ Instructions:
1 1 ad /.
i �'� t„,....,
I ' V
rt. ASS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDIT NAL F ES ASSESSED
A
Inspector: � Date: 6 635 Phone #: (503) 718-