Permit CITY TIGARD MECHANICAL PERMIT
6 DEVELOPMENT SERVICES PERMIT #: MEC2005 -00736
" cal I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/4/2005
PARCEL: 1S134BC-00300
SITE ADDRESS: 12244 SW SCHOLLS FERRY RD ZONING: C -G
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: TI: ductwork, diffusers, bathroom exhaust. Value: $17,760.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: M 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
BPP RETAIL LLC Description Date Amount
BY BURNHAM PACIFIC PROPERTIES [MECH] Permit Fee 11/4/200E $336.80
ATTN: JOHN WAT E RS [TAX] 8% State Surchar€ 11/4/200E $26.94
SAN DIEGO, CA 92101
Phone: Total $363.74
Contractor:
•
KLLM PACIFIC HVAC & R LLC
PO BOX 13246 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97213
Phone: 503- 287 -3336
Reg #: LIC 165618
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.
Issued By: gi Permittee Signatu/r , A j .. 1
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit 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 Application Foit oFFICI.: USE ONLY
!_Ci of Ti and Received
•J g DateBy: / 1 4 05 Permit No Iit // 3
rI�- ,
13125 S W Hall Blvd., Tigard, V " E f \ / C D Plan Review
Phone: 503.639.4171 Fax: 5 c 3. ": �/ C /mA,,;m.,,1 14 Date/By: other Permit. ,, . .
Inspection Line: 503.639.4175 :. j, e•_I I Date Ready/By: Juris: RI See Page 2 for
Internet: www.ci.tigard.or.us
NOV V 2005 Notified/Method: Supplemental Information
Cdr \ftib DI �. COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction B Qtt[bMil N placement 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: $ 1 i - 7 fo 0 r
� RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Y°' 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: l 9.714 SW C--L-cl l s J Red - Air conditioning or heat pump
ll r ` (requires site plan showing placement) 14.00
City/ State/ZIP: I `oP c - (D Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:Do l lQ r 7're 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
n ` Gas fireplace 10.00
/
—L YIS `�Q-F ( �Q I.C) (A-� l'� 1� t s e (� Flue vent for water heater or gas
Loat.4 ro -ic- S' f ` , fireplace 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: 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
A APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
q_,,, (_ Other: 10.00
Business name: LC-G� p ' /" I l c 4 R L . Fuel piping
Contact name: 11 l `� c1 " �,' 1 S ata i ` i $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E-mail:
Range
CONTRACTOR Barbecue
Business name: k Y`
j� I l� L 1_ _ ^ � \ - 4 ` f\ f p / [.- Clothes dryer (gas)
j') T,. :G l G_I f Ir' l
Address: 4 1(
[ Other:
he 5 f - MECHANICAL PERMIT' FEES*
City /State/ZIP: - - -- - { / J � ��4. ict 0 ' \ CO Xt. ' Subtotal
Phone: 6'63) 02 ? ^ 3 ?34 Fax: (95) 5�g- a. ?-]5" Minimum permit fee ($72.50) : &, KO
`- Plan review (25% of permit fee)
�
CCB Iic.: C /_ � ( — State surcharge (8% of permit fee) a & c/4
Q TOTAL PERMIT FEE 363 . /(t Authorized signature: /(/J� This permit application expires if a permit is not obtained within 180
d ays a fter i t has been accepted as complete.
Print name: l ` - 5C Date: I I /3/0s- • Fee methodology set by Tri County Building Industry Service Board
i:l Building \PennitsMEC- PennitApp.doc 12103 4400 - 4617T (I1/02/COM/WEB)
•
r
CITY :OF °TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00736
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/4/2005
Phone: (503) 639 -4171 Altb
l � l
Inspection Requests (24 Hrs.): (503) 639 -4175 •
INSPECTION WORKSHEET FOR DATE: 12114/2005 TIME: 7:01AM PAGE: 52
SITE ADDRESS: 12244 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: 1'I: ductwork, diffusers, bathroom exhaust. Value: $17,760.
OWNER: BPP RETAIL LLC, PHONE #:
CONTRACTOR: KLLM PACIFIC HVAC & R LLC PHONE #: 503 - 287
Inspection Request Scheduled For: Date: 12/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 023412 -01 503 -866 -5022 N
Corrections /Comments /Instructions:
/11W4 FR= Fla P
I Hi
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ( / Phone #: (503) 718- ��v�
CITY
BUILDING DIVISION PERMIT #: MEC2005 -00736
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/4/2005
Phone: (503) 639 - 4171- �lp�ht rl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/9/2005 TIME: 7:04AM PAGE: 28
SITE ADDRESS: 12244 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: TI: ductwork, diffusers, bathroom exhaust. Value: $17,760.
OWNER: ESPP RETAIL LLC, PHONE #:
CONTRACTOR: KLLM PACIFIC HVAC & R LLC PHONE #: 503 - 287 - 3336
Inspection Request Scheduled For: Date: 12/9/2005 Pour Time:.
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 023211 -01 503 - 666.5022 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR NSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .W� Date: (Cone #: (503) 718 -