Permit CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00585
rt II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/20/2005
PARCEL: 1 S134BC -00300
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD ZONING: C -G
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: New grilles & registers, duct modification. Valuation: $4000.
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:
Owner: FEES
VINNACOMBE CONSULTING Description Date Amount
12790 SE BLUFF RD [MECH] Permit Fee 9/20/200f. $118.50
SANDY, OR 97055 [TAX] 8% State Surchar€ 9/20/200: $9.48
Phone: 503 826 - 1726 Total $127.98
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97222
Phone: 503 462 - 4822
Reg #: LIC 50897
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: - Permittee Signature: 31 4 AA 6644.4.5-1
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 Foli OFFICE. I sF ()NIX
City of Tigard Y n :2g vi- Permit No..\ / — e y .
13125 SW Hall Blvd., Tigard, OR 9722343 plan Review
Phone: 503.639.4171 Fax: 503.598.19 ! Other Permit: lir' Inspection Line: 503.639.4175 _ ' ''• ,, i . Date/By. m
Internet: www.ci.figard.or.us ® • - Date ed/Met o la See Page for
! SEI- 2 O Notified/Method: Supplemental Information
2005
• TY Q_F WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
�� fY
• Mechanical permit fees* are based on the value of the work
❑ New construction [i • t t: �,; •! f;: t cement
N performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ L+ p(gp ,
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 and 2 family dwelling c2'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
Air conditioning or heat pump
Job site address:
a � S �� Sri, p � k S g2/L,,„ P (requires site plan showing placement) 14.00
City/State/ZIP: �t! turf Ores I Furnace 100,000 BTU (ducts/vents) 14.00
I J Furnace 100,000+ BTU (ducts/vents) 17.90
gtm
Suite/bldg. /apt. no.: Project name:Ove tt tm &L 1 Gas heat pump 14.00
Cross street/directions to job site: J vnIci-ru 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
Flue/vent for any of above 10.00
Subdivision: I Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
� ) 4 If P 3 Lt -S a � f0 Gas firepla gas 10.00
CR. Flue vent for water heater or
fireplace 10.00
mo/S ` Log lighter (gas) 10.00
VVV Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: Ova 5,,—r r „ e o r 4_ ()h. ( fr-rn 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
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City / State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) • Water heater
Fireplace
E -mail:
Range
I an CONTRACTOR Barbecue
Business name:
7`I-l1A Clothes dryer (gas)
Other:
_ � i c , ' l� er:
Address: `J k b b S� , `1-�) M. MECHANICAL PERMIT FEES*
City/State/ZIP: M utwc,�.. —(t!' ) Minimum permit fee ($72.50)
Ve�tn -, �'I7a. Subtotal
/
Phone: ( ) Fax. )
Plan review (25% of permit fee)
CCB lic.: 5 () SC - State surcharge (8% of permit fee)
S Ajlit,t_A:9......., Q.j13 L TOTAL PERMIT n ot obtained within 180
FEE
Authorized signature: application expires if a permit is n
l /v�Q �� This permit app days after i t has been accepted as complete.
I Print name: _ (eAr( E_: f - in velSrM I Date: q I r9 / c)-0 ' Fee methodology set by Tri -County Building Industry Service Board
is tBuitding \Penniu\MEC- PamitApp.doc 12/03 4404617T(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.
•
•
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
•
CITY OF TIGARD
BU DIVISION PERMIT #: MEG2005 -00585
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 82
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: OREGON COMMUNITY CREDIT UN
DESCRIPTION: New grilles & registers, duct modification. Valuation: $4000.
OWNER: VINNACOMBE CONSULTING, PHONE #: 503- 826 -1726
CONTRACTOR: HVAC INC PHONE #: 503- 462 -4822
Inspection Request Scheduled For: Date: 10/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 018559-01 360 -601 -7928 N
Corrections/Comments/Instructions:
► -� 1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ID Phone #: (503) 718-
\__
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEG2005 -00585
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20 /2005
Phone: (503) 639 -4171 ' 4 411) AI /
Inspection Requests (24 Hrs.): (503) 639 -4175 "__— r
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 66
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: OREGON COMMUNITY CREDIT UN
DESCRIPTION: New grilles & registers, duct modification. Valuation: $4000.
OWNER: VINNACOMBE CONSULTING, PHONE #: 503 -826 -1726
CONTRACTOR: HVAC INC PHONE #: 503 - 462 -4822
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time: N
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 018380 -01 503-462 -4822 dip
Correcti ns /Comments /Instructions:
I
4 C ,) dl-- \r(k_ j‘..._.,..-3 ______ 0-4/L_______
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v `� Date: 14) 4 /o #: (503) 718-
► .
CITY .OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00585
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20 /2005
Phone: (503) 639 -4171 , ,°1, / /
Inspection Requests (24 Hrs.): (503) 639 -4175 ''I�i 1
INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 47
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: OREGON COMMUNITY CREDIT UN
DESCRIPTION: New grilles & registers, duct modification. Valuation: $4000.
OWNER: VINNACOMBE CONSULTING, PHONE #: 503- 826 -1726
CONTRACTOR: HVAC INC PHONE #: 503-462-4822
Inspection Request Scheduled For: Date: 10/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Mess -ge
615 Mechanical rough -in 018083-01 503-462 -4822 0
JC?,vrr
Corrections /Comments /Instructions:
V -VO Ni-Q_ 1 crr , — a
/f-pAss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: b / -2 C----- Phone #: (503) 718-
r
CITY OF TIGARD . _
BUILDING DIVISION PERMIT #: MEC2005 00585
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2005
Phone: 639 -4171 4
Inspection on Requests (24 Hrs.): (503) 639 -4175 °` '� ��
INSPECTION WORKSHEET FOR DATE: 9/29/2005 TIME: 7 :08AM PAGE: 113
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: OREGON COMMUNITY CREDIT UN
DESCRIPTION: New grilles & registers, duct modification. Valuation: $4000.
OWNER: PHONE #:
VINNACOMBE CONSULTING, 603 -826 -1726
CONTRACTOR: HVAC INC PHONE # : 503-462-4822
Inspection Request Scheduled For: Date: 9/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 016890-01 360 - 601 -7928 N
Corrections /Comments /Instructions:
• -
u
•
❑ PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `) V C---- • Date: g /241ac— Phone #: (503) 718-