Permit p
.A . CITY OF TIGARD MECHANICAL PERMIT
�" ° DEVELOPMENT SERVICES PERMIT #: MEC2006 -10056
�.�
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/14/2006 PARCEL: 25111 DD -04800
SITE ADDRESS: 15815 SW STRATFORD LP ZONING: R -4.5
SUBDIVISION: STRATFORD LOT: 010 JURISDICTION: TIG
Project Description: Installation of A/C unit.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 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
JOHN PAXMAN Description Date Amount
15815 SW STRATFORD PL
TIGARD, OR 97223 [MECH] Permit Fee 6/13/200E $72.50
[TAX] 8% State Surcha 6/13/200E $5.80
Total $78.30
Phone:
Contractor:
WILLAMETTE HEATING & AIR CONDITION'
4370 NE HALSEY ST
PORTLAND, OR 97213 -1566 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 284 -3740
FAX 503- 284 -2821
Reg #: LIC 154438
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: _Aro _ �� Permittee Signature: r
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.
Mecha,>nlcal Permit �
� FOR OFFICE USE ONLY
City of Tigard I_ L 1.,,,f " ' A
Received
DDate/By. — .7—/k Permit N. .� -e __ � r
005
13125 SW Hall Blvd., Tigard, OR 97223 /It
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 \: of 2006 iti :,. Dale/By. Other Permit:
Inspection Line: 503.639.4175 __s-J,l -IL Date Ready/By: tads ® See Page 2 for
Internet: www.ci.tigard.or.us p � 'K f y Notified/Method: Supplemental Information
Tj E� 71k Tel''' COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction t ddition/alteration/replacement Mechanical permit fees' are based on the value of the work
111r��� 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*
i tfl - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / (. / t / -
(requires conditioning or heat pump
�� , �/ C.[/l (requires site plan showing placement) 1 14.00
City /State /ZIP: 7' JI��L_ Furnace 100,000 BTU (ducts/vents) 14.00
,, •• I `�� Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
r ........ 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
❑ PROPERTY OWNER ❑ 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
. ❑ 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: ( ) Fax:: ( ) Water heater
Fireplace
E -mail:
• Range
CONTRACTO ' Barbecue
Business name: _/......_.&_.„ �
L � _ / �
Cl dryer (gas)
Other:
Address: l ? 9 A ` /� MECHANICAL PERMIT FEES*
City /State /ZIP: ' G� Subtotal
Phone: ( )29 �j % j Fes: Minimum permit fee ($72.50)
' ( ( ) Plan review (25% of permit fee)
CCB lic.: / � r L/ di 3 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
/ This permit application expires if a permit is not obtained within 180
Authorized signature: / days after it has been accepted as complete.
Print name: / C9� 77 f -p I Date: l y A • Fee methodology set by Tri County Building Industry Service Board
i:\ Building\ Permits\MEC•PermitApp.doc 12/03 - // 4404617T(II /0b / COM/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 $10,000.0,0 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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is\ Building \Permits\MEC- PenmitApp.doc 12/03 2
02 / 0_6 /
i Yti I
CITY OF TIGARD m
BUILDING DIVISION PERMIT #:8,006 -- / 6 0 , 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) Ase
Inspection Requests (24 Hrs.): (503) 639 -4175 P:-
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /ST S CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: ( —/ 4 1-4 Pour Time:
Code # Inspection Description Confirm # Contact # Message
(o �'9 w\ec.2.. g °3 — 7 o 7
Corrections /Comments/ Instructions:
( //16. 7/
VL IDASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
0 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c/ hP Date: 6 •/ o 6 Phone #: (503) 718- V