Permit C ITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2006 -00100
'1I1 DEVELOPMENT H BMEN9 Tigard, -639 -4171 DATE ISSUED: 2/17/2006
PARCEL: 2S110DD -00109
SITE ADDRESS: 11053 SW SUMMERFIELD DR 2 ZONING: R -25
SUBDIVISION: SUMMERFIELD APARTMENTS LOT: 013 JURISDICTION: TIG
Project Description: Unit 2, install dryer vent.
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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: 1
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SUMMERFIELD ASSOCIATES, LLC Description Date Amount
HSC REAL ESTATE [MECH] Permit Fee 2/17/200E $24.25
1500 SW 1ST SUITE 1020 [TAX] 8% State Surchar€ 21171200E $1.94
PORTLAND, OR 97201
Phone: 503 - 546 - 5712 Total $26.19
Contractor:
SKYWARD CONSTRUCTION
15908 NE 10TH AVE REQUIRED ITEMS AND REPORTS
RIDGEFIELD, WA 98642
Contact #: FAX 360 -546 -1630
PRI 360 -546 -1625
Reg #: LIC 158289
•
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: /AU
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.
° '020/2006 11:50 FAX 5035981960 CITY OF TIGARD (1003
Mechanical Permit Application FOR OFFICE USE. ONLY
City of Tigard Received ' ffAl Permit No.:
Da 1 e 1Le. / .. i 0 6
13125 SW IIall Blvd., Tigard, OR 97223 Pin, Rcvicw
Phone: 503.639.4171 Fax: 503.598.1960 A F;t i i + +1 Dale/By. Other permit •
•
Inspection Line; 503.639.4175 A- ;,,,,, Dote Ready/By: June ® See Page 2 for
Internee www.tigard or,gov Nutilied/Method; t"' _ , C • Supplenteotal Information
TYPE OF WORK ;•:;' COMMIERCIAL;:FEE'!:SC:r - UUSE CHECKLIST
❑ New consGUCtion ❑ ittion/alteration/rcplacement 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: , , . , NT Value: $
_ :.. RESIDENTIA / SYSTEMS FEES*
ID 1- d 2 - family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist,
ulti family ❑ Master builder ❑ Other. Description 1 Qty. I Ea. I Total
: JOB SITE INFORMATION AND LOCATION:.: Beating cooling
•
Air conditioning or heat pump
Job site address: I 106' 3 H(M i2r 1 £ Cr "02, (requires site plan showing placement) 14.00
City /Scat IZIP: y ,,,k.g O p., 9 7s 24 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldgiapt no.: (11,1 t" r . Project name5,9-414L \ rt 1..) Gas heat pump I 14.00
Cross street/directions to job site: D.)a . , L 4 /_E Duct work J 14.00
•
' Hydronic hot water system 14.00
G C l L ( W`S i 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
I Gas fireplace 10.00
I t 5 j_ rto N.3 G J .1Th 1 C9L Flue vent for water heater or gas •
fireplace 10.00 •
D . "- t i '1'( Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner/flue /vent 10.00
PROPERTY OWNER .. I: • :.0 :TENANT. . . . '•. Other 10.00
Name-ji,»• ., r-x-revr�� [.A.,(:i ti5c ',-- Environmental exhaust and ventilation
Range hood /other kitchen
Address: ( 500 8'x.4-1 '(tz-z:,-r My ? u rrE (c' 7L ATE equipment 10.00
City /State/Z1P ;Po la G(y q 720 i Clothes dryer exhaust 1 10.00
Single exhaust (bathrooms,
Phone: (S03 s 4.L, - -7 2_ Fax: (TO) 54 ��'"6 3u i toilet contpartntents, utility rooms) 6.80
' . ( I NT API'LICA • ' a ONTACT• :PERSON : Attie/crawla� ace fans 10.00
_ - Other 10.00
Business name: �ltc iL,j � �-') (✓rjt3 <> "�„t; £- TL l3� Fuel piping _
Contact name: ° i k i $5.40 for first four; $1.00 for each additional •
•
Furnace, etc. .
Address: Gas heat pump _ '
City/State/ZIP: Wall/suspendcdhutit heater
Water heater
Phone: et°, 54' -- 162_5 Fax:: ( ) - = Fireplace
E -mail: Range
CONTRACTOR • • .. .:::. ` ..::. Barbecue. ,
• Clothes dryer (gas)
Business name:5' v ., .A I iL C A ∎I I. t, . - w �.,,i I• - Other.
:
Address C • • ., : • . : Iv11.CHA PERMIT FEES .
_ _ 1 �' �` tZ3�Z�1
City/State/ZIP: ¢t C X L Z 1 - ,,,A 1e44-7..... _ Subtotal
ivlinimum permit fcc (S72.50) Ar •
Phone: (%O) 5 is Fax: (34)) r - 74, ( (c:. • 270 Plan review (25% of permit fee)
CCB lie.: 1 Qz`�, B9 State surcharge (8% of permit fcc) I • I q
TOTAL PERMIT FEE ,
G&4 ' '.L, 4 . GJ �G�� This p erm i t application expires If a permit is not obi n within I RD li
Authorized sign J / Gays alter it has been accepted as compteka
/ ' ` �•1i1� Date: U • Fec methodology sa by Tri- County Building industry Service Board
Print name: /`
CITY OF TIGARD A4Vg film__
BUILDING DIVISION PERMIT #: 02 Z� 66_ d O /OD
I 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 jlil
Inspection Requests (24 Hrs.): (503) 639 -4175 P_—
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /1 Og _3 '' / / - • S OF WORK:
SUBDIVISION: LOT #: / 3 TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 —( -- o (O Pour Time:
Code # Inspection Description Confirm # Contact # Message
/-C ��.�,,, Rio -71 8-7 (� 1
Corrections /Comments /Instructions:
[fel ---v ._ .... —..., 0
v\ (--
0
'6; PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Vt.
(/" — Date: /L A ( Phone #: (503) 718- v l