Permit - w .CIT OF TIGARD
MECHANICAL PERMIT
ri ' DEVELOPMENT SERVICES PERMIT MEC2004 -00047
. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/5/04
. PARCEL: 2S103AA -01100
, SITE ADDRESS: 10900 SW WALNUT ST
SUBDIVISION: ECHO HEIGHTS ZONING: R -4.5 •
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: ALT 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace gas furnace., - . ,
Owner: FEES
TRAN, NHANG V Description • ' Date`" . Amount
11174 SW SUMMER LAKE,DR [MECH] Permit Fee 2/5/04 $72.50 '-
TIGARD, OR 97223 - -
[TAX] 8% State Surchar€ 2/5/04 $5.80
Phone: 503 - 590 - 1645 Total $78.30'
Contractor:
TRANAIR HEATING & COOLING
16682 NE PACIFIC
PORTLAND, OR 97238 - REQUIRED INSPECTIONS ,
Phone: 503 - 516 - 7907 Heating Unt Insp
Final.lnspection -
Reg #: LIC 154284 -
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 in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR ,
.952- 001 -0100. ou may obtain copies of these rules or direct questions to OUNC by calling ,
(503)246 -669' /
-
/
Issued By: �i . I i / Permittee Signature: `�
Call (503) 639 -4175 by 7:00 P.M. for inspections need t rir'e t bus ess day
G"
Mechanical Permit Application FOR OFFICE USE ONLY
Ci of i and Received _
1312 SW Hall Blvd., Tigard, OR 97223 P ate/B R e y 'S -O V No ine 'J3 _ see
view Phone: 503.639.4171 Fax: 503.598.1960 / ,, Date/By:
Other Permit:
Inspection Line: 503.639.4175 ,. M 1 Date Ready/By: Juns ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method -/61 Supplemental Information
. TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Addition/alteration/replacement 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
IZ and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: A 9 4 ten ',1 ] j �a CA�7€ Aiq res conditioning p ing or heat pump
, (requires site plan showing placement) � / ' 14.00
City/State/ZIP: 'Vlt l k,/Lo 4� t Z 1 1 Z ' 3 Furnace 100,000 BTU (ducts /vents) t 14.00
"'�1 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 7e 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
p �(,( Flue vent for water heater or gas
1 1 ����� t fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER ❑ TENANT Other: 10.00
Name: /9 1„,t_m_i - ` "' � Environmental exhaust and ventilation
C Range hood /other kitchen
Address: equipment 10.00
, City/ State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 0-a3) 5 Oj® - 4 (Q4 s Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT Ef PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: ' t �l A. 14 L T_ 14eai� It r t4� Fuel piping
Contact name: 1 $5.40 for first four; $1.00 for each additional
��� Furnace, etc. e yrg O., D13
Address: (.../6.):5--z._ l�j t° ` lc3 Gas heat pump
City/ State/ZIP: k c9w _ v it ( 7 e t -7 'Z t e:7) Wall/suspended /unit heater
Phone: (S S 'j au, ' 1 6 — ® --7 / Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR . Barbecue
Clothes dryer (gas)
Business name:
y 1"LAA_. 4(l TZ Other:
Address: A / _ 0 � 2 . . . A i f & (4 .(cc___ D MECHANICAL PERMIT FEES*
City/State/ZIP t.. eq- 72_3la-j Subtotal
/
Minimum permit fee ($72.50) 7A,50
w ) Phone: _ _ m > Fax: ( ) Plan review (25% of permit fee) II
CCB lic.: 4 25-A Z ( 4/0/06 State surcarge (8% of permit fee) 5, To TOTAL PERMIT FEE 78 , 35
This permit application expires if a permit is not obtained within 180
Authorized Signature:__
` ��_ days after It has been accepted as complete.
Print name: . C mot 2 ' - ' S — t'L� • Fee methodology set by Tri- County Building Industry Service Board
i• 4Building\Permits\MEC- PennitApp doe 12/03 440 -4617T (I I /02/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 $10,000.00 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:TICARD 24 -Hour _
BUCDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION = - - - • e: (503) 639-4171 MST
n .. BUP
Received °Z //7 3 '' /g Date Req este• a r � r/ l 1 PM BUP •
Location 0 6 1 (i( i �• Suite a* V --- Z V 7
Contact Person ? Ph (PO 3) X76 79,0 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: • SIT
Post & Beam C elLe • - 2 2∎0'6
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear �
Framing ' C 3A -S c s' -- klgr - i'•0 3
Insulation
Drywall Nailing
Firewall .
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
•
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain -
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line -
Smok= • - mpers •
F•.
'ART - FAIL
CTRICAL
Service
Rough -In .
UG/Slab
Low Voltage
Fire Alarm '
Final 0 Reinspection fee of $ • required before next inspe tion. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line .
ADA D ` .Z� l 9 --�
Approach/Sidewalk Inspector Ext
Other:
Final . DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL