Permit •
C ITY O TIGARD MECHANICAL PERMIT
. DEVELOPMENT SERVICES PERMIT #: MEC2005 -00042
. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 1/31/2005
PARCEL: 2S102BC -07600
SITE ADDRESS: 12735 SW WATKINS AVE
SUBDIVISION: PP1997 -113 ZONING: R -4.5
BLOCK: LOT: 003 JURISDICTION: TIG
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: 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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: A
Owner: FEES
HOYT, ROBERT Description Date Amount
12735 SW WATKINS AVE [MECH] Permit Fee 1/31/200: $72.50
TIGARD, OR 97223 [TAX] 8% State Surchari 1/31/200f $5.80
Phone: 503 - 524 - 3238 Total $78.30
Contractor:
ALINE INC.
4221 SE 113TH
PORTLAND, OR 97266 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Mechanical Insp
Reg #: LIC 138272 Final Inspection
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.
Issued By: 2.772 Permittee Signature: -
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanica Ella FOR OFFICE USE ONLY Tigard
�/�
City of
Date/By: / ?/"" -LIZ..
Plan Review Permit No .\\„\c.; C��J wD !-!�
13125 SW Hall Blvd., Tigard, OR22 1 33 2005
a ,
Phone: 503 639.4171 Fax 503 1960 I q'� Date/By. Other Permit
Inspection Line: 503.639.4175.ITY OF TIGARD •■ ��. e I ) Date Ready/By Juns El See Page 2 for
Internet: www.ci tigard.or.usl� Nonfied/Method. � I (� Supplemental Information
BUILDING DIVISION v • - - ' ‘ ; TYPE OF WORYC - -_ , ,t, . . • ` COMMERCIAY.,,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 matenals, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value $
1 - and 2 dwelling = - -''z RESIDENTIAL; EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building - ' ' ' '
For special information use checklist
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea Total
' JOB SITE INFORMATION AND LOCATION - - • ` ` .'= Heating/cooling
Job site address: / a 7 3s - S(� (,�Dk -f �c A, s � Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: 7 p 04 9-7 )13 Furnace 100,000 BTU (ducts/vents) 14 00
Suite/bldg. /apt. no Project name: Furnace 100,000+ BTU (ducts/vents) 17 90
Gas heat pump 14.00
Cross st str re eet/direc p tions to job site: 60,q14) ft 1{ 47 Is ft.ij Duct work 14 00
c' f7 ON / gLC. ,S t GO- 1l 6)44 -� R esiden i hot we adi 14.00
, Residential boiler (radiator or
`` e __ �^ �{ j� hydronic) 14.00
(, P + IC; n" S Aug.- L- JbU 1 t/� , j tRS piles J Unit heaters (fuel -type, not electric),
6(.., 1111JJJJ
, . / iv i.,:,,,_,`17. P in -wall, in -duct, suspended, etc 10 00
Flue/vent for any of above 10 00
Subdivisio Lot no.:
Other: 10 00
Tax map /parcel no.: Other fuel appliances
' DESCRIPTION OF WORK - Water heater 10.00
Gas fireplace 10 00
Add i �' .," 66 / S l--4 v\..Qi r'Stpve et ( o pikvit i �e x c. Flue vent for water heater or gas
'n' c:1-1;4, `tJ 1 / ( � nN •G Log 1000
�'C`-, A-( 'L � (° kAAe P' t
Y l!'_° A�( Log lighter (gas) 10.00
y 1 4 AI/UC&S , Wood /pellet stove 10 00
,p Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10 00
.
' - &PROPERTY' ' - ❑ TENANT y
ea At Other: 10 00
Name: Environmental exhaust and ventilation
Address: ) a 735 S I.FJ ¢t r A) S 4 U pi Range hood /other kitchen
equipment 10 00
City/State/ZIP: Ord, i q -- 7 -3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (spa ) , j 3x3 j Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑' CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10 00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Fumace, etc
Gas heat pump
City/State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E - mail: Range
. CONTRACTOR ^ ' ' ' Barbecue
Clothes dryer (gas)
Business name: / i
Other:
Address: 1i72) S d� ,,o - MECHANICAL PERMIT FEES* `
City/ State/ZIP: p6 27.-1 /4 - of 9 3 Subtotal
I r a Minimum permit fee ($72.50) '7 - Phone. (5e03) 3q 9 �� / �Q,l) Fax: (9�7 � 3J Plan review (25% of permit fee)
CCB lie.: ( , ' I' '(e.i1, -v 6_S-- State surcharge (8% of permit fee) [5-_.
TOTAL PERMIT FEE `7f" 3 ')
Authorized signature: This permit application expires if a permit is not obtained within 180
A. - / 6 days after it has been accepted as complete.
Print name: � - . ' Date: / / — 05 • Fee methodology set by Tn- County Building Industry Service Board
%m "t /
1 \BuilduigTemuts\MEC- PemutApp doc 12/03 440 -4617T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard •�
Page 2 - Supplemental Information
Commercial Fee Schedule:
`t'E+i � ��a:" `+�:�� %�r
61/ alulatfo� r Perxm><t Fee: G r ''
$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:\Buildmg\Permits\MEC- PermitApp.doc 12/03 2 -
CITY OF TIGARD 24 -Hour
BUILDING - Inspection Line: (503) 639 -4175 r '
INSPECTION DIVISION . Business Line: (503) 639 -4171 MST
BUP
Received - 77 I Date Requested ` M PM BUP
Location /3735 ,3J �� uite
Contact Person . Ph ( 3 ) 5 4 - 3 ?-3g' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 1 ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing (
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
Post & Beam rAfr
itt
Smo e Dampers
PART FAIL
E RICAL
Service
Rough -In
UG/Slab -
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA f �G
Approach/Sidewalk Date Inspector Ext
Other:
Final • DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL