Permit 4*--,
IIN il
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00080
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/9/2007
PARCEL: 2S110DC -01000
SITE ADDRESS: 11210 SW MEADOWBROOK DR 4 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 014 JURISDICTION: TIG
Project Description: Unit 4. Dryer exhaust.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 VENTS W/O APPL: VENT SYSTEMS: 0
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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
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
BY SUMMET REAL ESTATE MANAGEME
5320 SW MACADAM AVE
PORTLAND, OR 97201 Total
Phone:
Contractor:
SKY HEATING & AIR CONDITIONING
1635 SE NEHALEM
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 235 -9083
FAX 503- 235 -0454
Reg #: LIC 50244
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: A _4 Permittee Signature: / A i ,, / , • ,/
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.
02/08/2007 09:07 3605461630 SKYWARD PAGE 07/31
•
. '‘
Mechanical Permit App p_. 1,0R { 111 1:1't; ONI \- _ __
Cilty of Tigard
c 12 [_ ' fr I J , rcm,itNo,; j j �,�,dp7- t%O07O
i 1 3125 $W Hall Blvd„ Tigard, OR 972 3 = I`= _ ,l / • - ._ an Review
OtheT Permit:
• . Phone: 503.639.4171 .Fax: 503.598,196 DntclOy:
7 I r ; ;1 r, 1,
Inspection Line: nn Line: 503.639.4175 � Date Read /By' Sec Page 2 for
Internet: www.tigardor,gov FEB Ei) SJb 2007 Notified /Method: pplcmcata!Information
rill' rr:s ±r, ',;;.77;7-7,' yCr r, ti 'r T , r 1v rf t rv - '� r -
' n - 77 3z "' II t 1 0 i
y�, ., . � t .= ',, �r k . • . ! s '.,- 1 C 2� 'j `� >>;� i''' ''':'71 ''.. , ," ' { `L " 57 .''r , . i '5'7. . ,�t'' '
�� #,1 j7'W S��1�q�;'<ro if�' <�f rf +: s ! ' 4 �;1:� J� >.. „ Y .m., l iw v , J'r.m� ... . ,, e r5.:llyd ' .�. „iE t'. ,. _ {.'. %'T "i'.;3 cif •
V 1 N I 1 f�TI , yi r Mechanical permit fees' are based on the value of the work
El New construction ❑ Addition/alterattlyNrt�piat cur '�' 9 performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit, -
cr 7 A E 4 - S?'""': iF` . r. � 1 ; ,, F r ,., - - i ., 7' .' . 7 , 7,.5 °F IAV77 .'' �'• _ Value: rS _ -, r n
: 4 W r �,, a ' P ,u.' .N" . . ""-_'l f ry r I a i `� ,i,i
k1,4';;.,,4;,$,:,5,-',....,} h .y ,a,;!,.,5. r - , �. r^. ", !hi „ x ,�rtr; r i ' ^? . .,.
y'
i ,Sr 't.k{'(,� ;'i�;r�' .xr;.,era Ih , t ; L.Yt � .;;^.. ,�‘. r +.t
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building Fn►specivl information use. chrcklzTl.
❑ Multi-family ❑ Master builder ❑ Other. Description I Qty. i ..Ea. I Total
i ' - ,111 c ,.71 : , + .� :� ^ � . ' . I ? 7'.7' � rotht ' '"".. E ' I' Y. . t r§ ", ∎. ..'0 Hcal'1ngitonling -
Air conditioning or heat pump
Job site address: 11210 SW Meadowbrook Dr. (requires site plan showing placemcnt) 14.00
- City /State /ZIP: Tigard, OR 97224 Furnace 1.00,000 BTU (ducts /vents) - 14.00
Furnace 100,000+ BTU (ducts/vents) , 17.90
Suite/bldg. /apt. no.: 04 Project name: SummerReld Apartments
Clan heat pump 14.00
Cross street/directions to job rite: Duct work 1.4.00
Hydronic hot water system 14.00 1
Residential boiler (radiator or
- ydronic) 14.00
Unit heaters (filet -type, not electric),
in -wall, in -duct, suspended. etc. 10.00
- Flue/rent for any of above 10.00
Subdivision: Lot no.: Other 1 10.00
Tax map /parcel no.: Other fuel aj►)tliances
r ' T 777• -,*r 1 ti ti 0l' 7.-Fri, ',r r 7777 : , i� 7,„R b'f ".r Water heater 10.00
i' . : i" 4z "o ' . k . S „'1.,. ;;r a�,:, ., ,. r w`, .A- ?., 4 , -, lr// i.. f r ; k .� . . i s.. t . ti c.ti f«7 ` ;,,!4a.
Gas fireplace _ 1 0.00
Clothes dryer exhaust Flue vent for water heater or gas
fireplace 1 0.00
Lott lighter (Ras) 10.00
Wood /pellet stove .. 10
- - Wond flreplace/inscrt 10.00
, r R -7 7 . , ..,. , ,, , ,- . . 7 , 777 , 77. ,_ - ,., T-r . ,, - �*y 7 - 0. 7, ,4 ' Chimney /liner /flue /vent 10.00
i ,,cH,� 7 , ra '14+�P4, ,': ';',,6, ';7'.tit, 11 r' '? a,1�,:', .d ,f.. ..Lx� 1 .r; i•`i "• la � .r4s..t „nc n_ r,a ;` re. Other: I0.00
Name: BSC Real Estate, ins. Environmental exhaust and ventilation
Range hnod/other kitchen
Address: 1500 SW First Avenue, Suite 1020 c ui menr. 10.00
City /State /Z1.P: Portland, OR 97201 Clothes dryer exhaust I 10.00 10.00
Single -duct exhaust (bathrooms.
Phone: (503)546-5712 Fax (503)546-5301 toilet core ancients, uti rooms 6.80
r � -r? �.^� -,- r-7C 7, -:* ,, r 1 s4,� Attic /crawlspace a 10.0(1
?a . ` ,J } ,� n ��rJ i �' r 1 , r ' . - 4 l - �': 4 '.'� fvi L r r 1 1 R) 4 it �' r -'
4 ak' . �l;,; .N,q':I�nS� iai d�r r..l ace. , ^ .�, L.. .i {r '�.t. r' . L � �.., Yr _r.,�.a +. <.',K�,.. .�t d_^ , 1�r � fikkx .hm. ';
f�.�.:fiiYll t, Jf d,, 10.00
other:
Business name: Skyward Construction, inc Fuel piping
Contact name: Chad Walker $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 15908 NE 1e Avenue . -
_Gas heat pump
City /State /ZIP: Ridgefield, WA 98642 Wali /auded /unit heater
Phone: (360) 546-1625 I Fax:: (360) 546-1630 Water heater
Fireplace
E -mail: Chad ®Akywwardconstruetion.com Range
1tN '� 1 1,.'� Vi ', 4 -_ ° u t d 'i - ° "t' .e yW '. e Il Y Barbecue
, ��., u,, ?2� :1te�� �'�dl,i��,� �'� lr t ,. k c. � 1 ^ t. x,? 4�. g Y . is��fi � p' tr �c 9fwlG ' n. � 1�
Clothes tamer (gas)
Business name: Skyward Construction, Inc - Other:
r" r . , .: 7 r7.- c , : , .. -cc 7i n . �+Udti�4 7d
Address: 15905 NE 10 °i Avcnhi" �r ' t 1 � i ' ; yi� : s 4 { a +.1 / , ' 1 ,. .'7,•'' "I I �' r } ± }
i ,u- .r,rv�, r4 .rin,.m �tiM -,� r.r ; ' , Sn, l'k h.'..c ;
City/State /ZIP• Ridgefield, WA 98642 Subtotal
Minimum permit fcc (572,50)
Phone: (360) 546-1625 Fat: (360) 546 -1630 Plan review (25% of permit fee)
CCB lie,: 158289 State surcharge (8% of Permit fcc)
C e - TOTAL PERMIT FEE n TM. permit application expire* if a permit is not obtained within ISO
Authorized signature: t �"i i l I day,' niter it nail been accepted as Complete.
Print name: Chad Walker Date: 02/07/2007 • FCC ntrthodology sot by Tri- Conat:y Building lntluatry Service Board
410.46 (I I /021COMMEP)
U\ l
1 Pil .. . Building Division
TIGARD Request for Permit Action
TO: CITY OF TIGARD
Permit System Administrator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard- or.gov
FROM: ❑ Owner ❑ Applicant El.. Contractor ❑ City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) S }( y W (Ar 6 r C (), S (,
VOID Mailing Address:
City/State/Zip: / �9 r� cY 4)E/0 /O �Q
/State /Zi e /,' - Z LA
r oz4A tY p , ,: c f r N t\)/1 9 e Phone No.: 3 60 . 5 y 6 / (.2 S
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
b CANCEL PERMIT APPLICATION.
. 2 REFUND PERMIT FEES (attach receipt, if available).
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). Q -,�
111 REMOVE CONTRACTOR FROM PERMIT do not cancel ermit).N.A.k.�"" h nam_"'"' •
n if)Ec_ -o o7 - CeSIo— /�
• Permit #: ) i L / oz ( o - 00 04i q ece", ., �-' (,(4WA1
Site Address or Parcel #: / 102 / 0 6 t,✓ r eu d.o t„) 6 /-v a O to :
Project Name: S LA., ,, r-"tt C r / d A q 7 r
Subdivision Name: 1,Jt//6 w / rc o K f� , .,, Lot #:
EXPLANATION: 4 00„ / + CA A/ c le ci tA) G \ tvYR /Or y f a /nv s la
X 1 w.- Q
42_ dittx,L;),,aeu_ )A.c) -o-efb24tk pis_; pLavv,Ilige,NALL)kitiel
Signature: VA 06,- Date: 3 -/ S0r)
Print Name: 6C R ..5 6 0. tan)
Refund Policy
1. The Director or Building Official may authorise the refund of
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80 °%% of the land use application fee for issued permits.
c) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
d) not more than 8O% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
FOR OFFICE USE ONLY
Rte to S -s Admin: Date �a' i.�m Rte to Bld• Admin: Date au,AgEll B ' 7��f
Refund Processed: Date ..3/,./6/e 7 By 11. Invoice Processed: Date By
Permit Canceled: Date , /.,u By. j- Parcel Tag Added: Date By //
Receipt # 07- ,5 W
Date 9 /«
7 Method, Amount $
l:\ Building \Forms \RcyPcrmitAction.doc Re 05 /2 4/06 o_f.< - =- — �: �r_...-...._ -'.. • — ..m.7r' -vvsi - . - •'