Permit CITY F T I GA R D MECHANICAL PERMIT
Ik DEVELOPMENT SERVICES PERMIT #: MEC2006 -00404
I mo``° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/15/2006
PARCEL: 1 S134BC -00300
SITE ADDRESS: 12272 SW SCHOLLS FERRY RD ZONING: C - G
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: Add (1) duct to storage room. Project Value: $500.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B 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:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
BPP RETAIL LLC Description Date Amount
BY BURNHAM PACIFIC PROPERTIES
ATTN: JOHN WATERS [MECH] Permit Fee 8/15/200€ $72.50
SAN DIEGO, CA 92101 [TAX] 8% State Surcha 8/15/200€ $5.80
Phone: Total $78.30
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR, 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 462 -4822
FAX 503- 462 -6555
Reg #: LIC 50897
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 B ('! � �� L Permittee Signature: ^1 (9C4k7C-yl
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.
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- Mechanical Permit An� � _1 - .„.,.'.9..P'. � , ' 1 v, � dri- 1 I Ca Ejjr_ d S > O\ L1� < r c' ,n� 't °, i�'�a�t� F
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City of Beaverton Date Received: a /5" / / ( 7 , : : ) „ , / : ' Permit No : I / , (p 111 / 1/-
' 4 4 0 PO Box 4755, Beaverton, OR 97076 h / Phone (503) 526 - 2403; Fac: (503) 526 - 255OU G �- , , 200 Date Issued: By:
�� ''° ".„ Payment T
Internet address: www.d.beavertnn.or.tu Y"u Type:
TYPE OF WORK ? �, Tr , ,.. .�. T v COMMERCIAL FEE” SCHEDULE - USE CHECKLIST
9 New construction ❑ Additio alteration/
° lacem '' enf ` 1 \--.) '✓' ''' ''''''L. r� Mechanical permit fees* arc 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: S SCE O
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building For specterl information use checklist.
® Multi- family ❑ Master builder ❑ Other.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: / A• Sw X Us �. e,,, r.Ol Furnace or add-on air
I conditioning • •
City /State /ZIP: 14r44,443, O r Heat pump 52.25
I /� i � p I 4 Duct work 19.95
Suite bldg. /apt no.: Project nam
VI Hydronic hot water system 19.95
Cross street/directions to job site: Residential boiler (radiator
or hvdronic)
Unit heaters (fuel -type, not
electric), in-wall, in-duct. 40.00
suspended, etc.
Flue'vcnt for any of above 19.95
Other. 19.95
Subdivision: Lot no.:
Other fuel appliances
Tax map /parcel no.: Water heater 19.95
DESCRIPTION OF WORK Gas fireplace 28.60
Flue vent for water heater
an,U G ld- u.,41 7112 S LL n� y v
��vo' or eras fireplace 19.95
0 Loe liehter (gas) 19.95
Wood /pellet stove 28.60
Wood fireplace/insert 28.60
Chimney/liner/flue/vent 28.60
Other. 19.95
❑ PROPERTY OWNER 13 TENANT Environmental exhaust and ventilation
Name: 'k ,_ uk S Range hood /other kitchen
equipment 28.60
Addre Clothes dryer exhaust 28.60
City/State /ZIP: Single -duct exhaust
(bathrooms, toilet
Phone: ( ) Fax: ( ) compartments, utility rooms) 19.95
Auiderawl space fans 19.95
APPLICANT CONTACT PERSON
Other 19.95
Business name: mot... ,10._., Fuel piping
Contact name: Le-e_, Lere Joe S12.10 for first four Z.45 for each additional
Furnace, etc. # /outlets
Address: Gas heat pump #/outlets
City/State /ZIP: Wall suspended/unit beater #/outlets
Water heater # /outlets
Phone: ( ) Fax: : ( )
Fireplace # /outlets
E -mail: Ranee # /outlets
CONTRACTOR
Barbed.. # /outlets
Clothes dryer (gas) # /outlets
Business name: 1 l_I Other. it/outlets
Address: S t - g � � ( ` ( MECHANICAL PERMIT FEES*
City/State /ZIP: N I . , , GCUL( e, 1 v (Nl Subtotal -7A.-1' Phone: ( ) 1 (i $) / F ( ) Y01 — (055 J C� Minimum permit fee $3i5
Commercial plan review (25% of permit fee)
CCB lie.: 5O (9 7 State surcharge (8% of permit fee) 7 .80
TOTAL PERMIT FEE 7 .6o
Authorized LA:a- , � � 17' This permit application expires
has if a permit is not obtained
signature: �� within 180 days after it has been accepted as complete.
1 � 1 • Fee methodole se by Tri -Caauy Building Industry Service Board
Print name: S U� �� Date. I Co � •• Sec Fee Schedule
410 -4617T (11 /02/CQM/WEB)