Permit i
CITY TIGARD MECHANICAL PERMIT
? DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00501
I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/18/2006
PARCEL: 2 S 104 B B -0 7900
SITE ADDRESS: 14350 SW BARROWS RD 002 ZONING: C -C
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT: 002 JURISDICTION: TIG
Project Description: Duct work only. Value: $2000.00
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ALBERTSON'S INC #576 Description Date Amount
PO BOX 20
BOISE, ID 83726 [MECH] Permit Fee 10/18/20( $72.50
[TAX] 8% State Surcha 10/18/20( $5.80
Total $78.30
Phone:
Contractor:
WILLAMETTE HVAC SERVICE
PO BOX 23334
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 628 -6841
FAX 503- 848 -2597
Reg #: LIC 56951
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: K
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.
fA IL ', 'k
r--- � ` ,� :�-a1 � � �.�-y � � � � � � z , �° � ,�n r3^ K 'T teary -u
Mechanical Permit App lCa loll t , , < r � 1 1' 4r 4,, r c)R ()ll 1(.l , lI 4 V l:l ,k „,-,
P ; , 02, 1 4 4 • ' Received
Permit No
.n.
; r Ci of Tigard ry D ate/BY t pJ .� , o 4. 6.0 .� 4G
13125 SW Hall Blvd., Tigard, O 31 8 2 ` �70Cv • t�o sa 1
C .i. P lan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
i G A°Kill Inspection Line: 503.639.4175 ; • , a '
P Fit.i ` Date Ready/By: auri� ® See Page 2 for
r .ae Internet: www.ti ard -or. ow 4 -I - t \ -d
y
g g Notified/Method: f Supplemental Information
- 2,3 ITT .gr ,
- TYPE OF WORK _ . - COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
• Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION • Value: $G_
1- 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* "
❑ y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND . LOCATION Heating/cooling
Job site address: 7', ! $ O ,S'A-) /!� / Air conditioning or heat pump
/3.0.,A v!/p tJ ``«/ (requires site plan showing placement) 14.00
/
City /State /ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 2 Project name:
Gas heat pump 14.00
Cross street /directions to job site: Duct work ..it 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
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK
Water heater 10.00
f ' iew /-1/4 Gas fireplace 10.00
.--- .--- J� (,,f w 1
e v -'< 4 C Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
• ❑ PROPERTY OWNER 1 ❑ TENANT
Chimney/liner/flue/vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
. equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
•. , ❑ APPLICANT • ❑,:CONTACT PERSON Atticicrawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: 55.40 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
Business name: 4_2 /a,,,,,,, c-tt- � �i4C Clothes dryer (gas)
Other:
Address: / J3 , ,,2 �) 3 3 MECHANICAL PERMIT FEES *' .
City /State /ZIP: T _ ,, W q'( �pZ g t Subtotal
U Minimum permit fee ($72.50) 70._
Phone: ( ) .. 2e. - 6 8 Lt. t. Fax: ( ) 5c( 8- 2 S cl / Plan review (25% of permit fee)
CCB lic.: ,- 6 S / State surcharge (8% of permit fee) 4% $o
TOTAL PERMIT FEE /] g, 3 a
Authorized SI ature: This permit application expires if a permit is not obtained within 180
!'� Q days a it has been accepted as complete.
Print name: �k [� c5'ti
C ' ptiv c Date:IC)- /8 - • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Pennits\MEC- PennitApp.doc 04 /06/06 440-4617T(11 /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.
1:\Building\Permits\MEC- PermitApp.doc 12/30/05 2
�
���~���' OF ��mw~m n�"w� mm����u���
- BUILDING DIVISION PERMIT #: MEC200&00SO1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: iD/18V2006
Phone: (503) 639-4171 I Ilk
Inspection Requests 824 Hrs.): (503) 639-4175 aK44
INSPECTION WORKSHEET FOR DATE: 12y1{2006 TIME: 6l68AM PAGE: 35
SITE ADDRESS: 14350 SW BARROWS RD 002 CLASS OF WORK:
SUBDIVISION: RUSSFLL'S3CH0LL'S FERRY SUB LOT #: 002 TYPE OF USE:
PROJECT NAME: 8pEcSPACE
DESCRIPTION: Dud work only. Value: $2000.00
OWNER: ALBERTS()N'S INC W676. PHONE #:
CONTRACTOR: WILLAMETTE HVAC SERVICE PHONE #: 503.628
Inspection Request Scheduled For: Date: 1Z/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 040542-02 503-957-3348 Y
Pa.
^A � k
Corrections/Comments/Instructions: �\��^��--
. ,------- 4 00 1......._ .
Ilk ' .� �� �N�--'- - '
� ' ^ _�~~ �=� _ � ''
q� "�p�
_
I - - RARTIALAPPRCyVAL CANCEL NC)ACCESS
--
FAIL 1111 CALL Fe R INSPECTION ADDITI NA FEES ASSESSED
deo .
( 2{ ( Inspector: Omta: / �~^�~ Phone #: (503) 718-
MIIII.