Permit CITY T GA D MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00048
DATE ISSUED: 2/14/2007
f 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 113 B 0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG
PROJECT: CLEAN WATER SERVICES
Project Description: HVAC Value: $60,000.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: F2 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: N 30 - 50 HP: 1 REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: U 50 + HP: 0
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS: 1
> 10000 cfm: 1
Owner: FEES
CLEAN WATER SERVICES Description Date Amount
2550 SW HILLSBORO HWY
HILLSBORO, OR 97123 -9379 [MECH] Permit Fee 2/14/2007 $525.50
[TAX] 8% State Surcha 2/14/2007 $42.04
[MECPLN] Plan Rev 2/14/2007 $341.58
Phone: 503 -681 -3600 Total $909.12
Contractor:
HYDRO TEMP MECHANICAL INC
28465 SW BOBERG RD
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 230 -9359
Reg #: LIC 63907
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: ( - l
Call 503.639.4175 by 7:00 a.m. for inspections that businesg <y.
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 A t � �a� t w ) Received „. ,, . L,htt) lcl t9ti ON ): t r, . '� -.
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M
r City of Tigard - / / _ , a7 Permit No.:�7 -00*
• i% '' M1 ° 13125 SW Hall Blvd., Tigard, OR 94 i Plan Re •• -H , j 4 Phone: 503.639.4171 Fax: 503.": 1 j 2001 Date/By. 1 Ir ?O? Other Permit:
..4. Inspection Line: 503.639.4175 Date Ready : tugs El See Page 2 for
TiG'nIL�O1 ��
iadv I Internet: www.tigard or.gc i )' t T I ,�, p , Notified/Method 1 ", Z '�/ 7 ./ 1 7/� Supplemental Information
1t Ul 11 U -t ad (/1
TY WORK' '. �1 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST , 4
❑ 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: $ 4t/ " S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES* `�
❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building .. '
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total r
. JOB SITE INFORMATION .AND LOCATION Heating/cooling
Job site address: (v Sd t:u - qa S 7j�
Air g conditioning ho heat pump
S. /� 1� (requires site plan showing placement) 14.00
City /State /ZIP: 7 1 c i Q12, ( c '7 2_24- Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: y{ 43 &Z_ R� . Soic Coati HKr Gas heat pump 14.00
Cross street /directions to job site: Duct work 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.: 6 t0
Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: 25 (t '3 8 pout p Other fuel appliances
DESCRIPTION.OF WORK Water heater 10.00
Gas fireplace 10.00
New/4114G. vN ,r- on 01.-r1)& 6c1T5r L)c'c R viLOl a 4 - 55oG•r.4fEo Flue vent for water heater or gas
fireplace 10.00
Duc-it -- txtrir E But b INC-- Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
1°1 PROPERTY OWNER I ❑ ,TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: c .e. -N / /�7 t 1L S Vi c FS Environmental exhaust and ventilation
V � Range hood/other kitchen
Address: (( S'w BS re tAvc-- equipment 10.00
City /State /ZIP: 7l b ` oa Cr 1 2 24_4- Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( b3) S$j_ $ f 6 Fax: (o)) 7 .- g 1 to toilet compartments, utility rooms) 6.80
APPLICANT . ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: _ ,_E f w, yu St jt c 5 Fuel piping
Contact name: • it ,t Roo,/ e-ds,-,_J 55.40 for first four; $1.00 for each additional
Address: o �D S a ---7) Furnace, etc.
I f p Gas heat pump
City /State /ZIP: (7, ,e,.,2--. 9'7 7.--7 9- Wall /suspended/unit heater
Phone: ( ) g t $ ( Fax: : ( ) S47 _ g ( Gl (o Water heater
Fireplace
E -mail: r0 r.ci Caw ± @ G(P�iINJAN erseyv(Cec . a rj Range
. CONTRACTOR • Barbecue
� n n ,� _ c
Clothes dryer (gas)
Business name: I
j "v GH it,,4 t G/tit.
Address: 2 $ S S• w ar MECHANICAL PERMIT FEES*
City /State /ZIP: W ((SoKilt ((c- OP- 7 .0 O Subtotal
l Minimum permit fee ($72.50)
Phone: (5b3) s-$ 2 - 8 5-2 S Fax: (9:3) ss2. - (q 1 q- Plan review (25% of permit fee)
CCB lic.: 4.39 p 7 State surcharge (8% of permit fee)
TOTAL PERMIT FEE -r" -
• signature: This permit application expires if a permit is not obtained within 180
Authorized si
/ '�-� days after it has been accepted as complete.
Print name: Ti M Rcpt./6 Date: t - - QI' 6 � • Fee methodology set by TO- County Building Industry Service Board
\ B
I:uilding \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
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00048
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 21'14/2007
Phone: (503) 639 -4171 �� , ��i
Inspection Requests (24 Hrs.): (503) 639 -4175 �- F'I
INSPECTION WORKSHEET FOR DATE: 9/24/2007 TIME: 7: 00AM PAGE: 50
SITE ADDRESS: 16580 SW 85TH AVE : CLASS OF WORK:
SUBDIVISION: SLR TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WATER SERVICES
DESCRIPTION: #6312 - Room 5020, cooling unit. HVAC Value: $60,000.00
OWNER: CLEAN WATER SERVICES, PHONE #: 503 -681 -3600
CONTRACTOR: HYDRO TEMP MECHANICAL INC PHONE #: 503 - 230.9359
Inspection Request Scheduled For: Date: 9/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 056151 -01 503 -519 -1903 N
Corrections /Comments/ Instructions:
/
V CANCEL NO ACCESS
Ii6 PASS /PARTIAL APPRO A — n
n FAIL %' ALL FOR INSPECTION ( ] ADDITIONAL FEES ASSESSED
Inspector: Date: Z 0 Phone #: (503) 718-
ill■ 7—___6*