Permit , a CITY OF T I D MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00567
Tt9.AJ.,P,' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/18/2008
PARCEL: 1 S135DA -03500
SITE ADDRESS: 11481 SW HALL BLVD 101 ZONING: C - P
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: HEALTH TOUCH
Project Description: Relocate registers for TI. Project Value: $2,000
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
L N PROPERTIES, LLC Description Date Amount
12725 SW 66TH AVE
PORTLAND, OR 97223 [MECH] Permit Fee 11/18/20C $72.50
[TAX] 12% State Surch 11/18/200 $8.70
Phone:
Total $81.20
Contractor:
WILLAMETTE HVAC SERVICE
3075 SW 234TH AVE. #206
HILLSBORO, OR 97123 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.
yvic<<-41) ---
(A/Y/-16w?)
Issued B j�: I /�I J Permittee Signature:
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.
TT j" °'F
Application t i "pia
Mechanical Permit A lii '� `
, 0.,:.-- ,, ,, , � .,,� t FOR OCUSENL1 !r ! n
,
�.,. «....FFI E tw ,O,.,.... rR > �. ��
:'e"'Mt rFM1 am 1C Received
a q City of Tigard RE CEIVED VE� Date /By: # 1 g Og Pennit No.: W���i� �jyi d 7
4
13125 S W Hall B Tigard, OR 97223 Y �/ µ'V
Plan Review
; ' ; Phone: 503.639.4171 Fax: 503.598,196 i Q Date /By: Other Permit:
TIGA D' Inspection Line: 503.639.4175 1 2008 Rea .192 ®
GAR� ���.���I / /// ``
Date dy /By: r See Page 2 for
�s6�* Internet: tvww.tigard or.gov CI Notified/Method: /I Supplemental Information
R� 1 � , TYOFTItl
TYE' HoI`/ISION 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: $ $2,000.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION bleating /cooling
Air conditioning or heat pump
Job site address: 11481 SW Hall Blvd
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: 101 Project name: Health Touch Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
•
DESCRIPTION. OF WORK Water heater 10.00
Gas fireplace 10.00
Relocate registers to accommodate new office layout. 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
Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER ❑ TENANT
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
Attic /crawls ace fans 10.00
❑ APPLICANT . 0 CONTACT PERSON p
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
•
Gas heat pump
City/State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR • Barbecue
Business name: Willamette IIVAC Clothes dryer (gas)
Other:
Address: 3075 SW 234'' Avc Ste 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro, OR 97123 Subtotal
Minimum permit fee ($72.50) .. /7,5 - (:)
Phone: (503) 628.6841 Fax: (503) 848.2597
Plan review (25% of permit fee) --0—
CCB lic.: 56951 } State surcharge (12% of permit fee) g. 70
/ TOTAL PERMIT FEE g . A
\
This permit application expires if a permit is not obtained within 180
Authorized signature: / n days after it has been accepted as complete.
Print name: Michael Malstrom Date: 11/14/08 • Fee methodology set by Tri.County Building Industry Service Board
1: \ Buildingcrmitss \MEC- PermitApp.doc 01/19/07 440 -4617T (1 I/02/CO,`.1AVEB)
•
tIIIIIIIIIIIHIIIII _ r1 `` .._.
{ Imo 1111
M
III 1111 MIN 1 ii, ar /i 1�_ Milli ,` +� 1 " 1, ' ail
i r -::a �111t.: I •llf :1a"i. �.�.� ' 1 �,I 1011
. � :�`j1j
181 + 101.12 101 11.10 101.09 _ + 101.01 1
IIM �� ) I €
6 , _, ....,... I � , , :; .■ - g Provi.e J box above
.. 1 - _
.. �o ��r .�1���:;r', �� F , i•7r� isir! t:gititi• •t't5 •fut "ite
� i1� `11 a . c.
�� . Closet ® ■� O + p + �. 1 ® 1 11.05 "..... + p 1
e �� . I
■ • lii
,,
0 ,
.li + �1. y r RI it 111111 INN , MIS
� WY: Sri(' ir1 l mininiirm
1 +i + [� 101.02
"t W......_ . rrr..l iL rr.Y.:
.g '' .. "* ai mm s rte! _.....y.wrr.r.m.rrrrrr. ... ..._..... .._..._.. �. i . t.
Yr,,,,, ,r.,rnrr,,,rr. nn W
1
1
0 4 0
CITY OF TIGARD
��o m m m�`u u n����nn��
BUILDING DIVISION PERMIT #: ME02008-0%67
| 13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 1j/18/2008
Phone: (503) 639-4171 Awigint
Inspection Requests (24 Hrs.): (503) 639-4175 AA 'la:.
INSPECTION WORKSHEET FOR DATE: j/5/20/- TIME: 7 PAGE: 22
SITE ADDRESS: 11481 SW HALL BLVD 101 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HENTHTUUCH
DESCRIPTION: Relocate 'wt*nohxlD. Project Value: $2,000
OWNER: L N PROPERTIES, LLC, PHONE #:
CONTRACTOR: HVAC SERVICE PHONE #: 683-02a-0011
Inspection Request Scheduled For: Date: 1/5/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 079354-02 371-998 W
Corrections/Comments/Instructions:
K IITA S PARTIAL APPROVAL CANCEL fl NO ACCESS
IL '111 CALL FOR INSPECTION r AOD|T|ONALFEESASSE8SEO
/
|Inspector: } / Date: ) ' .z g y Phone #: 8503\ 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200I ..00€67
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ii/ 113/20013
Phone: (503) 639- 4171 "rNP�VI
Inspection Requests (24 Hrs.): (503) 639 -4175 1.L.
INSPECTION WORKSHEET FOR DATE: 11/201/2008 TIME: 7 :00AM PAGE: 10.E
SITE ADDRESS: 11481 SW HALL BLVD 101 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HEALTH TOUCH
DESCRIPTION: Relocate registers for TI. Project Value: $2,000
OWNER: L. N PROPERTIES, LLC, PHONE #:
CONTRACTOR: VA LAMI•.: FTE HVAC SERVICE PHONE #: 503 - 62B - 6841
Inspection Request Scheduled For: Date: 11/20/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mechanical rough -in 078313 -01 971 -998 -2908 N
Corrections /Comments /Instructions:
j`ASS PARTIAL APPROVAL I CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 7O5 Date: 4Zo/ti; Phone #: (503) 718- 2 / 3