Permit a :4
A A IT TI MECHANICAL PERMIT
1 I �: DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00029
� ' � I ' ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/18/2006
PARCEL: 2S 113AD - 01700
SITE ADDRESS: 16920 SW 72ND AVE ZONING: C -
SUBDIVISION: ROSEWOOD ACRE TRACTS LOT: 030 JURISDICTION: TIG
Project Description: TI, Install (1) new rooftop unit, gas line conversion, adding (1) new gas line w /meter set. Duct work
modification on (1) gas pack. Project Value: $20,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: 360,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: 2 <= 10000 cfm: 1 GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
BRIDGEPORT LAND LLC Description Date Amount
3939 NW ST HELENS RD [MECH] Permit Fee 1/18/200E $367.85
PORTLAND, OR 97210 [TAX] 8% State Surcharf 1/18/200E $29.43
[MECPLN] Plan Rev 1/18/200E $91.96
Phone: 503 224 - 2676 Total $489.24
Contractor:
HUNTER DAVISSON INC
1800 SW PERSHING REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Contact #: PRI 503 234 - 0477
Reg #: LIC 01612
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- . --
Issue• By: „ l � , �1, , � PermitteeSignature:X �,2, .//
Call 503 - 6394175 by 7:00 a.m. for inspections tha ness ay.
This permit card shall be kept in a conspicuous place on the job site until completion of he project.
Approved plans are required on the job site at the time of each inspection.
Merckaffical Permit Application FOR OFFICE USE ONLY
,
City of Tigard
OR 9 93 C . D Received
Date/BY: 1 / fs' 4 Big Permit No.: a / C0 /
, 6 op , •
13125 SW Hall Blvd., Tigard, 2 /0 ' , Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 i I / 41. Vi. • ..,t,. I A A\ Date/By: Other Permit:
Inspection Line: 503.639.4175 3AN ),/t 2006 ._.4 I( Date Ready/By: pral la See Page 2 for
Internet: www.ci.tigard.or.us CiNY OF TIGARD Notified/Method: i f , Supplemental Information
' ',. ni.lr'; ".::--.. t 'f ''.: .,•: :,::„:.'.:,:, ,cOM.MERCIAL FEE*.SCREDULE • USE CHECKLIST
Mechanical permit fees* are based on the value of the work
0 New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
q K :;:::; '- ::: .7 '' ' Value: $ 2 0 060
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
0 1- and 2-family dwelling XCommercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. Ea. I Total
.f0*'4*'::_10),5Wkori . Heating/cooling
Air conditioning or heat pump
Job site address: le q2 C g 64 , 72 fr a 4 ii-c-- (requires site plan showing placement) 14.00
City/State/ZIP: ,-77,91zici to 12 q7 22-9 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: 8/4 , e_ Project name: 'PG i SA oe f --7-_-
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
Flue/vent for any of above 10.00
Subdivision: Lot no.: ,
Other: 10.00
Tax map/parcel no.: Other fuel appliances
,::,■ l 'i:' .;1;'-'; Water heater 10.00
;:,-. ; ' ,....:: ..,._ ..,.. e..':':. -‘,.',.: :-.-.-- `
Gas fireplace 10.00
4 ddd_ °At_ / /.4- Pat k 14/ ( i.'nk_ Flue vent for water heater or gas
i i fireplace 10.00
C i +lc/ FA I l'Ak_ tliocti Denin 9ti-c-÷ Log lighter (gas) 10.00
i
4// 0 ,i) V2/& Ploc 1 4, 6 I 411/te--1 0 A- Wood/pellet stove 10.00
Wood fireplace/insert 10.00
., . .. Chimney/liner/flue/vent 10.00
• ! :,;' : , .", , ,,.;,,:',' : , "10 . *Op* ji !:.9'' w , 1■1]' - '''''''tiZr ., :::0,:‘":; , .. , : ': 7.1E: NAN , t.'/, , , ": , :: .,•. . -,
Other: _ 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
0 ,.. ." .- • : Attic/crawlspace fans 10.00
Other: I 0.00
Business name: H 4 ii,A - p iir
Fuel piping
&
Contact name: /4 4/ . 2Ajtj i $5.40 for first four; $1.00 for each additional
// Furnace, etc.
Address: /rev cE' Pe .1 Gas heat pump
City/State/ZIP: Toidano, ae qV02.- • Wall/suspended/unit heater
Phone: (c,66,3 ) 6 2 - 7e 2.? Fax: : ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR . ;,... .% •.:' I Barbecue
Clothes dryer (gas)
Business name: ..g 4
Other:
Address: : MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Minimum permit fee ($72.50)
:6
Phone: ( ) Fax: ( ) ,
Plan review (25% of perrnit fee) 1 4 q4
CCB lic.: i /f .
a_ e. State surcharge (8% of permit fee) , s4g
\ Authorized signature: L '
\ A r if e j pi r ^ g-eg
i \ Building \Permits \ MIC.PermitApp doc 12/03 ke'IV(/
Date: / 440-4617T (1 I /02/COM/WEB) TOTAL PERMIT FEE qqq, pi.
This permit application expires if a permit is not obtained wffh in 180
Print name:
days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry Service Board
Mechanical Permit Application 7 City of Tigard 4 -
Pagel 'Stippleniental Information . •
CommercialFee Schedule:
iitiFeb
Farearillittar
$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.
• ,
•
i:\Building\Permits\MEC-PermitApp.doc 12/03 .2 Al
CITY1F TIGARD
BUILDING DIVISION PERMIT #: Ml=c;1008-00029
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/10/2.006
Phone: (503) 639 -4171`
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2121/2006 TIME: 7 :02AM PAGE: t31
SITE ADDRESS: •i692fi SW 72ND AVE CLASS OF WORK:
SUBDIVISION: RC)C;E.WO )I ACRI TRACTS LOT #: 0 • TYPE OF USE:
PROJECT NAME: i_ )SW SHOES
DESCRIPTION: TI, Irr;t4.II (1) new rooftop Unit, gay: line conversion, adding (1) new gas ling: w /meter Duct woir
• Modification on (1) gar: pack. Project Valise: $2.0,000
OWNER: BRIDGEPORT LAND LLC, PHONE #: x 22 - 2676
CONTRACTOR: I DAVISSC>N INC PHONE #: 503.234..04.77
Inspection Request Scheduled For: Date: 2/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Gib Mechanical rough -in 027206 -01 971 - 219 -EA:36 Y
Corrections /Comments /Instructions:
Clio rr •
•
�7 :S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL • ❑ CALL FOR INSPECTION ❑ ADDITI"NA FEES ASSESSED
i,
Inspector: • , ► Date: ZA 4P. Phone #: (503) 718 -
CITY OF ■ IHARD
BUILDING DIVISION PERMIT #:
Kit f t2006 C ;f0 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111a /2ref;;;
. Phone: (503) 639- 4171p0
Inspection Requests (24 Hrs.): (503) 639 -4175 , '111.
INSPECTION WORKSHEET FOR DATE: 1/31/2006 TIME: 7 :0 PAGE:
SITE ADDRESS: 16920 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: rosFwooD ACRE TRACTS LOT #: 030 TYPE OF USE:
PROJECT NAME: DSO - SHOES
. DESCRIPTION: TI, Ins tall (1) new rooftop unit., gas line conversion, adding (1) new gas line wfrneter et. Duc:t work
modification on (1) gas pack. Project Value: $20,000
OWNER: BRIDGEPORT LAND i_LC, PHONE #: E.;03-224-2676
CONTRACTOR: HUNTER DAVISSON INC PHONE #: ,(13.•234 -0477
•
Inspection Request Scheduled For: Date: 1/31/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
610 Gas line 026016-01 60'3 - 969.4153 N
Corrections /Comments / Instructions:
'I • IU ((
•
•
•
❑PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION • ❑ ADDITIO AL FE S ASSESSED
Inspector: Date: #: (503) 7186Y-1
1\