Permit CITY TI GARD MECHANICAL PERMIT
4 '40 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00411
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/28/2004
PARCEL: 1 S136CD -00600
SITE ADDRESS: 08060 SW PFAFFLE ST 100
SUBDIVISION: SPRINT PCS WIRELESS MONOPOLE ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
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:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: New duct, diffusers and balance.
Owner: FEES
CAMERON, KIRK (EEI SOLUTIONS) Description Date Amount
5665 SW MEADOWS RD. [MECH] Permit Fee 6/28/200 $164.50
STE. 300 [TAX] 8% State Surcharl 6/28/2002 $13.16
LAKE OSWEGO, OR 97035
Phone: 503- 221 -1121 Total $177.66
Contractor:
REQUIRED INSPECTIONS
Phone: Mechanical Insp
Final Inspection
Reg #:
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.
Issued By: Permittee Signature: • ; tit._ 411
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Applica#on / FOR OFFICE USE ONLY
City O lgarfl 1 ���J y Dat , B y : (4 a 8 Permit No ° i —_/•/ • -- 00 ,��li
DateB
13125 SW Hall Blvd., Tigard, OR -97223 PlanRevie
Phone: 503.639.4171 Fax: 503.598.1960. , ain,,dioY I \ Date/By:
Other Permit:
Inspection Line: 503.639.4175` r � _ I _ � I Date Ready/By: kris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
L.
- _ " TYPE OF WORK " " ;COMMERCIAL,_FEE *. SCHEDULE USE CHECKLIST
❑ New construction El teiatio 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: $ .3,200 VC>
t, ' RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1 - and 2 - family dwelling mmercial dustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. Total
• JOB SITE INFORMATION AND LOCATION - . Heating/cooling •
•
Job site address: ay° 0 5� r '�^ Air conditioning or heat pump
, (requires site plan showing placement) 14.00
City/ State/ZIP: 0./.1, j q 7 22-3 Furnace 100,000 BTU ( ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: J Project name c T r 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.: 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
Gas fireplace 10.00
Net L) Lk CIA 'C' /ge�y/ S Q 10 cL1.0,/W o__- Flue vent for water heater or gas
/ l fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER - ❑ 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 ' • 0 CONTACT PERSON Attic /crawlspace fans 10.00
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: A. T,„ e Clothes dryer (gas)
Other:
Address: ZW: SE ( � (t • . MECHANIC PERMIT FEES* -
City/ State/ZIP: Ilk l a j t ittcc c� J f 9 7.a a- Subtotal
Minimum permit fee ($72.50)
Phone: 603) (/6,Z —Z/ k � L " Fax: ( -50-3 ) 2 62 - Goss 5 Plan review (25% of permit fee)
CCB lic.: 50S - 7 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
�1
This permit application expires if a permit is not obtained within 180
Authorized Signatur , l� -R./ � � (, ' days after It has been accepted as complete.
Print name: S ke/y (te-- r- P..06 s611 Date: Co 1.aj31 o ./ * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 - 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.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION QAPTS1ON Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7—Ls" AM f/ PM BUP
Locat : a • r I / . _ t r' ' 1 Suite r 49 MEC d 00 4 1 (
Contact Person Ph ( )
Contractor Ph ( ) SWR
BUILDING Tenant/Owner '" ' ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall r
Fire Sprinkler
Fire Alarm A� - — I 1 r
Susp'd Ceiling 1
Roof
Other: l '
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service _A
Sanitary Sewer ' .4 -
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Gas Line
ampers
A go
PART FAIL
RICAL
Service
Rough -In i1 �rJk
lt
Low Voltage IIVANIINOMM:1
Fire Alarm ME
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL