Permit i
CITY TIGARD MECHANICAL PERMIT
010 DEVELOPMENT SERVICES PERMIT #: MEC2006 -00191
i I DATE ISSUED: 5/9/2006
`e 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 112 D C -00701
SITE ADDRESS: 15989 SW 72ND AVE BLDG -A ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK III LOT: 038 JURISDICTION: TIG
Project Description: Move type II hood, gas line and SA (2).
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [TAX] 8% State Surcha 5/9/2006 $7.27
[MECH] Permit Fee 5/9/2006 $90.90
Total $98.17
Phone:
Contractor:
OREGON HEATING + NC INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 125815
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:
‘c Permittee Signature✓' e 4
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.
Me han.tal Permit A:Dplicat F C { ii %/ i f F( ( use O,6/i.,,
City of Tigard Received a o
5 / 9 J �
0k G ( Permit No 4 t 4 Do 9 /
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
C ' Phone: 503.639.4171 Fax: 503.598.1960 MAY ( v 2006 Date/By.
her Permit:
T 1 G A It 1) Inspection Line: 503.639 Date Ready/By: i Page
d ov Supplemental Se e P t l for
Internet: www.ti
� 8 ���'� � ( - 1 1 y J ��.�� No tified/Method: 7-/ � Supplemental Information
e�A��j flP - .r.z Ty� '
TYPE O F WOR COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ 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: $ 7
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 0 f 7 56() 7? 11/e Air conditioning or heat pump
< T! / (requires site plan showing placement) 14.00
City/State/ZIP: / ri ,Ajittte) Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg./apt. no.: ! Project name: , Furnace 100,000+ BTU (ducts/vents) 17.90
S 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 WO K Water heater 10.00
�sr, ,
g-( // �%a�/" / Gas fireplace 10.00
� Flue vent for water heater or gas
fireplace 10.00
///e(-), g 5 A `/ Log lighter (gas) 10.00
_/11/4'.,2 Wood/pellet stove stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 10.00
_
Other: 10.00
(/, � Environmental exhaust and ventilation
Name: a) ,,, / ,
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 Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: Gas heat pump
City /State/ZIP: WalUsuspended/unit heater
Phone: ( )
Fax: : ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
On,(4,,,).—, Clo thes dryer (gas)
Business name: v /rl iG ���.
f Other: I
.
Address: / MECHANICAL PERMIT FEES*
City /State /ZIP: ����`` /l ' � e C- � � '9 7/0} Subtotal
/ Minimum permit fee ($72.50)
Phone :f 2 1 S30 Z '3 l Fax: ) ,3 - 37 ?(7Z Plan review (25 %of permit fee)
CCB lic.: /zc j State surcharge (8% of permit fee)
TOTAL PERMIT FEE CO / 1
Authorized si ature: C This permit application expires if a permit is not obtained within 180 /
days after it has been accepted as complete.
Print name: L 7 Z Date: ,�5 / COMMEB) b • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building\Permits \ C PPennitApp.doc 04/06/06 440.461
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\NEC- PermitApp.doc 12/30/05 2
CITY.O.RTIGARD
BUILDING DIVISION PERMIT #: MEC2006.00191
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2006
Phone: (503) 639 -4171 ropoi
Inspection Requests (24 Hrs.): (503) 639 -4175 AL
INSPECTION WORKSHEET FOR DATE: 6/7/2006 TIME: 7:06AM PAGE: 106
SITE ADDRESS: 15989 SW 72ND AVE BLDG -A CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 038 TYPE OF USE:
PROJECT NAME: DOMINOS PIZZA
DESCRIPTION: Move type II hood, gas line and SA (2).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503 - 538'2953
Inspection Request Scheduled For: Date: 617/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 031207 -02 503649 -8162 Y
Corrections /Comments /Instructions: CLI /0T
AM
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL II CALL FOR INSPECTION ❑ ADDITIO L F ES ASSESSED
► 4 7
Inspector: ���f Date: ` 0 Phone #: (503) 718- 7423
CITY. OF. -TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00191
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2006
Phone: (503) 639 -4171 Ate
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/7/2006 TIME: 7:06AM PAGE: 107
SITE ADDRESS: 15989 SW 72ND AVE BLDG -A CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 038 TYPE OF USE:
PROJECT NAME: DOMINO'S PIZZA
DESCRIPTION: Moe type II hood, gas line and SA (2).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503-538.2953
Inspection Request Scheduled For: Date: 6/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 031207 -01 503 - 849 -8162 Y
Corrections /Comments /Instructions:
f
O V C y i p
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •
Inspector: AmIlWAvi. Date: 7 Phone #: (503) 718-
CITY. F- TlGARD
BUILDING DIVISION PERMIT #: MEC2006 -00191
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/912006
Phone: (503) 639 -4171
'to
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/8/2006 TIME: 7 :03AM PAGE: 102
SITE ADDRESS: 15989 SW 72ND AVE BLDG -A CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 038 TYPE OF USE:
PROJECT NAME: DOMINOS PIZZA
DESCRIPTION: Move type II hood, gas line and SA (2).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: -
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503-538 -2953
Inspection Request Scheduled For: Date: 6/812006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 031313 - 01 503 - 849.8162 Y
Corrections /Comments /Instructions: 3%' T
j 7 iron is ry :INV/
IW?_ (5
lA1)
W° _ � ue
❑ 7 .9 -
PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDIT ONAL FEES ASSESSED
Inspector:
WV,/ C J vc3 Phone #: (503) 718 -011