Permit r .
171 ` CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00546
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/28/2007
PARCEL: 2S 112AC - 02800
SITE ADDRESS: 14865 SW 74TH AVE 170 ZONING: I -P
SUBDIVISION: METRO PART /MLP2002 - 00007 LOT: 001 JURISDICTION: TIG
PROJECT: A & A DISTRIBUTION
Project Description: Walk - in freezer and equipment. Value: $25000.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: 1
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 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
ACTION FUND RAISING Description Date Amount
14865 SW 74TH AVE. #170
TIGARD, OR 97224 [MECPLN] Plan Rev 9/17/2007 $108.50
[MECH] Permit Fee 9/28/2007 $434.00
[TAX] 8% State Surcha 9/28/2007 $34.72
Phone: 503- 684 -9899 Total $577.22
Contractor:
SHEPLER REFRIGERATION
3961 N WILLIAMS AVE
PORTLAND, OR 97227 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 282 -7255
FAX 503- 282 -7567
Reg #: LIC 92342
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.
111111 / /
Iss ed By: ' �� // /�..f.I Permittee Signature: A I Ai `( 1`...l_ Ili
Call 503.639.4175 by 7:00 a.m. for inspections that b -iness'ay.
This permit card shall be kept in a conspicuous place on the job site til completion of the project.
Approved plans are required on the job site at the time f each inspection.
�� . 1A 8 &)5 7A- AN
Mechanical Per pi e ' li ‘ .. a ,, . ., .: FOR.OFFICE USE ONLY
r :i.,. z„ . Received p
w « Date By: (
City Of Tigard ' ��, PermitNo.M 00 9' ex , SVb
13125 SW Hall Blvd., Tigard, OR 9722 Plan Revie /
Phone: 503.639.4171 Fax: 503.598.1 P 17 2007 Ga/ t� " t Plan R 1 Other Permit:
�i ! j 1l' I: rai
Inspection Line: 503.639.4175 -
r l iCi '�; c nJ�. •
Date Rem Juris: y :y: H See Pa ge 2 for
1
Internet: www.ci:tigard.or.us r` U i ' _ r _ �W Notified/Method: Supplemental Information
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e tw y 4 s f ' `i-z, - max a ' , Awm qua a
Vaat - -:ZIAd - �'.. ._ . 1 �� -��.,. > ,� . max . A _ t�, �„ i OMIVIERCIAIr. F -, • • E� � - -• C :# � CIQ T S T '
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❑ 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.
v ?A ° " r ' i ll CATEGORY OF CONSTRi1CTIOrt� Value $ o 2SOOO
m� e -,- wt ,,. � . .w � . „An,,e.:,:....*s <� ,,, .,..s: � . ” ». s .a. ' k. _ :C,A:^+ ' x ... .0 ,, -
RESIDENTIAL EQUIPMENT SYSTEMS FEES
❑ 1- and 2- family dwelling r] Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
� ` , a- v. cog JOBr°SITE fti6iATION��,:NATLtOC TTON r "
'VIAut ,- �r � _,, _. .,. , .. .,, .,,,, ,...t . ,.4 ... Heating cooling
Job site address: 14 8 6 S 8 U3 74141 AVE Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: " t i c P OK cl 7 224 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Su i4{„. A70 Project name: A e V A M D N » Gas heat pump 14.00
Cross street/directions to job site:. 2yo /V t ez 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
"l ^= �,;: .., Vii? , ' . D $ #GRIP IOAt O WORK it, ._;' . * I,, � -.in Water heater 10.00
Gas fireplace 10.00
&V p Li . 11 S T OY I,,1_ efr t6 X 24 x c' . . Flue vent for water heater or gas
c 2 E c IAA I cU I `k _S-OCA PIT - Log l igh ter (gas) 10.00
' 10.00
\C._v Log lighter r G-EMT I 0 /J • E& v k ? �(CNT . Wood /pellet stove 10.00
Wood fireplace /insert 10.00
g ., ry r Chimney /liner /flue /vent 10.00
' ROPERTY ;OWNER�� ` , . v '' j ,TEI AN t l Other: 10.00
�.w „ .e _, � __,a_a..�u.� �, ..«m ,.v 3s, s':..�.A'da, ��'. N °,. ,�.n �'fs,a, _..� ..
Name: A q - d N.1 1 \\.`S \ & Environmental exhaust and ventilation
Address: \ ` - k 1 7V4\ g �J. ` V-70 Range hood /other kitchen
( C��+ll I equipment 10.00
City/State /ZIP: TGpt�n r 0 V-- C17`2'"ZCT Clothes dryer exhaust 10.00
( O ) 6 t3 r7 ,q s c 3 (g d) 6 S " � t' , T (7
Single-duct t exhaust (bathrooms,
Phone: S ' Fax: r ' toilet corn comp artments, utility rooms) 6.80
`;: r� d` �, APP ...
`F ,,.: r ^ CbNTA a PERSON 'S K ,.a i Attic /crawlspace fans 10.00
..,. .�.v_ .,.�,,.i',�� ..��x r aW. ..r, �:��. .�- vat :... ,a . . z �.a�»5 ,.. -. . > SY
_ �/� \ Other: 10.00
Business name:
is I epfL �4�R 1�Ioi C..._
Fuel piping
Contact name: J 0 �p4 MA 2A.& $5.40 for first four; $1.00 for each additional
Address: 3 q 6% K t k 1-1.-, P‘M) sV e--- Gas h
, ea p
Gas heat pump
City/State /ZIP: Poi'- -"I't , t 0 ci 1 22-1 Wall/suspended /unit heater -
Phone: (SCA) 282.12..��a Fax: : (5'�) 2$1,-2_,.-7,--6.--/ Water heater
I � W1'Q 4 S Range
E -mail "• '" � l � lY� [, C'C� � Rne
a - s § u z y 4, a, . n rya ^ ' ,
' lxi 1- CONTR C ,OILi ,1t� t Barbecue
Business name: Clothes dryer (gas)
� /� Other
Address: A" �� i 4I FEES* t
City/State /ZIP: Subtotal 43 y.
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) -- ---- Plan review (25% of permit fee) f . 50
CCB lic.: 9 .A30 1 ( / 77 State surcharge (8% of permit fee)
/ TOTAL PERMIT FEE 5577. 22--
Authorized signature: A.......- - This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: v , o.F . i . n 1...A10r4c-424S Date: q 11 7 t 1 * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits\MEC- PermitApp.doc 12/03 440 -4617T (1 I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard • f'' '
Page 2 - Supplemental Information
Commercial Fee Schedule:
total 'Valgat><o>�.....
$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
BUILDING DIVISION .. PERMIT #: MEC2007-00E46
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9128/2007
Phone: (503) 639-4171 ANA1Pttitti I l'i
Inspection Requests (24 Hrs.): (503) 639-4175 ,-.411 li. /ICC t.2..r) 0 7- 0
INSPECTION WORKSHEET FOR DATE: 10116/2007 TIME: 7:01AM PAGE: 62
SITE ADDRESS: 1406f; SW 74TH AVE 170 CLASS OF WORK:
SUBDIVISION: IviETRO PART1MLP2002 LOT #: 00.1 TYPE OF USE:
PROJECT NAME:
A & A DISTRIBUTION
DESCRIPTION: Walk-in freezer and equipment. Value: $25000.00
OWNER: ACTION FUND RAISING, PHONE #: 503-684-9899
CONTRACTOR: SIEMER REFRIGERATION PHONE #: 50'3-282-7265
Inspection Request Scheduled For: Date: 10/1612007 Pour Time:
Code # Inspection Description Confirm # Contact # Mess- .-
699 Mechanical final 057638-01 .503-282-7255 ;AL iii
Vt-1,
Corrections/Comments/Instructions:
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I I PASS I I PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
O CTPD , 11% CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: ..... Date: /( / h ,? Phone #: (503) 718-
___ _—
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00546
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ! 1;10/7007
Phone: (503) 639 -4171 4 '>rlu�yq 1
Inspection Requests (24 Hrs.): (503) 639 -4175 r • . Ee• aoe 7- 005 V G
INSPECTION WORKSHEET FOR DATE: 1010/2007 TIME: 7:00AM PAGE: e54
SITE ADDRESS: 14865 SW 74TH AVE 170 CLASS OF WORK:
SUBDIVISION: METRO PART /MLP2002•-00007 LOT #: 001 TYPE OF USE:
PROJECT NAME: A & A DISTRIBUTION
DESCRIPTION: Walk-in freezer and equipment. Value: $25000.00
OWNER: ACTION FUND RAISING, PHONE #: 603 -G84 -9899
CONTRACTOR: SHEPLER REFRIGERATION PHONE #: 50.x- 782 -770;5
Inspection Request Scheduled For: Date: 10/9f2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
695 Misc. inspection 057182 -01 503-282 -7256
IP A
Corrections /Comments /Instructions:
C=sS im -- 77S) *4— 1O'30
•
",!4 P " 11 PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL / ALL FOR INSPECTION ❑ ADDITI NA FEES ASSESSED
Inspector: ■ Date: Phone #: (503) 718- --
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