Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 -00368
�•�� DATE ISSUED: 6/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112DC -01400
SITE ADDRESS: 15865 SW 74TH AVE 105 ZONING: I -P
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK LOT: 004 JURISDICTION: TIG
Project Description: New ductwork. No separation walls. Value: $9000.
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: 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:
Owner: FEES
PACIFIC AMERICAN PROPERTY EXCHAN Description Date Amount
PACIFIC SANTA FE CORP [MECH] Permit Fee 6/21/200E $72.50
17700 SW UPPER BOONES FERRY RD [TAX] 8% State Surchar€ 6/21/200E $5.80
PORTLAND, OR 97224
Phone: Total $78.30
Contractor:
WILLAMETTE HVAC SERVICE
PO BOX 23334 REQUIRED ITEMS AND REPORTS
TIGARD, OR. 97281
Phone: 628 - 6841
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.
Issued By: i, � 9 r . „ � , 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.
: IV's'
ilanical Per = �- f -A n , a
p' licatitm ,t . , R.,,FOR ONtx. ` A k ,.�, i,? +
/ Permit No:
L of Tigard � Received .
12 Hall Blvd., Tigard, OR 2005 Date/By: .V._ / �d �� ? S
Phone: 503.639.4171 Fax: 503.598.1960 you/ Plan Review
DateBy:
["` Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD �� S1/ � 1 cm I : Date Ready/By:
Internet: www.ci.tigard.or.us �.r Notified/ Method: fiedJMe thod: S See Page 2 for
BUILDING DIVISION Supplemental Information
'`"'' '^ Y �t , H s � -, zra;� e %N t g w .. a ,a ,; rM � :i r'�' b '�23,°.,s+t:'t:, -
� e T E OF O t � , CO MMERCIAL .FFE* S CR E DULE = rt1JSE CFTE
� E
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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, an
- add rofit.
at;'' ,L p�r'+ rs^ -r.a. s a .=te i ' .hz, a.t 4� Value $ [ C/`�i
F °., 14 - oreo.: R OF CONS TRIIC' o t, 3 .. ' ., . . ,.. i z r . w � , s „ - c: t r a
t s
liI2ESiDENTIAZ EQUIP / S FEES
❑ 1- and 2- family dwelling 111 Commercial /industrial ❑ Accessory building
M builder For special information use checklist.
M ulti -famil
❑ Multi-family ❑ ❑ Other:
Description Qty. Ea. Total
1, ' t JOB I 1 XOR�I TTON rAND C, 9 ON .A , ei1 Heating/ cooling
Job site address: / s--- g 5' s f . Th ,/1' e�,e -rte Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: /05 Project name: (_ 00e p
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
4 fr Iiik T# ON WORK -
a 10.00
Water heater
Gas fireplace 10.00
�! n '
/V �.C_) c�Vcf t.,�.x�✓ K 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
0, Chimney /liner /flue /vent 10.00
' _ ....! „,1.r PI OW ; , g .s ;lr fg 7T N a A .Meil , 3 Other: 10.00
Name: ` ri jx . „,____ P �� ..1 c /I ` "yU , / Environmental exhaust and ventilation
Address: c 00 ) c ,t.) 1 � `` � c3-- ,,:� _ Y Range hood /other kitchen
equipment 10.00
City/State /ZIP: 1 �D k g —) (9-Q. 4 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
"ta , '' WPLTCANT t 1 V Ay CONTACT rPER Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: ( & 1,4-v $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
Barbecue
rt �r CONTRAC QRf ;r^
. a... k.� . .:. �mr.... k� -'gym x �....... s�. x�,, z. .....w . l.a .:1�i uv*. ,. 'e .bXwa
Business name: 1 G Clothes dryer (gas)
Other:
Address: f I MECHANIC ZPERMITFEES #
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.:C 4 q„S" State surcharge (8% of permit fee)
TOTAL PERMIT FEE J'.
This permit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete. •
Print name: /"(, 1..t g c,a -v 62.- Date: G —a j Q S` * Fee methodology set by Tr - County Building Industry Service Board
c\Building\Permits\MEC- PermitApp.doc 12/03 440 -4617T (11 /02 /COM /WEB) / . 3 d
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
I
TotalValnat>go �`Per�n><t T��
$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 #: MEC2005-00368
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 621/2005
Phone: (503) 639 -4171 /o � mrrdr �gpufl�ublhl i ;
....'. :
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/21/2005 TIME: 7 :09AM PAGE: 8B
SITE ADDRESS: 15665 SW 74TH AVE 105 CLASS OF WORK:
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK LOT #: 004 TYPE OF USE:
PROJECT NAME: COGNEX EXPANSION
DESCRIPTION: New ductwork. No separation walls. Value: $9000.
OWNER: PACIFIC AMERICAN PROPERTY EXCHAN, PHONE #:
CONTRACTOR: WILLAML I i E HVAC SERVICE PHONE #: 628 -6841
Inspection Request Scheduled For: Date: 7/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final • 011813 -01 503-628 -6841 N
Corrections/Comments/Instructions:
il 1
t .
1or(
\, u/)--k- \
1
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FO' INSPECTION n ADDITIONAL F ES ASSESSED
di -.
Inspector: / \r' Date: ; j � Phone #: (503) 718-