Permit CITY TIGARD ' MECHANICAL PERMIT
l DEVELOPMENT SERVICES PERMIT #: MEC2004 -00155
��'l 13125 SW Hall Blvd., Tigard 223 (503) 639 -4171 DATE ISSUED: 3/29/04
PARCEL: 2S1 14AA -00200
SITE ADDRESS: 16285 SW 85TH AV -101
SUBDIVISION: DURHAM HALL BUtN PARK • ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: - EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: Fl VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG - 3 - 15 HP: COMML. INCIN:
MAX INPUT: 196,000 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:
Remarks: Gas piping
Project Value: $2,000 .
•
Owner: FEES
BIRKEMEIER, BRENT T /JANET D TRS Description Date Amount
BY THE BIRKEMEIER FAMILY TRUST [MECH] Permit Fee 3/29/04 $72:50
10573 SW NAEVE ST
TIGARD, OR 97224 • [MECPLN] Plan Rev 3/29/04 $18.12'
• [TAX] 8% State Surchaq 3/29/04 $5.80
' Phone: Total , $96.42
Contractor:
•
ROSE HEATING CO
9945 NE 6TH DR
PORTLAND, OR 97211 REQUIRED INSPECTIONS
Phone: 503 - 283 - 5183 Gas Line Insp
Final Inspection
Reg #: LIC 2084
•
I
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 • • ation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
95 10.1- 0100. You m.y obtain copies of these rules or direct questions to OUNC by cling
:03)246 -6699. / j
4 ly i �
ssued By: �. /:� Permittee Signature: •�_ _ / _
Call 03) 639 -4175 by 7:00 P.M. for inspections needed the next busines day
Mechanical Permit Application ( � � FOR OFFICE USE ONLY �/�J,�
`J g p DateBy: a ei7 ( Permit No.: / WE ` �1 TI�.[y 00/.7
Cl f Tl and
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 Aitu �� DateBy: .Cf..O4' /15J/3 Other Permit:
Inspection Line: 503.639.4175 6.1i Date Ready/By: s' ®See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: a l j Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based o • = - . . - . r
❑ New construction p Addition/alteration/replacement performed. Indicate the valu = Barest dollar , f all
❑ Demolition ❑ Other: mechanical material ipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
• Value: $ •
RESIDENT 0.. EQUIPMENT SYSTEMS FEES*
❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information u • .
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / (O c2 t) 5 R -- -t ii U i / Air conditioning or heat pump
( (requires site plan showing placement) 14.00
City/State/ZIP: ' .. w r . , 0 °-� �� Furnace 100,000 BTU (ducts/vents) 14.00
/ r ` � tJ / Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: ( , t vi h Project name: ✓ ;i4 �� K---die Gas heat pump 14.00
Cross street/directions to job site: , 1 ' 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
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
58 42 Flue vent for water heater or gas
�L S fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
. Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
❑ PROPERTY OWNER ❑ TENANT Other: 10.00
Name: D IA y A m
�/ ) j 5 , rt ro 55 4/ k Environmental exhaust and ventilation
Address: -*II hood /other kitchen
/ S yJ e quipment 10.00
City/ State/ZIP: T Clothes dryer exhaust 10.00
f 1 � ) C- Single -duct exhaust (bathrooms,
Phone: ( ) ( Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 1 0.00
Business name: 1 �
E P C°2 /
Contact name: T j �? p / F uel t to
piping
$5.40 for first four; $1.00 for each additional
1 ) L 1 .-
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall /suspended /unit heater
Phone: (,20) 8 3 _ 'I Q 3 Fax: : ( ) Water heater
C Fireplace
E -mail: Range 2
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
Other: -.
Address: 5 ee v)- •a MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Minimum permit fee ($72.50) fey
Phone: ( ) Fax: ( )
Plan review (25% of permit fee) / 0. /
CCB lic.: a 2 g Li State surcharge (8% of permit fee) 5,
TOTAL PERMI F E E //�,
4/. T his permit application expires if a permit is not obtaln vin 180
Authorized signature: days after it has been accepted a c
Print name: ,f h + Pk,. - V t Date: "� . . /O ! • Fee methodology set by Tri- County Building Industry Service Board
A, Pr / /
i:\ Building \PetmitstMEC- PennitApp.doc 12/03 440- 4617T(I1 /02/COM/WES)
Mechanical Permit Application - City of Tigard
P - Supplemental Inforniation
Commercial Fee Schedule: ,
:;Total ,. ;s :, `Permit `.Fee: "; _. - .;,w.•;•:.0
$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 $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 \Pemtits\MEC- PernvtApp.doc 12/03 2 '
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171
// , / BUP
Received / (7-& C/ Date Requested 71 /7`� $`" PM
Location • /( ZF s Suite /) / MEC — 001&P
Contact Person e4 I M t. A D G (50 3 ) ?Os 2 215 a z, </- ()' f 3 e
Contractor Ph ( ) SWR
BUILDING Tenant/Owner k p 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
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS RT FAIL / j�
LU G
st & Beam /
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
F
PART FAIL , -
0114 CHANICAL `/
Post & Beam
Smoke Dampers
Fin I
P PART FAIL
ECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
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: El Unable to inspect — no access
Fire Supply Line �
ADA l G' G
PP
A roach/Sidewalk Date c� / // v Inspector Est Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL