Permit '1 AL
CITY TIGARD MECHANICAL PERMIT
, r'll DEVELOPMENT H BMENg Tigard, R 9 2 CES ) 639 -4171 DATE PERMIT #: ISSUED: 2/14/2005 00234
13125 PARCEL: 2S111 AC - 02700
SITE ADDRESS: 14650 SW 97TH AVE
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5
BLOCK: LOT: 037 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: El 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: 308,000 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: 3 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 3
Remarks: Installation of (3) roof top units and gas piping. Project value: $3870
Owner: FEES
TIGARD /TUALATIN SCHOOL DIST #23J Description Date Amount
6960 SW SANDBURG ST [MECH] Permit Fee 2/14/2001 $72.50
TIGARD, OR 97223 [MECPLN] Plan Rev 2/14/200E $18.12
[TAX] 8% StateTax 2/14/200E $5.80
Phone: 503- 437 -4048 [MECH] Investigation Fe 2/14/2001 $72.50
Total $168.92
Contractor:
HEINZ MECHANICAL
2615 NW ST HELENS RD. REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97220
Phone:
Reg #: LIC 43866
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: t y Permittee Signature ,_. —
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
1, so 97- '" /IV
� I \ : {FOR OFFICE USE ONLY , . - i ,
Mechanical Perm'it(�A i � I1C =a non R ece i ve d ' 2 Mechanical
'. -- -I — — Date /By: 0 "2 0 ) Permit No.: Ft cc, xo,- COe 3 ,/
of Tigard Planning Appri al Building
City g l ",Y 0 ',/ 2003 DaieBy: Permit No.:
13125 SW Hall Blvd. Plan Review ` Other
Tigard, Oregon 97223 CITY OF TIGARD DateB ( '�` NJ , �5P Permit No.:
Phone: 503- 639 -4171 Fax: 5.981T-960VISIi Post- Review' Land Use
i nooti m i II '1 Date /By: aril? Case No.:
Internet: www.ci.tigard.or.us , e I Contactgj w / -bli s El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 '° W Name/Method: 5/AA y a° r Supplemental Information.
,got 57/00r r .
; :`=' 41 i TYvPE OF WORK` ifii ; s " A: ,At : 'VCOMMERCI'AIs FEE* SCHEDJEV USEZCHECIWST,f `,' ;
_ _ 0 New construction _ ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
a `4, ,,, CAT,EGORY (E C ONS i7 C;TION .'f x " _:,114 mechanical materials, equipment, labor, overhead and profit.
f -' ❑ 1 & 2- Family dwelling Commercial /Industrial Value: $ A 70 See Page 2 for Fee Schedule
v) _ RESIDENTIAL, EQUIPIYIENT /SYSTEMS,T.FEE *;SCHED,ULE. :
❑ Accessory Building ❑ Multi- Family
Description Qty I Fee(ea) Total
❑ Master Builder III Other: ng/Coli .Heiti_ ' „ o n , .. . `
Net .JOB SITEu°T1V,FORMATION anti'ILOCATION,trMia Furnace - add - air conditioning* 14.00
4- !j1 Job site address: /1 t,5 .S&" F7-'.=2-- Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name:.. / ' Hydronic hot water system 14.00
Pro
/7✓d ! 7 /Y7 -�'- Residential boiler
, Cross street/Directions to f b site: (for radiator or hydronic system) 14.00
• ? Jam'' 9t rile ea ,, 7/ Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00 ,
Flue /vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12.15
._ Otlierliiel : _ .
c t Tax map /parcel #: Water heater 10.00
,�` = ��;_�,�° °�` DESCRIPTION�OF'WORIC''` - °' �• =� , �;,��'
ax,. � ,? :�_ - :�"`".� r n =s�' w.a ,:��`se�,'a Gas fireplace 10.00
J� Flue vent (water heater /gas fireplace) 10.00
LA //r a/ t 6� f�l/AC it,v
Log lighter (gas) 10.00
• Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
�.m.
: P; MARTV OWNER E X01 ' TEtfO , Lam' t h t & 1 t i
Chimney/liner/flue/vent 1
O ther ii 00 _ �
. T. � � i „ . > z��;'pEnviroriinen aleEx'aus €V.epti a on;;,'.* �:a �'< �,•�
Name: k y ‘,//4..,,i., �j,U� ,��o ��� ' Range hood/other kitchen equipment 10.00
Address: ‘ cl 'a' S s',,,,,./4 w r q S�. Clothes dryer exhaust 10.00
CX, City /State /Zip: a- I I / r 7 2 2 7 Single duct exhaust
Phone o ,� '7/2 V yr FaX 0 ./j /•- 5 a (bathrooms, toilet compartments,
V ) " :APPLICANT ` , .. ONTACT PERSON€ •:_', : utility rooms) 6.80
N.- Name: ,�r� ft y /�ds i a,_S Attic /crawl space fans 10.00
Other: 10.00
I Address: 9/D d' la/ S' ,„ : „;, . ' , i: -” rµ,, ° ;3z , ;° Fiiii,Pip iig,, :.t::,- - - :: :ii s`= =,''_ N1ss ;,.iE_ >
City /State /Zip: , a .. r 1 ex_.. 9.A.2-- 2 * *($5.40 for first 4, $1.00 each additional)
CN. Furnace, etc. **
Phone:,( ? v g j - -zf/ F ax: s'oj - Y,7i- go 2 o Gas heat pump **
y) E-mail: 6 % ,. i , f 627 r- i 2 , (9?-, cc' Wall /suspended /unit heater **
7f„ :.. _ �'S r t- , •,,:. - :r,=
�r�, ��,� � t � r .,:�� �CON,TRAC�T®R�. � ':�r.:�i,�� ?;z. A Water heater **
A Business Name: ,/�.e i' it/ 4_ /gec „,; c y l Fireplace **
N i Address: 2 Z s jt/ 5 //e /e w r r a< < Range
D BBQ
City /State /Zip: • = ✓ - " 2 Clothes dryer (gas) **
Phone:6 03 - ,2 Z o -08 r Fax: Other: i1„nFToP **
CCB Lic. #: el g-1 l Total:
• • - Mechianical.Permit Feesf , , ' � . , .
Authorized --- Subtotal: $
gnature: J
(Please print name)
Notice: This permit application expires if a permit is not obtained within
Date: . 5 / 7 / 0,3 Minimum Permit Fee $72.50 $ 7P., , J v
, ' �/� L /� k�' s Plan Review Fee (25% of Permit Fee) $ / k . /
" State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $96,,,e./.2, *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. . '4i 5"D •
i:\Dsts\Permit Fotms\MecPermitApp.doc 01/03
/b 1
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information N.
•
Commercial Fee Schedule:
•
Total lValuation ;
$1.00 to $5,000.00 Minimum fee $72.50' •
$5,001.00 to $10,000.00 $7.E.50'fo'r`the firs' $5;000.00,and $1.52
for each additional5100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
Assuiied V Iii tion_s_ Per Appliance ;, ,,; ,
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts // 1,170 ��
& vents J 7
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb. unit, 3,400 •
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non- portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1 -4 outlets - / 360 054
Each additional outlet 63
TOTAL COMMERCIAL Mfy
VALUATION: 61'6 7O
•
is \Dsts\Permit Forms\MecPermitAppPg2.doc 01/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: It r'd"-> -602
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171brlloypil +r
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: to /mil TIME: PAGE:
SITE ADDRESS: /A (e, SIL) ?Z CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: . (46(p2_, d/ /4, PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
1i [ IGZ- MNOfC6,
Corrections /Comments/ Instructions:
fl
(;) (111 p
11
1 Li'
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
I ns ector: ak
Date: 6 (J Phone #: (503) 718 -