Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00756
f� l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/14/2005
PARCEL: 1S135DC-02000
SITE ADDRESS: 11865 SW 91ST AVE MAINT ROOM ZONING: R -7
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT: JURISDICTION: TIG
Project Description: Gas line to relocated meter. Value: $665.00
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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
VILLA LA PAZ LIMTED PARTNERSHIP Description Date Amount
BY COMMUNITY PARTNERS FOR [MECH] Permit Fee 11/14/20C $72.50
AFFORDABLE HOUSING INC [TAX] 8% State SurcharE 11/14/20C $5.80
TIGARD, OR 97281
Phone: 503- 968 -2724 Total $78.30
Contractor:
LMC CONSTRUCTION
4915 SW GRIFFITH DR. #301 REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97005
Phone: 503 646 - 0521
Reg #: LIC 161282
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: Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business 44y.
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.
Mechanical Permit Application FOR 'OFFICE USE ONLY •
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City of Tigard J ld ku t u Received / ``
Date/By. 1 I t( 0 a IA. i / Ir i
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598 ^1960 ii, ,,,..b,-, . I� j Ready/By: Other Permit:
Inspection Line: 503.639.4175 � u U Q 2005 . h AA , �" Date
/B '' Date adyBy: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TIGARD
BUILL ypEttjF )6i}K COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ddition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
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mechanical materials, equipment, labof, o oyrr, and profit.
CATEGORY OF CONSTRUCTION Value: $ (0
El 1 - and 2 dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
[Multi family ❑ Master builder ❑ Other:
Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: 6. i2T Air conditioning or heat pump
1 / � �� I (requires site plan showing placement) 14.00
City /State /ZIP: "II / t2 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (duds/vents) 17.90
Suite/bldg. /apt. no.: Project name:
-S �D p V 0,4. Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
Hydronic hot water system 14.00
CO V -VA it. Ui - �p ..-0 0 .i,J '' , C Z . 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
i`k(Afe G7et - S 7'Q e .f-p ✓ - (Z.uti1 ,-)„a--,,J Flue vent for water heater or gas
fireplace 10.00
il1 / A-Le Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
1ROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name L// '1k pi.,; e y p � r Environmental exhaust and ventilation
Address: p l Range hood/other kitchen
s!ti W`'� equipment 10.00
City /State /ZIP: .j- I i 1 (,2 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: („5-03) £ (5f _. 27 'Z r Fax: ( ) toilet compartments, utility rooms) 6.80
D1PLICANT El-e NTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: L„A,,(c_ - f4 , Fuel piping
Contact name: Gtit Li ,s- . k- t $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
(.503) (p G j 27 I ( )
Fireplace
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E -mail: Range
CONTRACTOR Barbecue
Business name: 4--.r /A�� Clothes dryer (gas)
Other:
Address: L,1 / y G V L / (.121- OK 1Y ,v ( MECHANICAL PERMIT FEES*
City /State /ZIP: B.v joi .,�j,rJ , /' - 7ol > ,- Subtotal
(� ) / 0�2 p er: r/ ) < z____:3 Minimum permit fee ($72.50)
Phone:
b l� ( r� l� (� Plan review (25% of permit fee)
CCB lic.: /b /,--ir•-- State surcharge (8% of permit fee)
TOTAL PERMIT FEE '
Authorized signature: f"--z---f-----
This permit application expires if a permit is not obtained within 180
gn days after it has been accepted as complete.
Print name: G P 1 f / nom Date:/ / - <1/41 o. • Fee methodology set by Tri- County Building Industry Service Board
\ Building \ \ M
i:PerrnitsEC- PermitApp.dot 12/03 440 /02/COM/WEB)
Mechanical Permit Application - City of Tigard y j"
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: • ; ° Permit Fee:
$1.00 t. $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,004.00 and $2.30
for each additional $101.00 or fraction
thereof, to and includ g $5,000.00.
$5,001.00 to 0,000.00 $141.50 for the first ;.5,000.00 and
$1.80 for each ad.' ional $100.00 or
fraction thereof, •4 and including
$10,000.00.
$10,001.00 to $50,001 10 $231.50 for • e first $10,000.00 and
$1.35 for e.ch additional $100.00 or
fraction - ereof, to and including
$50,00
$50,001.00 to $100,000.00 7 0 for the first $50,000.00 and
$ 15 for each additional $100.00 or
acti thereof, to and including
$100,001 10.
$100,000.01 and up $1,396.50 .' the first $100,000.00 and
$1.10 for each . • ditional $100.00 or
fraction thereof.
Note: / new commercial buildings require 2 sets ; flans.
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i:lBuildinglPermits\MEC- PermitApp.doc 12/03 2
7 - ,
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MEC2005-00756
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/20(6
Phone: (503) 639-4171 Ill lir
Inspection Requests (24 Hrs.): (503) 639-4175 .4.W ....
INSPECTION WORKSHEET FOR DATE: 6/20/2006 TIME: 7:01AM PAGE: 49
SITE ADDRESS: 11865 SW 91ST AVE MAINT ROOM CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS
•
DESCRIPTION: Gas line to relocated meter. Value: $665,00
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #: 503-968-2724
CONTRACTOR: LMC CONSTRUCTION PHONE #: 503-646-0521
Inspection Request Scheduled For: Date: 6/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 031986-01 503-969-3279 Y
.—.:
Corrections/Comments/Instructions: t:. 4 .--. Lae a p -
__„...------"
1 1
' . I
ASS 0 PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
I I FAIL n CALL FOR INSPECTION El ADDITI NAL F ES ASSESSED
Inspector:
0111‘1" Date: 47 - ° one #: (503) 718- l_, _
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. . .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005•00756
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11114/2005
Phone: (503) 639 -4171 � a idy j�ll
Inspection Requests (24 Hrs.): (503) 639 -4175 �_'
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7:02AM PAGE: 42
SITE ADDRESS: 11865 SW 91ST AVE MAINT ROOM CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS
DESCRIPTION: Gas line to relocated meter. Value: $665.00
OWNER: VILLA LA PAZ UNITED PARTNERSHIP, PHONE #: 503 - 968 -2724
CONTRACTOR: LMC CONSTRUCTION PHONE #: 503-646 -0521
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 021291 -01 503-969-3279 V
Corrections /Comments /Instructions: "� a AM
,<___. .4 L 1/4 0 .
Imisirgr
II
IOW
iiii A.A. „
I PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITION FEE ASSESSED
r/
Inspector: Date: 'hone #: (503) 718-
_CTIA-1______________________