Permit Er CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00045
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/22/2007
PARCEL: 1 S136DD -00900
SITE ADDRESS: 06830 SW ATLANTA ST 120 ZONING: MUE
SUBDIVISION: HAINES CROSSING II LOT: JURISDICTION: TIG
Project Description: Installation of grilles to existing ductwork. Project Value: $3,000
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MALCOM ESLINGER Description Date Amount
11575 SW PACIFIC HWY
PMB 160 [MECH] Permit Fee 1/22/20M $95.50
TIGARD, OR 97223 [TAX] 8% State Surcha 1/22/20(N $7.64
Total $103.14
Phone: 503- 620 -9515
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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 di .1.- e -stions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue By: I � � / Permittee Signature: ZMI
Call 503.639.4175 by 7:00 a.m. for inspections that busin s • ay.
This permit card shall be kept in a conspicuous place on the job site until c• 4 . • letion of the project.
Approved plans are required on the job site at the time of each inspection.
Media w a1 Permit Application FOR OFFICE USE ONLY
Received i Permit N
a ermo.:M �O
I . City of Tigard Date/By
� , maw /, ..�/ -
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
G Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit:
TI G A It D Inspection Line: 503.639.4175 Date Ready/By: MI ® See Page 2 for -
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK - COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
)4 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.
CATEGORY OF CONSTRUCTION Value: $ Ot
RESIDENTIAL EQUIPMEN1 FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: 0g30 g e t. ,c9 Ili- ap Air conditioning or heat p pump
(requires p
uires site plan showing placement) 14.00
City /State /ZIP:
........I7' Da Of 012. f 7 0- �� Furnace 100,000 BTU (ducts/vents) 14.00
l Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: /�
l, 1.11 (t +- Gas heat pump 14.00
Cross street /directions to job site: I 0I , dr 6 -� 7 i) , _ • , 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: 1 Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' DESCRIPTION OF WORK Water heater 10.00
�/
� -�. f �_/�� L / & _ vent fo Gas fireplace 10.00
�'J� I� l. I �'C't`� ° Flue vent for water heater or gas
F fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent
Other: 10.00
10.00
j �,�^�, 4 Name: �a j 1 q y F [ , t_.0_, Environmental exhaust and ventilation
Address: 11,5-4-S— v w Q�. L 3 w� P /ten Range hood/other kitchen
r�"�! Ya�`� equipment 10.00
City /State /ZIP: f 40 2- `' Clothes dryer exhaust 10.00
r— Single -duct exhaust (bathrooms,
Phone: ( s wt.—Fl ) 7� ( 0 97 Fax: dSFD6) 6'4 - g 47 toilet compartments, utility rooms) , 6.80
❑ . APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: 6/` r / ` j�n ' � ` :/f� Other: 10.00
!� � µ Fuel piping
Contact name: 114, tom"'' it 1 $5.40 for first four; $1.00 for each additional
l / 5' ! Furnace, etc.
Address: f / ..i.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: 4,4 6/ 5 ,... Clothes dryer (gas)
Other:
Address: �o 6 1 9,/„.9,/„.c-- fD MECHANICAL PERMIT FEES*
City /State /ZIP: ab�/ 0 !21 7 7 5 Subtotal
/- ( / Minimum permit fee ($72.50)
Phone: (503 ) a� _ Fax: 5 ) 9.66 347
tp l� ! Plan review (25% of permit fee)
CCB lic.: 114 g State surcharge (8% of permit fee)
A 02 " 0 --....L TOTAL PERMIT FEE
signature: /� ' / This permit application expires if a permit is not obtained within 180
Authorized
ti./ ' days after it has been accepted as complete.
Print name: i/ l me m Date: Ili, • Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permits\MEC- PermitApp.doc 04 /06/06 1 440 -4617T(tt /07/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information •
- Commercial Fee Schedule:
Total�Valuation:a •, Permit •Fee • .
$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:\Buildin PermitApp.doc 12/30/05 2
CITY OF TIGARD
BUILDING DIVISION " PERMIT #: MEC2007 -00045
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/2212007
Phone: (503) 639 -4171 i j���d��l f1l�i
Inspection Requests (24 Hrs.): (503) 639 -4175 =�� '__..
INSPECTION WORKSHEET FOR DATE: 3/27/2007 TIME: 7:02AM PAGE: '13
SITE ADDRESS: 06830 SW ATLANTA ST 120 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Installation of grilles to existing ductwork Project Value: $3,000
OWNER: ESLINGER, MALCOM PHONE #: 503 - 620.9515
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503. 266 -1249
Inspection Request Scheduled For: Date: 3/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final • 045497 -01 503-997-8478 N
Corrections /Comments /Instructions:
dp C.r
PASS 7 PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL MI ALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED
^ G/
Inspector: Date: �� / a?Phone #: (503) 718 -