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Permit N CITY TIGARD MECHANICAL PERMIT I D EVELOPMENT SERVICES PERMIT #: MEC2005 ma 6 �' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/16/2005 PARCEL: 2S101 AB -01608 SITE ADDRESS: 07455 SW BEVELAND RD ZONING: MUE SUBDIVISION: HERMOSO PARK LOT: 019 JURISDICTION: TIG Project Description: New furnace and AC. Value: $6600.00 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: GAS 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: GAS OUTLETS: 1 > 10000 cfm: . Owner: _ FEES WESTERN TIGARD HOLDINGS, LLC Description Date Amount 20019 SW ATEM RD. [MECH] Permit Fee 8/15/200e $109.30 BEAVERTON, OR 97007 [TAX] 8% State Surchaq 8/15/200.` $8.74 Phone: 503 -628 -8508 Total $118.04 Contractor: B + S HEATING BOX 1623 REQUIRED ITEMS AND REPORTS OREGON CITY, OR 97045 Phone: 503 720 - 5608 • Reg #: LIC 45838 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 9 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU NC b .I . g 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: )t reit..c.A.4 2.:_ er , e a ... „ Permittee Signature: l 'y 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. • Mechanical Pe I .'t FA ii` hh1 FOR off N I USE. oN ONLY �, City of Tigard ! � Date/By Q? / /b /� 1?� Permit No.:/�/I� 1 .�_ _, (,/9 . 13 't; SW Hall Blvd., Tigard, OR 97223 5j °` f 1 1 + o�a�c T] 503. 60 2��5 Plan Revie Phone: 503.639.4171 Fax: � „ � ii� , Date/By. ther Permit Inspection Line: 503.639.4175 ARD -t+i I. y _ Date ReadyBy: l : • See Page 2 for ternet: www.ci.tiiAard.Qr.0 G, QF T�G 1 J Notified/Method: Supplemental Information • TYPE OF WORK COMMERCIAL FEE* SCHEDULE .— USE CHECKLIST ❑ New construction rgi 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: $ la 60:, 4212- . RESIDENTIAL EQUIPMENT / SYSTEMS FEES ❑ 1- and 2- family dwelling (Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other • Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION , . Heating /cooling Job site address: 7 S J' T etJ I L. kY1 6 Air conditioning or heat pump 1 (requires site plan showing placement) 14.00 City /State /ZIP: TI'(, 6 Orc (0 Furnace 100,000 BTU (ducts/vents) ( 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: I Project name: 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: I Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 � R -- t — Als4 OU t r4eltC - Al (W Gas fireplace fo e 10.00 kJ �� L 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 ❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 10.00 Other: 10.00 Name:' (/tJej} er'"t Yo /p 5 LL G Environmental exhaust and ventilation Q Range hood/other kitchen Address: 19 $ w ills l �/ v` y,:ii, equipment 10.00 City /State /Z1PB -�a 0-N,..\ CD (Z - G11 1 Clothes dryer exhaust 10.00 � Single -duct exhaust (bathrooms, Phone :0 R) / b ow 2.6-41v Fax: ( ) toilet compartments, utility rooms) 6.80 ❑• APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 • Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unitheater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: • Range CONTRACT OR Barbecue Business name: he4TJ✓�j Other: dryer (gas) �QX /6 r. Address: A MECEIANIGAL PERMIT FEES* City /State /ZIP: ore c ,-r 0t( 9�01(J 5 c c yi i Subtotal / &, Phone: (- ) 7,�a — ��,og Fax: ( 3 ) S'� g= ��SZ Minimum permit fee ($72.50) J ��� Plan review (25% of permit fee) CCB lie.: 'w Q State surcharge (8% of permit fee) F, 'f TOTAL PERMIT FEE // p .0 Authorized signature: �® .1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: C/,/lv s -a Date: C - 65 * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Pennits\MEC- PennitApp.doc 12/03 440- 4617T(I1 /02/COM/WEB) • Mechanical Permit Application - City of Tigard Page 2 = Supplemental Information Commercial Fee Scheduler Total Valuations • Permit Fee:r $1.00 to $2,000.00 Minimum fee $72.50 U $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 3 ( - for each additional $100.00 or fraction thereof, to and including $5,000.00. 0" $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and `rf $1.80 for each additional $100.00 or l� fraction thereof, to and including $10,000.00. q O $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. 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NC • , • ,- 1 N • . .. . \ . • I . •, , . --_, --- I I ---„ 20b .., . . . , . . • .., . „.... • . i .,,,, „ „..,, 204I-.. , . . .. , ..,.... „ s 1 .„. .. . .., ,-. ________, . . 202 I -„ • .... ------, • - (E) PA ... R .._ -- N .,.. G ....... „,.., ‘'NS 1 1: ., ............ ......._. .. ! --......,,_.., .. . ........ s., . . , - .. . . 200 Is -- I .„ . .„ 1 ., ,......,. ' -------„ . . • • I .. --.. „ . CITY`0F TIGARD BUILDING DIVISION PERMIT #: MEC2005 00482 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8116/2005 Phone: (503) 639 -4171 �' �tiiputllq� 1 Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 9/ X2005 TIME: 7:07AM PAGE: 65 SITE ADDRESS: 0755 BEVELAND RD CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT # : 019 TYPE OF USE: PROJECT NAME: WFSTERN TIGARD HOLDINGS DESCRIPTION: New furnace and AC. Value: $6600.00 OWNER: WESTERN TIGARD HOLDINGS, LLC, PHONE # 503-626_8508 CONTRACTOR: B + S HEATING PHONE # 503- 720 -5608 Inspection Request Scheduled For: Date: 9/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 016409-01 503- 720 -5608 N Corrections /Comments /Instructions: ( 1 I –/— itilf- 1:W' w e i \if • , . 1 i PASS I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL CALL FOR INSPECTION I ADDITI NAL FE S ASSESSED Altf Ins ector: Date: �" `/ �� `Phone #: 503 718 - p . )