Permit j CITY OF TIGARD
MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00772
1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/21/2005
PARCEL: 2S101 AB -01604
SITE ADDRESS: 07307 SW BEVELAND RD ZONING: MUE
SUBDIVISION: GILROY BUILDING LOT: 016 JURISDICTION: TIG
Project Description: Mechanical work for new office building. Other unit is gas fireplace.
Project Value: $10,000
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: 5
STORIES: 2 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 3 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: 3 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 2
Owner: FEES
PAT GILROY Description Date Amount
5100 SW MACADAM AVE SUITE 240 [MECH] Permit Fee 11/21/20C $231.50
PORTLAND, OR 97239 [TAX] 8% State Surchaq 11/21/20C $18.52
Phone: 503- 225 -5559 Total $250.02
Contractor:
SURE FLOW HVAC INC.
16209 SE WEBSTER RD REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97267
Phone: 503 653 - 1636
Reg #: LIC 109777
•
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 -set forth in pAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct qu stions tO OI,�NC by Iling 503 - 246 -6699
or 1 -8e e-332-234 .
Iss ! Permittee Signature:
Call 503 - 6394175 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 Permit Application FOR. OFFICE USE ONLY
City of Tigard ( C Date/By. � "t Q5 f Permit No.: lair —05) 77.2
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
r
Phone: 503.639.4171 Fax: 503.598.1960 /,M . i Date/By
Received
Inspection Line: 503.639.4175 4 . " 1 2005 .
Internet: www.ci.tigard.or.us t e. -- `! I 1
-� Date Ready/By: S See Page 2 for
g Notified/Method: Supplemental Information
r'rry (1F TIGARD
• TYP OF vy,oliKISIO COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El New construction 1:1 Addition /alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 10 MO '
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building •
El ❑ Master builder ❑ Other: For speciesl information use checklist.
Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
r� Air conditioning or heat pump
Job site address:
S c.-) p G, l 4M;cD (requires site plan showing placement) 14.00
City /State /ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
�'1/t(�� C -L lU'1 7 22 Furnace 100,000+ BTU (ducts/vents) 17.90 •
Suite/bldg. /apt. no.: 200 Project name: et i 14 OC/ OFFJCIi- Gas heat pump 14.00
Cross street /directions to job site: I Duct work y 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 * 1 0.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater ' fl 10.00
+�-�, Gas fireplace 10.00
'I to 1\\A "L� ( t50 / 000 k 7-7000a) I I( Flue vent for water heater or gas a [
�[, p� (� ,, - fireplace f ' 10.00
t 024 s 1 r � 1 PAA S – 1 ' l R A,th Log lighter (gas) 10.00
1/ 1 1 ) elle, T i4 R_ ?WE— Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
PROPERTY OWNER ❑ TENANT Other: 10.00
Name: 1 6,x\ 'gv Environmental exhaust and ventilation
Address: `'1' 01 SAO/ 3 eL � b 2a® Range hood/other kitchen
equipment 10.00
City /State /ZIP: ( E1, 0 a/l- 017 77 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( Z 7 els 26 Z( Fax: (cE5S) ) "7 5 toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; SI.00 for each additional
Address: Furnace, etc.
Gas heat pump .
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACT OR Barbecue
Business name: C U ✓Lri �t Clothes dryer (gas)
� Other:
Address: 1 O ' 5 L i g S 1 ' 2 MECHANICAL PERMIT FEES*
City /State /ZIP: V t/l-Y t Li I [C.-He— 4 �' 7Z � Subtotal
2 w - ..5 -„, Fax: ( ) Minimum permit fee ($72.50)
Phone: (
9(3 � ? / Plan review (25% of permit fee)
CCB lic.: 1 1r C3 '11 _ State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: " r , (4' `'� f Date: 1 ` i 1 11 t) ' Fee methodology set by Tri- County Building Industry Service Board
\
is Building\Permits \ MEC - Perm itApp.doc 12/03 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard -�
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation:" 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:\Building\Permits\MEC- PermitApp.doc 12/03 2
CI TIGARD
BUILDING DIVISION PERMIT # c)s OO 7 7L
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: "7 3 7 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - Z ? v Pour Time:
Code # , Inspection Description Confirm # Contact # Message
o
2-4 7Thl/
Corrections /Comments /Instructions:
�► I 4111!
•
Z n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAI n CALL FOR INSPECTION n ADDITI'INAL F' ES ASSESSED
► r`ii
Inspector: /NM Date: w � P hone #: (503) 718 `�
P ( )
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00772 1
13125 SW Hall Blvd., Tigard, OR 97223
i il l t DATE ISSUED: 11/21/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7:06AM PAGE: 58
SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE:
PROJECT NAME: GILROY OFFICE BUILDING
DESCRIPTION: IViechanical work for new office building. Other unit is gas fireplace.
Project Value: $10,000
OWNER: GILROY, PAT PHONE #: 503-225-5559
CONTRACTOR: SURE FLOW HVAC INC. PHONE #: 503-653-1636
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
I
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 023612-02 503-793-2621 N
Corrections/Comments/Instructions:
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I I FAIL . 0 CALL FOR INSPECTION [ ADDITIONAL FEES ASSESSED
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Inspector: / \ / Date: ( 6----- Phone #: (503) 718-
. ,
CITY OF TIGARD
BUILDING DIVISION
AgiA, " PERMIT #: MEC2005-00772
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2005
Phone: (503) 639-4171 hv/bili f
Inspection Requests (24 Hrs.): (503) 639-4175 ,,,-4 t li.
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7:06AM PAGE: 59
SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE:
PROJECT NAME: GILROY OFFICE BUILDING
DESCRIPTION: Mechanical work for new office building. Other unit is gas fireplace.
Project Value: $10,000
OWNER: GILROY, PAT PHONE #: 503-225-5559
CONTRACTOR: SURE FLOW HVAC INC. PHONE #: 503-653-1636
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 023612-01 503-793-2621 Y
Corrections/Comments/Instructions:
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10 144 ( 0 •
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At Ar
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p ASS El PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
I I FAIL 0 CALL FOR INSPECTION 0 ADDITIONA FEES ASSESSED
Inspector: drfki a.:
Date: 1 (7 Arr Pr Phone #: (503) 718-
CITY OIL TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00772
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7:06AM PAGE: 55
SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE:
PROJECT NAME: GILROY OFFICE BUILDING
DESCRIPTION: Mechanical work for new office building. Other unit is gas fireplace.
Project Value: $10,000
OWNER: GILROY, PAT PHONE #: 503 - 225-5559
CONTRACTOR: SURE FLOW HVAC INC. PHONE #: 503 - 653 -1636
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
625 Duct work 023612 -04 503 -793 -2621 N
Corrections /Comments /Instructions:
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_ Ar" proP—
/ CT IS
PASS n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: =. �� Date: (. ♦ "et Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200&00712
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2005
Phone: (503) 639 -4171 '" o l
Inspection Requests (24 Hrs.): (503) 639 -4175 �' � ' L.
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7 :06AM PAGE: 57
SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE:
PROJECT NAME: GILROY OFFICE BUILDING
DESCRIPTION: Mechanical work for new office building. Other unit is gas fireplace,
Project Value: $10,000
OWNER: GILROY, PAT PHONE #: 503-225-5559
CONTRACTOR: SURE FLOW HVAC INC. PHONE #: 503-653-1636
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
695 Misc. inspection 023612 -03 503-793 -2621 N
Corrections /Comments /Instructions:
•
Ai l
' r
i .. s
o i! -�• _ S�f
ASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: p,I Date: (z 1 [cne #: (503) 718 -
1