Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -10042
II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/23/2006
PARCEL: 2S 102AD -02200
SITE ADDRESS: 08900 SW BURNHAM ST F004 ZONING: CBD
SUBDIVISION: BURNHAM TRACTS LOT: 006 JURISDICTION: TIG
Project Description: New HVAC unit, add a /c. Project Value: $5,800
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: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
BURNHAM BUSINESS + STORAGE LLC Description Date Amount
9500 SW BARBUR BLVD STE 300 [MECH] Permit Fee 4/5/2006 $155.90
PORTLAND, OR 97219 [TAX] 8% State Surchar€ 4/5/2006 $12.47
Phone: 503 620 - 7204 Total $168.37
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 125815
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:CL_____,6ilizi Permittee Signatur i ,
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 permit Application FOR OFFICE USE ONLY
City of Tigard Received
3 3 g ®g V E Y, ;4 dor
13125 SW Hall Blvd., Tigard, cri, Plan Review I Permit No.: 0 Phone: 503.639.4171 Fax: 513. 1960 if y ; p .
• ,.. Date/By Other Permit:
Inspection Line: 503.639.4175 ^., i �h '
az
MAR _ Date ®
e Ready /By: See Page 2 for
Internet: www.ci.tigard.or.us M j A 1 v 200 6 Notified/Method: Supplemental Information
•
;TiiiFir KV AWdRK COMMERCIAL FEE* SCHEDULE = USE CHECKLIST
g Iit t i DN1810AI Mechanical permit fees* are based on the value of the work El New construction ddtton/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labo, erhea and profit.
CATEGORY OF CONSTRUCTION Value: $C�
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Vfj Commercial /industrial ❑ Accessory building
El ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB ,SITE INFORMATION AND LOCATION Heating /cooling
Job site address: grVv ,514i 3•a[k7 wf,, Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: -r fry. r4 i (J,/ Furnace 100,000 BTU (ducts /vents) 14.00
Suite/bldg. /apt. no.: Project name: 0 Y U �l�'��+ Furnace 100,000+ BTU (ducts/vents) 17.90
y 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
Subdivision: Lot no.:
Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
. DESCRIPTION OF WORK Water heater 10.00
f L u ' / Gas fireplace 10.00
1/ Q Z.- �/ZYI — 0 id 0 (./ 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 TENANT
Chimney/liner/flue/vent 10.00
Other: 10.00
Name-7.- : t ,pC Dust IJE 5b c4.. . D d,t. Li..e., Environmental exhaust and ventilation
AA.) r / . � Range hood/other kitchen
/47,0 Address: equipment 10.00
City /State /ZIP: D 6 2 9 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 5 7D ) (. 7Zdt' Fax: ( ) 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; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: / (I-/ izQ Clothes dryer (gas)
c (mot Other:
Address: /7/1 / G( - /� MECHANICAL PERMIT FEES*
City /State /ZIP: / / t f4 / CIV--- ‘, 2/i r j Subtotal
• J) g K — 7> / 4 Fax: ( ) Minimum permit fee ($72.50)
Phone: (
5--3s- �,� Plan review (25% of permit fee)
CCB lic.: / Z <0/ State surcharge (8% of permit fee)
C TOTAL PERMIT FEE
Authorized signature: This permit application e xpires if a permit is not obtained within 180
y days afte it has been accepted as complete.
Print name: (,— L/i 14./T-' t Date: .,. /ei� * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits\MEC- PennitApp.doc 12/03 440-46117T ((I 1/02/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
CITY TIGARD n v
BUILDING DIVISION PERMIT #: A 00 /00 4/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171 Joratil Illi �
I nspection Requests (24 Hrs.): (503) 639 -4175
I
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 6— j 4 l� - CLASS OF WORK:
SUBDIVISION: � �'' LOT #: TYPE OF USE:
PROJECT NAME: V
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -30 r O' Pour Time:
Code # Inspection De cription Confirm # Contact # Message
R I 5_3 F a-qs_)
Corrections /Comments /Instructions:
I i = /al ��
in , il I ( -MAW
•
a PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
_ FAIL ..4 CALL FOR INSPECTION ❑ ADDITI +NAL F' ES ASSESSED
■ Ilk.' ,
Inspector: I`' Date: - • Phone #: (503) 718- 2-4-0