Permit CITY TIGARD MECHANICAL PERMIT
l DEVELOPMENT SERVICES PERMIT #: MEC2004 -00601
.�� 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/9/2004
PARCEL: 2S 114AA -00100
SITE ADDRESS: 08680 SW DURHAM RD SCHL. SWIM CTR.
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 3
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 3
> 10000 cfm:
Remarks: Venting and gas piping for replacement of (2) boilers and (1) water heater.
Owner: FEES
SCHOOL DISTRICT 23J Description Date Amount
6900 SW SANDBURG RD [MECH] Permit Fee 9/9/2004 $130.00
TIGARD, OR 97223 [TAX] 8% State Surcharl 9/9/2004 $10.40
Phone: 503 431 - 4000 Total $140.40
Contractor:
REQUIRED INSPECTIONS
Phone: Gas Line lnsp
Mechanical lnsp
Reg #: Misc. Inspection
Final Inspection
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 -669 .—
Issued By: Permittee Signature: �G� (�f'"f�!�)
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application , FOR OFFICE U _ . .
- SEO(
13125 SW Hall Blvd , Tigard, OR 97223 ' ON ' ' • ;
_ .. , .
City of Tigard . Received
Date/By • ffA 1 i ii Permit No
Plan Review
Phone. 503.639.4171 Fax: 503.598.1960 ta.,eolte t Date/By Other Permit
Inspection Line 503 639 4175 —14 el 1 Date Ready/By. R7 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method 011 Supplemental Information
"" 4 Vai'''''6&iiqit ':usk61-IE' CICLIST'
F irai - L;:.41KqP*1-W•tx6Azi2", ,, ,11,W , A, , ,,Lt'.??,1= .!-;,,it,,,..,,d ..1.t-.4,4M ,, -,e- ,,-, -- -, '. 1 ,- , ''' . ' -
Mechanical permit fees* are based on the value of the work
0 New construction 2"Addition/alteration/replacement
performed Indicate the value (rounded to the nearest dollar) of all
D Demolition D Other. mechanical materials, equipment, labor, overhead, and profit
1,ge,• :„.-7,,yEAA,_ ,7.k,-, ,,+, , ,,,lAw . , , i.,;,, Value. $ 5: 00. °
%„L.,__ •
',..'4,
"M3
0 1- and 2-family dwelling E 0 Accessory building
For special information use checklist
0 Multi 0 Master builder 0 Other:
Description Qty Ea Total
,k1,!- '''ro'':;g-mixt:ii
.
,- .
,' 1 H t ea Ing/cooling
Job site address. gcso 5 p 0 g (M- 01 X P Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP. 77 6- 4-g 4' o
u q. 2 z z (-I Furnace 100,000 BTU (ducts/vents) 14 00
Furnace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg./apt. no.: Project name 7 (6 0 .- 4 j ,, y)
Gas heat pump 14 00
Cross street/directions to job site: C-4,4"- Duct work
,_ 14 00
Hydromc 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 2, 10 00
Subdivision: Lot no.:
Other. 10 00
Tax map/parcel no.: Other fuel appliances
,iiiiii:MEIXT:A6,.. Water heater 10 00
11.4 Gas fireplace 10.00
■vd: ..— 17 (9) 1 00j,./....4 5 •1- (6 wiPtrf. L 1-1-61-71,
,.. Flue vent for water heater or gas
fireplace
1
WA4 /4-E4-71P Log lighter (g„) 10 00
Wood/pellet stove 10 00
Wood fireplace/insert 10 00
itcp ir ,,,, ; : Chimney/liner/flue/vent 10 00
-• 10 00
Nanle --- A-,0 - `1", .-1T 4- LA-Ti 0 , C.Ficiel 12 - r )1 4,7 12- t Cr- Environmental exhaust and ventilation
Range hood/other kitchen
Address: Le , ,. 4. ) ( .. ov o t. . -- 6 u IA I. equipment 10 00
City/State/ZIP1 1 2 .. .. t .. Oa 41. 2 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (553) q 31- 400o Fax: ( ) toilet utility rooms) 6 80
0 *If:fail:4 eoN Ath c/crawlspace fans 10.00
';•,,,, , >4g4
Other 10 00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
1
Fireplace
E-mail: Range
47 W4v:' , : , is-q•Wfab'rI5iiyrw> 4 !' •11 s Barbecue
a, ,,._ V
dry (gas
Business name: e 0 £.L i rii d i_cl / cry (... Clothes 80 er )
Other:
Address. ? P , 0 8 ,„,, 2, 960 :OlitC NTA U 4.',..M
City/State/ZIP: 4 5 ec ,_ 0 4 C 171-; 0 t e e 1 70 1145— Subtotal
— - OG
Minimum permit fee ($72 50)
Phone: (563) 72 O i 3 i Fax: (S (9 cs-6 _ /..,‘ R7 Plan review (25% of permit fee)
CCB lie.. / 9' re:13 State surcharge (8% of permit fee) /0 .5Z-
Authorized signature: ei I
A k._ ---•"(- TOTAL PER MIT FEE.i.qt0 xpires if a permit is not obtained within 180
This permit application e
days after it has been accepted as complete.
Print name: atitAJ/06. i, CO (....L, /,,,,, 5 Date 'r - 49 6 f e . Fee methodology set by Tri-County Building Industry Service Board
1 \Building \ Perrruts \ MEC-PerrrutApp doe 12/03 440-4617T ( I 1/02/COM/WEB) . ,
Mechanical Permit Application - City of Tigard •
Page 2 Supplemental Information
Commercial Fee Schedule:
.Totaul s aluat on ; :, E.:.
$ 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- PermmtApp doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION . Business Line: (503) 639 - 4171
BUP
Received Date Requested 4- — AM PM BUP
Location g g■ U/? Suite MEC ° 60 60/
Contact Person Ph ( ) � � c l' - /7a ' PLM
Contractor �! Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
at Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof A A/ t�
Other:
Final
PASS PART FAIL v _-
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole •
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
- oke P ampers
PAS • PART FAIL
L TRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required • - - - •ext inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call fo reinspe on RE: \ El Unable to inspect — no access
Fire Supply Line 1I /IM
ADA
Approach/Sidewalk Date � Inspector , !• Ext
Other: _r
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL