Permit - Yi
CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00132
��I: DATE ISSUED: 3/22/04
�--" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 114A0 -00100
SITE ADDRESS: 09000 SW DURHAM RD
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: CMS UNIT HEATERS: VENT FANS: 2
OCCUPANCY GRP: El VENTS WIO 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Ductwork and (2) bath fans for new portable.
Owner: FEES
TIGARD - TUALATIN SCHOOL DIST Description Date Amount
13137 SW PACIFIC HWY
TIGARD, OR 97224 [MECH] Permit Fee 3/22/04 $74.80
[TAX] 8% State Surchar€ 3/22/04 $5.98
Total $80.78
Phone:
Contractor:
CJ HANSEN CO INC
PO BOX 7397
SALEM, OR 97303 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Final Inspection
Reg #: LIC 499
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 -00
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Iss d By: • 4; S " �� / 'Permittee Signature:
Call (50 .: -4175 by 7:00 P.M. for inspections needed the o e vr bus' ess day
Mechanical Permit Application . a.. ,. • .. FoR oFF iCL USE ONLY . ' '
Clfy Of 1 lgard Received n i /
Date/By f " �`f Permit No.' _ i t . / - mg��
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1<us•. b' I Date/By. Other Permit•
Inspection Line: 503.639.4175 ._a - Date Ready/By: Ju H See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: / ( 7. Supplemental Information
- TYPE OF' WORK.' ," , .. ._.......,.. : COMMERCIAL FEE SCHEDIJI:E .USEyCHECI{I:IST'
❑ New construction ddition/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.
:.f, �; ,:L0: ti . X '.r .,�, �%E, '� �FrcONSTRUcFION�'4K- ', ue: $ t a! • (e O
?,�'�` ', '
.__„ , ,'� , :xCATGORY _�O ..... - . -. -..,. :�.,,: - . y� -. r,�_ Val
- - .�� ,rw: . - * :� o •.., �:_�:�, -y ��mr .,.,,r
?: J - ° ' - RE SID E NTIAII E QUIPMENT'/ � . * =`'< ''in
ID 1- and 2- family dwelling Commercial/industrial El Accessory building " ' ' ` °`
For special information use checklist.
El Multi-family Master builder ❑ Other: Description Qty. I Ea. Total
2
JOB ``STPE ; I1siFOR MATIQNaAN]D ^I;OCATION: °;: <<':. 't:::.: H eat i o g/ coo li n>;
541/4) Air conditioning or heat pump
Job site address:
�00 0 / c2 - � »I/ 4 it!(if. • (requires site plan showing placement) 14.00
City /State/ZIP: 77 / � / 9.�h t 0 7 772P-Lt Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: 7 l c ( Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
-_ Gas heat pump 14.00
Cross street /directions to job site: Be'- ei1 sil� qg e . 9 - Duct work 14.00
�]�� Hydronic hot water system 14.00
3 (,(� ��) ar/ Residential boiler (radiator or
C -E[(-- X0 - `13 33o Unith hydronic) 14.00
(3-0 � Unit heaters (fuel -type, not electric),
e..0/10t7;
n 8 7 t fe Fj e n / ' �J /� N S�(� goat/ in -wall, in -duct, suspended, etc. 10.00
Subdivision: F " ` `� /1 Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
,.: _ a �,, = n .,. .,., ��.,; Water heater
10.00
y � 4 ! '' .�"',�= K": ,VViTA . <
-, =. =7- , A.4. ,,} = � OFF WORK: _;:," t -; .., ...:' = �I, 'M,x
-, .- �, •:cK•' --:_. .... .., N „n ,. ,?:-� �A -mss. .,_- ...._. -� . ...«..- «:.4:...._. ... -- •118;r. elf'. .
•
Gas fireplace - 10.00
I ba 1-- 2,- 4'4oO# FAA 5 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 .
_ x 'fir "`> r; >•,_c ^, . pif 3x' t; Chimney/liner/flue/vent 10.00
"5'�!;;: - - ." PROPERTYWNER 1` �r Y' a -.. s Y'....� �;vTEN cRgW -.' s ii%
- - Other: 10.00
Name: - 71 6' j e/i 2 C , g _ te,`7 �3�'� Environmental exhaust and ventilation
ry dal Range hood/other kitchen
Address:
1 ( ! SO) AO( A 0_ M G(/ . equipment 10.00
City /State /ZIP: ...r-t1/172,4) - nn 7 a aD Clothes dryer exhaust 10.00
( Single -duct exhaust (bathrooms,
Phone: (60,) 4 / - --c/_bj 0 Fax: ( ) toilet compartments, utility rooms) 6.80
'' ''4'74-- " -"' .� „ 7 :��' : �x�� e�:•.. u� % �, l e tan
Attic/crawls 10.00
f . .k ® APPLIBANI' Ag - , ;.t . < CONTACT' PERSON ° T�: f� '
fig,- �:�,s`x'b `"�,f..,_,_::s -.tna. _.. �.:;z.i�te:'fr:r ^r...o.., .. �^� r:}'J �:�� "u -,.. _..z. . ..• >�. xz „ ;� , ;, , =. <.
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
�
=� ', ''�;fr:� .rr�'�; ;,�'" . ,� . � � � '
� � ' �� " ;a$ = =,� ,,��:_�:,� ., �X�� Barbecue
, r,,,iso == •a?,.. .. . > -,.. t;,�`,w�3', S 3- .�.�:,,_. .,m=x -a <a+,.. ., .' °_ .e`. v °r..". T.'•^ __. .. -, -r�' __ ,.
Business name: �1 T 1,14 - i5 E - ,J , Jt Clothes dryer (gas)
Other:
Address: f . (� 19(' '7 R q 7 t ; • 4 .' , " e ,.. * no-. - ,
i ;:,.�.; _ , =:� �_• M ECAANICAt y j •P RMIT:_FEES�� -�-' ,.:_,�
City /State /Z1P- 3 4 L n, 1 9 97503 Subtotal __
ff / '' // 1 Minimum permit fee ($72.50)
Phone: (5-� l� a (O '7" Fax: (s 5.-? / - '{p a-7 . - --
Plan review (25% of permit fee)
CCB lic.: q 91 State surcharge (8% of permit fee) .5
TOTAL PERMIT FEE 0. 7'
Authorized signature: / ii - This permit application expires if a permit is not obtained within 180
C days after it has been accepted as complete.
I /
I Print name I Date I • Fee methodology set by Tri- County Building Industry Service Board
, /f /1-g// eI, /1-g// 7 ' d� // 14
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
q BUP
Received Date Requested / - - oZ AM PM BUP
Location 9 v D Suite (f MEC , e7( CI C) 1-3
Contact Person Ph ( ) 36 °' - 3CP ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner • ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: m SIT
Post & Beam _ -
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler 1"441111
v "
Fire Alarm
Susp'd Ceiling I
Roof
Other:
Final
PASS PART FAIL MOM
PLUMBING 101%
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
Smoke Dampers
AS PART FAIL
I CAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL