Permit 'A
••• s CITY OF TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 -00594
4! f I: 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/21/2005
PARCEL: 1S126DC-04400
SITE ADDRESS: 09430 SW CORAL ST 200 ZONING: C -P
SUBDIVISION: LEHMANN ACRE TRACT LOT: 007 JURISDICTION: TIG
Project Description: Add (1) RA grill.
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: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
• > 10000 cfm:
GAS OUTLETS:
Owner: FEES
MARTIN, ROBERT CLARE Description Date Amount
THELMA M
BY JO RENE M MOODHE [MECH] Permit Fee 9/21/200f $72.50
SHERWOOD, OR 97140 [TAX] 8% State Surchaq 9/21/2008 $5.80
Phone: Total $78.30
Contractor:
OREGON HEATING + A/C INC
PO BOX 397 REQUIRED ITEMS AND REPORTS
DUNDEE, OR 97115
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Phone: 503 - 538 - 2953
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.
, (1
Issued By: i . Permittee Signature
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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.
re' .Mechanical Perm ' - 1, 1I l,': AWED FOR OFFICE USE ONLY
AI.' i City of Tigard Date /By Permit No.: I y / "'"' I
13125 SW Hall Blvd., Tigard, OR 9722SEP 21 2005 Plan B ew 1
Phone: 503.639.4171 Fax: 503.598.1960 /ft/; �( \ Date/By: Other Permit:
�
Inspection Line: 503.639.4175 ^ a ¢., ii
Internet: www.ci.tigard.or.us CITY OF TIGARD - __ l Aft/t010, Date Rea dy/By: runs: ® See Page 2 for
g BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE -'USE CHECKLIST
❑ New construction [ 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 nd profit.
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CATEGORY OF CONSTRUCTION ; Value: $ 1,15
RESIDENTIAL EQUIPMENT / SYSTEMS PEES*,
❑ I - and 2 family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi -family y ❑ Master builder ❑ Other:
Description Qty. I Ea. Total
. JOB SITE INFORMATION AND LOCATION - , Heating /cooling
• Job site address: ,v- / �� .Air conditioning or heat pump
�[�) /9�/�J/ �W \ (requires site plan showing placement) 14.00
City /State /ZIP: fi 1 !, Furnace 100,000 BTU (ducts/vents) 14.00
► " Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: bip Project name: /�S/ ,
Gas heat pump 14.00
Cross street /directions to job site: ¢¢¢%%%vvv 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
J I �r Gas fireplace vent for 10.00
� ,"f_. :_ 4 d® 4 � 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
Chimney /liner /flue /vent • 10.00
❑ 'PROPERTY OWNER, ' ❑' TENANT
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON . Attic/crawlspace fans 10.00
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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/unit heater
Phone: ( ) Fax: : ( ) Water heater •
Fireplace
E -mail:
Range
CONTRACTOR .. Barbecue
1 , 4 , 1 A l
Business name: [ T/ V— (✓ Clothes dryer (gas)
Other:
Address: ,e/ 17. MECHANICAL-PERMIT FEES* ,
City /State /ZIP: "47 �,.�/' . [ in Subtotal
Phone: ( J "3 c p Plan review (2255 Fax: ( )
Minimum permit fee r% of permmit it fee)
ee)
CCB lie.: 12 G State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: ' T his permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: g 1 j 7, Date: 9 /5/S * Fee methodology set by Tri- County Building Industry Service Board
i : \Building\Permits\MEC- PtmmitApp doc 12/03 t 44 " 617T(I1/02/COM/WEB)
Mechanical Permit Application - City of.Tigard
Page 2 = Supplemental Information •
Commercial Fee Scheduler
Total V'aluationrr , PermifFee: `
$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.
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i: \Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD
BUILDING' DIVISION PERMIT MEC2005-00594
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2112005
Phone: (503) 639 -4171 u�ll� ulpi��1�liI
Inspection Requests (24 Hrs.): (503) 639 -4175 nr `__..
INSPECTION WORKSHEET FOR DATE: 9/72/2005 TIME: � : , i2AM PAGE:
SITE ADDRESS: CLASS OF WORK:
09430 SW CORAL ST 200
SUBDIVISION: LEHMANN ACRE 'I TRACT LOT #: 007 TYPE OF USE:
PROJECT NAME: DR. CLARK
DESCRIPTION: Add (1) RA grill.
OWNER: MARTIN, ROBERT CLARE, PHONE #:
CONTRACTOR: OREGON HEATING + NC INC PHONE #: 503.538 -2953
Inspection Request Scheduled For: Date: 8/2212005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 016294 -01 503. 849 -8162 N
Corrections /Comments /Instructions:
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1\l'ItCL. 0 .1
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PASS El PARTIAL APPROVAL El CANCEL NO ACCESS
FAIL n CALL F. • INSPECTION ❑ ADDIT ONAL FEES ASSESSED
Inspector: 4110 Dater Phone #: (503) 718 -