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Permit
_7 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00297 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/27/2008 PARCEL: 1 S126DC -04400 SITE ADDRESS: 09430 SW CORAL ST 200 ZONING: C -P SUBDIVISION: LEHMANN ACRE TRACT LOT: 007 JURISDICTION: TIG PROJECT: DENNIS CLARK DDS Project Description: Valuation = $3,700 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1 OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: 2 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: 1 > 10000 cfm: GAS OUTLETS: Owner: FEES MARTIN BUILDING LLC Description Date Amount 9430 SW CORAL ST STUITE 100 TIGARD, OR 97223 [MECH] Permit Fee 6/12/200€ $123.10 [MECPLN] Plan Rev 6/12/200€ $30.78 [TAX] 12% State Surch 6/12/200€ $14.77 Phone: Total $168.65 Contractor: OREGON HEATING & A/C PO BOX 397 DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS Contact #: PRI 503 -538 -2953 • FAX 503 -537 -2172 Reg #: LIC 172126 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: Permiftee Signature: 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. Mecba njcal Permit Application _ ___ FOR OFFICE USE ONLY ' City of Tigard Dateiv (o Permit No.:& • 2 III : 13125 SW Hall Blvd., Tigard, OR 97223 Plan Reui t � Phone: 503.639.4171 Fax: 503.598.1960 Date /B rye M T I G A'R D Inspection.Line: 503.639.4175 Date Ready/By: . IA See Page 2 for . Internet: www.tigard - or.gov Notified/Method. 0/ of i /,. k ' Supplemental Information . \ TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction v a 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 1:1 Demolition ❑Other: 4c anical materials, equipment, labor o e d prof C�EGORX OF CONSTRUCTION . - , 00 Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: / 7,/ �j - _ ✓ 1 5± Air conditioning or heat pump (( /� vf/ (requires site plan showing placement) 14.00 City /State /ZIP: l TiV J l /)' Fumace 100,000 BTU (ducts /vents) 14.00 / �/ lll/////� Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: U/ / / i g e _ Gas heat pump 14.00 Cross street/directions to job site: b Duct work 10.00 Hydronic hot water system 14.00 67e: ' Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK, Water heater 10.00 Gas fireplace 10.00 h j/ ©]/t e/ . % Flue vent for water heater or gas Ate— / ' / n , / fireplace 10.00 V ! ' t [/ Log lighter (gas) '10.00 #41V c /j'1'r, AA ne_A t 5 /A Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ❑ PROPERTY OWNER IV TENANT Chimney /liner /flue /vent 10.00 / Other: 10.00 Name: ad G /Ilik Environmental exhaust and ventilation Address: SSS 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 ( y CONTACT PERSON' Attic /crawlspace fans 10.00 Business name: 0/1/4( Other: 10.00 Fuel piping Contact name: C71 $5.40 for first four; $1.00 for each additional Address: l Fumace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater - Fireplace E -mail: (�� .''�/�,, / � - ' �L �/l , 1j C'L3N'1' �eG -- " J l lit /) h y � ��' -. Range RACTOR J Barbecue Business name: -SIC/ Clothes dryer (gas) Other: Address: l/ 1* q MECHANICAL PERMIT FEES* . City /State /ZIP: 91/ 9,iL C ,' 9 7 / Subtotal Minimum permit fee ($72.50) t2 5 , )� Phone: ( ) S� n�l� Fax: ( �� j) 1 --7iv Plan review (25% of permit fee) ' ---TO) CCB lic.: State surcharge (12% of permit fee) /, TOTAL PERMIT FEE , % ,,, Authorized signature: C, ! This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: C LA " - > " 1 . . . : - — \ 1 Date: G I 1. 0 5 * Fee methodology set by Tri- County Building Industry Service Board I:\Building\Permits\MEC- PermitApp doc 01/19/07 440 -4617T (11 /02 /COM/WEB) Mechanical Permit Application - City of Tigard 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 01/19/07 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: MIC000097 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/270008 _ - Phone: (503) 639 -4171 llmpl�Ii+� Inspection Requests (24 Hrs.): (503) 639 -4175 „Jig INSPECTION WORKSHEET FOR DATE 7/28/2008 TIME: 7 :03AM PAGE: 32 SITE ADDRESS: 09430 SW CORAL ST 200 CLASS OF WORK: SUBDIVISION: t EHMANN ACRE TRACT LOT #: 007 TYPE OF USE: PROJECT NAME: DENNIS CLARK DDS DESCRIPTION: Valuation = $3,700 OWNER: MARTIN BUILDING LTC, PHONE #: CONTRACTOR: OIREGOI'J HEATING & Alt;, PHONE #: 50 ;$- 538 -2963 Inspection Request Scheduled For: Date 7/28/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 073261 -01 503 - 849.8162 Y Corrections /Comments/ Instructions: ) y I 5,2 e_ Ve_62.64 dCkket) "3 - 25 -0E3 OD 5 C I/C ( 5.2_ q" \ PASS n PARTIAL APPROVAL CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 3-- Date: ,q6:17), ® 8 Phone #: (503) 718- 2 P - 2 -...? • if CITY OF TIGARD . r , BUILDING DIVISION PERMIT #: E 007 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23f2008 Phone: (503) 639 -4171 ° m�i " Inspection Requests (24 Hrs.): (503) 639 -4175 �'� lilt Inspection INSPECTION WORKSHEET FOR DATE: 7/15/2008 TIME: 7:00AM PAGE: SITE ADDRESS: 09430 SW CORAL. ST 200 CLASS OF WORK: SUBDIVISION: I EHMANN ACRE TRACT LOT #: 007 TYPE OF USE: PROJECT NAME: DENNIS CLARK DDS DESCRIPTION: Valuation • $3,700 OWNER: MARTIN BUILDING LLC, PHONE #: CONTRACTOR: OREGON HEATING & NC PHONE #: 503 - 538, 353 Inspection Request Scheduled For: Date: 7/26/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 616 Mechanical rough -in 073182 -01 503- €349 -8I62 �' y Corrections /Comments /Instructions: ‘AP / - l r. - 4� l• Ur-e... J • CD i \\ 1'.e3 ,}fr ® PASS n PARTIAL APPROVAL [11 CANCEL ❑ NO ACCESS ! FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ? Date: 25i 25ThulyOg Phone #: (503) 718- ,2 C423