Permit - CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00024
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/14/2008
PARCEL: 2 S 102 BA - 01100
SITE ADDRESS: 12220 SW GRANT AVE ZONING: I -P
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 058 JURISDICTION: TIG
PROJECT: AG SPECIALTIES
Project Description: Installation of furnace, ducts and grilles
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: 1 DOMES. INCIN:
NAT 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
JOHN & BARBARA HADLEY Description Date Amount
12220 SW GRANT ST
TIGARD, OR 97223 [MECH] Permit Fee 1/14/200E $186.50
[TAX] 8% State Surcha 1/14/200E $22.38
Phone:
Total $208.88
Contractor:
RITE -WAY HEATING + A/C INC
PO BOX 1815
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 359 -3613
Reg #: LIC 71242
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: L
C.._ i !�44 _4 Permi ttee Signature: � 4
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 . FOROFFICE USE ONLY
l'.. ,/
r ,CPc Received
� of Tigard Date/By: 7 o Permit No.: , a6Vg, -�D0
® 13125 SW Hall Blvd., Tigard, OR 97223 '
.
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Permit:
DateBy:
,T I G A R D Inspection Line: 503.639.4175 Date Ready /By: lija 63 See Page 2 for
Internet: www.tigard- or.gov Notified /Method: Supplemental Information
• TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fccs* arc based on the value of the work
❑ New construction �Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and •rofit.
CATEGORY OF' CONSTRUCTION Value: $ 'f$'oo
❑ 1- and 2-family dwelling Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES *'
y g ❑ Acc essory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling
Job site address: ,2a �a c5 id 6 ,./.
Air conditioning or heat pump /
(requires site plan showing placement) 14.00
4
City /State /ZIP: .14 9 7 �'3 Furnace 100,000 BTU (ducts /vents) 14.00
/ Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: cc��
d/1,, v//i eS Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
� �� Hydronic hot water system 14.00
�
Q y if Y A. Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
.k 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
/O 00 . o ., Q `a.c p I ]; 7`' / i ,- gas
as
-. Flue vent for water heater or
•---1 <J fireplace 10.00
�'� h Q/ � b Q Log lighter (gas) 10.00
( � Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Ce PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
0 i ' ' Other: 10.00
f 4 N ame:
\ 7: ) 4„,,,, R I 6,, ✓ b4 . V -4 / 4 7 Environmental exhaust and ventilation
L) A S/_ Range hood /other kitchen
Address:
/r, p 9 r) ( e C ✓ equipment 10.00
City /State /ZIP: T fQ , mo d r ,0/ q7. Clothes dryer exhaust 10.00
l Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
(APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
�7 4' Other: 10.00
Business name: \ rso�S' (�J4 5� ✓� x+ -, Fuel t in
P�P� g
Contact name: / a y v 7,--Ca A $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: / 5 uJ 4-1,,,,,..
Gas heat pump
Ci ty /State /ZIP: 5 O- rt.) a -ssi d /' 9 7140 Wall /suspended/unit heater
Water heater
P hone: (.�v� 75, ef - l3 Fax: :( ) 5 1` , 36
n // Fireplac
E -mail: /-,L J e L Q 6 r 4 l°'" 4'6 , t'Cr. -v't Range
— CONTRACTOR' Barbecue
—
Business name: /(( rt. — W 4 t( Ti"✓d " t A-/CI / /k) Clothes dryer (gas)
Other:
Address: � /g, _ . MECHANICAL PERMIT FEES*
City /State /ZIP: th (�rj s 6-0/...o 9' 0.2 Subtotal
Phone: ( ) / Fax: ( ) l Minimum permit fee ($72.50) /g � .* 5-C
Plan review (25% of permit fee) —.6)
CCBlic.: State surcharge (8% of permit fee) a,3u
TOTAL PERMIT FEE M , , g
Authorized signature: This permit application expires if a permit is not obtained within 180
�� / /`� . days after it has been accepted as complete.
Print name: Z 4 ✓'ry 34 e e, 544 Date: / //Z/ / O 8 * Fee methodology set by Tri- County Building Industry Service Board
1. \Building\Permits\MEC- PermitApp.doc 01/19/07 440 -4617T (11 /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
' ' f/86 Sd $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.
•
1: \Building \Permits \MEC- PermitApp.doc 01/19/07 2
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BUILDING DIVISION PERMIT #: WEC2008-00024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/14/2000
Phone: (503) 639-4171
Inspection Requests (24Hmj:(503)83S'4175 ~J�m r�J�
INSPECTION WORKSHEET FOR DATE: 3/7Y 8 TIME: 7:00AM PAGE: 52
SITE ADDRESS: 1223DSW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: AG SPECIALTIES
DESCRIPTION: Installation of furnace, ducts and grilles
OWNER: HADLEY, JOHN & BARBARA PHONE #:
CONTRACTOR: RITE-WAY HEATING -f A/C INC PHONE #: 503-359-3613
Inspection Request Scheduled For: Date: 3/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
cos Mechanical final 066250'01 503-78e-1368 N
Corrections/Comments/Instructions:
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BUILDING DIVISION PERMIT #: MFC2009-00074
13125 SW Hall Blvd., Tigard, OR 97223 , A DATE ISSUED: 11
Phone: (503) 639-4171 47 4001iii
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/23/2008 TIME: 7:00AM PAGE: 4
SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 068 TYPE OF USE:
PROJECT NAME: AG SPECIALTIES
DESCRIPTION: Installation of furnace, ducts and Oyes
OWNER: HADLEY, JOHN AL BARBARA PHONE #:
CONTRACTOR: RITE HEATING + NC INC PHONE #: 503
Inspection Request Scheduled For: Date: 1/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough•in 063760.01 503-784-1358 N
Corrections/Comments/Instructions:
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BUILDING DIVISION PERMIT #: MEC2008-00024
13125 SW Hall Blvd., Tigard, OR 97223 , A DATE ISSUED: 1/14/2008
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Phone: (503) 639-4171 444 111lii . I ( e l 1
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1117(2008 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: AG SPECIALTIES
DESCRIPTION: Installation of furnace, ducts and grilles
OWNER: HADLEY, JOHN & BARBAFZA PHONE #:
CONTRACTOR: RITE-WAY HEATING + NC INC PHONE #: 503-359.3613
Inspection Request Scheduled For: Date: 1/1712008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615
Mechanical rough-in 063392-02 503-784-1358 N
Corrections/Com nts/Instructions:
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CITY OF TIGARD
BUILDING D IVISION PERMIT #: MEC7008- 08024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/14/200F3
Phone: (503) 639 -4171 '
Inspection Requests (24 Hrs.): (503) 639 -4175 �..' I'I �..
INSPECTION WORKSHEET FOR DATE: 1/17/1008 TIME: 7 :00AM PAGE: 57
SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: AG SPECIALTIES
DESCRIPTION: Irisiallation of furnace, ducts and grilles
OWNER: HADLEY, JOHN & BARBARA PHONE #:
CONTRACTOR: RITE -WAY HEATING + NC INC PHONE #: 503-359-3613
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 063392-01 503-7841358 N
Corrections /Comments /Instructio •
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BUILDTNG DIVISION PERM|T-#: MEC2008-00024
13125SVV Hall B|vd, Tigard, ORQ7223 DATE ISSUED: 1/14K308
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Inspection Requests (24 Hrs.): (503) 639-4175 u�-M+ * �J.
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7:0DAM PAGE: 6
SITE ADDRESS: 1222USVV GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: AG SPECIALTIES-
DESCRIPTION: Installation or furnace, duct and grilles
OWNER: HADLEY. JOHN &BARBARA PHONE #:
, CONTRACTOR: RITE-WAY HEATING + Aft: INC PHONE #: 003-359-3613
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections/Comments/Instructions: U
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