Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00141
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/18/2008
PARCEL: 1 S135CA -02600
SITE ADDRESS: 11130 SW GREENBURG RD ZONING: R -12
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: GOOD NEIGHBOR CENTER
Project Description: Relocate ducts and grilles, all work to take place in office area. No plan review required. Project Valuw
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 VENTS W/O APPL: VENT SYSTEMS:
S TORIES: 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
GOOD NEIGHBOR CENTER Description Date Amount
11130 SW GREENBURG RD
TIGARD, OR 97223 [MECH] Permit Fee 3/18/200€ $81.70
[TAX] 12% State Surch 3/18/200€ $9.80
Total $91.50
Phone: 503 -443 -6084
Contractor:
RABE HVAC INC
PO BOX 691
DONALD, OR 97020 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 678 -2887
FAX 503- 678 -2099
Reg #: LIC 147885
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: , tA I ,2 , Permittee Signature: *
�� -
Call 503.639.4175 by 7:00 a.m. for inspections at 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 FOR O FFICE USE ONLY -
4 'lir City of Tigard Received ' Permit No.: f /J18 T
I q 13125 SW Hall Blvd., Tigard, OR 97223
Date/By: dr Emma
C • Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
Date/By: Other Permit
TI G ARD Inspection Line: 503.639 Date Ready /By: Juris g
Internet: www.ti and -or. ov S See Page l for
g g Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
LI 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, and nFgfit.
CATEGORY OF CONSTRUCTION' Value: $ 2 3 5 0 J
•
RESIDENTIAL EQUIPMENT [ SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Multi-family Master builder For special information use checklist.
1:11 y ❑ ❑O ther: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION . Heatinp/cooling
Job site address: / / / 3 0 G , N ht/ r i P. ey Air conditioning or o heat pump
(requires site plan showing placement) • 14.00
City /State /ZIP: /3 ,p c n K. q 7 2 E ( , Fumace 100,000 BTU (ducts /vents) 14.00
!1 // Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name:
O, c �IrLCl1lO$7r c--¢r„/er Gas heat pump 14.00
Cross street/directions to job site: 64 ee ". AO cs -e (4)2S f v ,E' 2 / 7 Duct work 10.00
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. 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
A c cQ / d -A Sc.}�, C -Q Pe 7 v (' I d it/ OCA.J Flue vent for water heater or gas J fireplace 10.00
Q.:".Q.:"../ Q.:"../ / 1 I t ` , /' y - O0.-c ex. ) s � JyL �U G -6s-) S� Log lighter (gas) 10.00
/'e /6 c_iii r / i 0 50 IJ 1 - �
P e ("� r i 3 -) #e_5- 7 Wood /pellet stove 10.00
/J c G Om 60o c,60 �0 /-C e t 0 t e t; s (z e xi � (y.)O r K , )^per - Wood fireplace /insert • 10.00
P OPERTY 0 I R ❑ TEN ANT A c -e'os) Chimney /liner /flue /vent 10.00
q - • k / :
Ether 10.00
Name: ,i h ( 1 ' Environmental exhaust and ventilation
2 (� tr • Range hood/other kitchen
Address:
/// ✓ z„.0 - e-Q�+� equipment 10.00
City /State /ZIP: f l t r)2 9 ‘7.0
- 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
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $L00 for each additional
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
y) - 1 2 / r 7 C / ,
Business name: � C !�S l/ /I Clothes dryer (gas) Other:
Address: T O IS 0 x 6/ MECHANICAL PERMIT FEES*
City /State /ZIP: p 6 4\_,A / c t 0 2 C I -2 0 Z O Subtotal �D
Phone: (5 iD3) 6 7 8 - / Z { 7 Fax: ( 50'4 -6 . - Z l) °( Minimum permit fee ($72.50
/ Plan review (25% of permit fee) -�
1 � &� ((( --
CCB lie.: 1 7 is i � n State surcharge (12% of permit fee) 9 , t
/ TOTAL PERMIT FEE 9/ (
Authorized signature: This permit application expires if a permit is not obtained within 180
_ _ days after it has been accepted as complete.
Print name:
/ i oj1 / Date: 3. / �- * Fee methodology set by Tri- County Building Industry Service Board
• I:\ Bui lding\Permits\MEC- PermitApp.doc 01/19/07 440 -4617T (1 I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard .r
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
$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 A PERMIT #: MEC2003-00141
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3119/2008
Phone: (503) 639-4171 hodo / 1',1\
Inspection Requests (24 Hrs.): (503) 639-4175 -.,-4,1V'4 .
INSPECTION WORKSHEET FOR DATE: 4/16/20 t TIME: 7: 00Alvi PAGE: 49
SITE ADDRESS: 11130 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GOOD NEIGHBOR CENTER
DESCRIPTION: Relocate ducts and grilles, all work to take place in office area. No plan review required. Project
• Value: $
OWNER: GOOD NEIGHBOR CENTER, PHONE #: 503-443-6084
CONTRACTOR: RABE HVAC INC PHONE #: 603-678-2887
Inspection Request Scheduled For: Date: 4/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
$99 Mechanical final 068421-01 603 6-23O N
Corrections/Comments/Instructions:
WI -
P ' --
111 PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
I FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
/ ,..
Inspector: , _ ______. Date: /1 . Phone #: (503) 718- Ei.
w
. •
CITY OF TIGARD
BUILDING DIVISION .
PERMIT #: MEC2003-00141
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3118/2008
Phone: (503) 639-4171 01 .1
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/20/200 TIME: 7:02AM PAGE: 13
SITE ADDRESS: 11130 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GOOD NEIGHBOR CENTER
DESCRIPTION: Relocate ducts and grilles, all work to take place in office area. No plan review required. Project
Value: $
OWNER: GOOD NEIGHBOR CENTER, PHONE #: 503443-6084
CONTRACTOR: F2ABE HVAC INC PHONE #: 503-67&2887
Inspection Request Scheduled For: Date: 3/20/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mochanical rough-in 067047-01 503-678-1267
Corrections /Comments/ Instructions:
•
• ;IA PASS A PA IAL APPROVAL CANCEL NO ACCESS
11 /fLL 0 fl FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 4 Dat- • ZO Phone #: (503) 718-
410
•. _