Permit p
A C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00300
�•fI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/20/2004
PARCEL: 2 S 101 AC -01400
SITE ADDRESS: 07125 SW HAMPTON ST
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 020 JURISDICTION: TIG
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: 2 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Split system.
Project Value: $4,000
Owner: FEES
SPECIAL DISTRICTS ASSOCIATION OF OR Description Date Amount
727 CENTER STREET, NE #208 20 [MECH] Permit Fee 5/20/2002 $118.50
SALEM, OR 97301 [MECPLN] Plan Rev 5/20/200 $29.63
[TAX] 8% State Surchar€ 5/20/200 $9.48
Phone: 503 371 - 8667 Total $157.61
Contractor:
MILLENNIUM HVAC INC
312 NE 135TH ST
VANCOUVER, WA 98685 -2812 REQUIRED INSPECTIONS
Phone: 971 Cooling Unt Insp
Final Inspection
Reg #: LIC 154708
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 i r• u e • OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699.
Issue. By: eat LWt 1 Permittee Signature: ` j71/01r,
Call (503) 63' -4175 by 7:00 P.M. for inspections needed t, a ne ''business day
Mechanical permit Application -- FOR OFFLCE USE ONLY` '
City of Tigard Received Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223
Plan Re : �// •
P j/ L �
Plan vie �
Phone: 503.639.4171 Fax: 503.598.1960 AiA dill ^ I i k Date /By: • ,20 ►Q Other Permit:
Inspection Line: 503.639.4175 . 1
Internet: www.ci.tigard.or.us "�.. Date l I
g Notifieed/Metd /Met hoo d: )urls Supplemental See Page for
upplementt al Information
Ei - a; MA , r�- ":�, *.. k.,,�; '^3.' s. a:��' _ a•m.. - "�'a ::'r'?s r'a •.k�et,,�'�€�"
4 a s 'i- ; --TYP ORS FOR <KA - ,, c ` „ �,t i. -r C,, IER_CIAL fFEE'' S-' — 'J F' = ' IUSI 0 HECKI1ST'
t.. a` v:.> �•,. ��. z<.�- a•,�,,�;,.r."»��.s <�.. _ -.. .:. n,� - - _ .a-. .�, >,��'� ._=�a.'�t -._- h wi': �,��., � _ � � -
❑ New construction `)R' 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 profit.
age r, u*' M z ;, �332�:. ,. r_:,r.-�.. - ^: a� . gy m -,. .„,� .;; =,:. E a E; `/ 0e,
%� WAATEGOR „ arg ". >- Value: $ op. �
?.E, J1 ' J v cr Y OE± nCONSTRU.CTION� tG • L . _. - .) .
RESIDENTIA'L EQUIPMENTt/ S YST E MS •FE
❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
;it , w Agr ; :•. �. „r =R.,,.; Description Qty. Ea. I Total
µtin l ` I SITE` ORIVPATIO ED�L®Ct RI '`:r�s .f , ",w;; >r, li
; ;:t; Heatin coon
,.. � ef�7,,._ . rcx, „» a „�:.zroz.xw�z,..�ns,... � .c ...: %,t' !.�. , >�. � .?bc,. ->- 1?J g
Job site address: -7/2 S 5 (.4...) Alr conditioning or heat pum
(requires site plan showing placement) / 14.00
City/State /ZIP: — y ei O`„e- Furnace 100,000 BTU (ducts /vents) 14.00
Suite/bldg. /apt. no.: Project name: Fumace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: 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
If r 't m oESCRII'TrIU , ^�'O W ORI J 'f t r � ”" Water heater 10.00
/ / Gas fireplace 10.00
�i1 S /1 c i �/ it 'f /e se S7 f: f S ti e J Flue vent for water heater or gas
n `C; ■ L e /e J `� ` p ,J ' L l igh 10.00
/-t- ` ° r�” �' � Log lighter (gas) 10.00
//0 „ ( 1 -1 (.4.4.....Z. ) Wood /pellet stove 10.00
Wood fireplace /insert 10.00
_: r .. ,•„ rte.: ,:" =4 ; -: "; ` ijA e �ct" is,:. ' " . . , rir: , i Chimney /liner /flue /vent 10.00
�� ` { ° P R OP ERT Y OW NER 3 . `r, ` r 4 F , ':fa N T $z r t° a
� „ ��.:;.. � .. ,...„...�r�, _ � ��., �- �' . � �1��.. �. _,, „ � r . c � _ .- `>�, _ : �bM.': Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6.80
t .; r : y ..; Y ° ` , k, "^.ti..:eNSti.:+3 ;4” .,o�a; }'a '".':.." A' ,.4:' xF`.'.'.e`�zw•� , �s�;ev, .yL
u ` , . =t1 ltW " i Y*,' f ,iii °` xgi Attic /craw ace fans 10.00
:n,7 s x ..»._., , ,: 'c . ' It` ON AG I P „, P
Business name: �/� Other: 10.00
Q - ` q p�c^ t^� i+M U e ) �. Fuel piping
Contact name: 3 — ,�,, r3 T 4 � S � $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: --i2- 14 E l as Alik S4-, Gas heat pump
City/State /ZIP: \. / 4 _,, e. LA- q 0 &DS Wall /suspended /unit heater
Phone: ( '7 - ) z 2 -- 34,9? Fax: : (3ev0) f .1 ‘, — p Z Water heater
Fireplace
E -mail:
Range
: sue.' "l ..'1'°'° 4, . CONTRACTOR. °° -,t M 4i) a Barbecue
°
�" x-n 14,- �� "�,..;�°#� �• 's��s<+'�....aa.«��`° e'Nsma:.;,,1 „ fix... �. - c±�.��.'.'v'
Business name:
Clothes dryer (gas)
Other:
_ t he _
Address. _ "� :� ”" „ 'C'HAN AL P : �� ��„: S f -
,, "` r r ..� °1vIE IG' EIi VII . ::' •
City/State /ZIP: Subtotal 1/9,0
Phone: ( ) Fax: ( Minimum permit fee ($72.50)
0.5 Plan review (25% of permit fee) 2 7. G3
CCB lie.: - S d 4 9 r, j /1 70 State surcharge (8% of permit fee) cfg
Q TOTAL PERMIT FEE i.5-- C
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ... - Date: // i 7/ * Fee methodology set by Tn- County Building Industry Service Board
I:\Building\Permits \MEC- Permit '° pp.doc 12/03 440 -4617T (11/02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information t
Commercial Fee Schedule:
To tallValuation,14 & P ermif r e 3 . ' A ;t _ a, . . , , • .
$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 12/03 2 •
CITY OF TIGARD 24 -Hour
BUI ' id. Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7--; AM PM BUP ,, //
Location � I�tL /.i _�.� Suite MEC0�D`f 0 C
Contact Person _ Ph (� 7/ ) nZ� S- 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear _
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof I,ATIW n- y w
Final
PASS PART FAIL
PLUMBING
Post & Beam •
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS- L
ECHANICAL
Post-:ear
Rough -In
Gas Line •
Smoke Dampers
ART FAIL
- - .�' ICAL
Service •
Rough -In I
Low Voltage Ie .I�,���i/. r VAV -
Fire Alarm ` -W --
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: 111 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