Permit CITY TI CARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00526
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/25/2005
PARCEL: 2S 101 AB -01501
SITE ADDRESS: 07555 SW HERMOSO WAY 200 ZONING: MUE
SUBDIVISION: HERMOSO PARK LOT: 021 JURISDICTION: TIG
Project Description: Re- locate HVAC outlets & ducts. Valuation: $795.
CLASS OF WORK: OTR 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: WOODSTOVES: •
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
LIONEL LLC Description Date Amount
7555 SW HERMOSO WAY [MECH] Permit Fee 8/25/200: $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 8/25/200E $5.80
Phone: 503- 620 -5203 Total $78.30
Contractor:
FAITH HEATING & AIR COND. INC •
15167 NW VANCE DRIVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97229
Phone: 503 356 - 8686
Reg #: LIC 133911
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: --. )7d . 3) .. .,6. 1 fteC Permittee Signature: :
Call 503 - 639 -4175 by 7:00 a.m. for inspection 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 ADDlication�V - FOR OFFICE U SE ONLY .
• f Recei
City of rigalr� Date/By. 1 , " p � Permit No _ j / '114 6
13125 SW Hall Blvd., Tigard, OR 97223 --r-- AUG „...,,....1
�(` 17 20�� , Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 I ,.. ,, Plan Daze /By.
•
Review
Inspection Line: 503.639.4175 r. �( i i
ard.or.us DateReady/By: 0 See Page for
Internet: www.ci.ti
g CITY OF TIGARU Non fied/Method: Supplemental Information
Ett ntnt(-1 nIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction g..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.
• CATEGORY OF CONSTRUCTION. Value: $ '757. d D
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. I Total
' JOB SITE INFORMATION AND LOCATION Heating /cooling
_j w yep y
Air conditioning or heat pump
Job site address:
S; r [ (�C./� -�d � � / (requires site plan showing placement) 14.00
City /State /ZIP: n( ti , 6A t 7 a a 3 . Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: aO-c.) Project name:4 f C 6-"eejt.ripols Gas heat pump 14.00
Cross street /directions to job site: Duct work 7 14.00
' n q I Hydronic hot water system 14.00
7,1,144 7b 4EvE � s1 (L/'44(d 1,0-Gi--6/7) _ Residential boiler (radiator or
�J o (
6 c to � � hydronic) 14.00
c� Unit heaters (fuel -type, not electric),
5",_.& rottClZC t( i q :t R A in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
y- �"� Gas fireplace 10.00
r �/vo�A(r Zn / ° Flue vent for water heater or gas
RE — Ld - c 4 tE 4 c e n t_ " fireplace 10.00
Log lighter (gas) 10.00
. R /t 7 e f /C(C. (,�9 rat-Li— Wood /pellet stove 10.00
Wood fireplace /insert 10.00
• PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00 .
},,-� Other: 10.00
Name: 4attef ) L � G (myki�C'C/"( "Oa) Environmental exhaust and ventilation
Address: 96 S � S' ,(,J ( e/I �'� (.01 > J Range hood/other kitchen
equipment 10.00
City /State /ZIP: t16 Ata OA T707 oZ 3 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) ao - 3- &4 Fax: (J3) 6020 51373 3 toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
� � Other 10.00
Business name: S /Nt t : �f / i V4 Fuel piping
• Contact name: 0e DA Vt SD v $5.40 for first four; $1.00 for each additional
•
Furnace, etc.
Address: SE
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) 57 Fax: : ( ) if/iV(if Water heater -
Fireplace .
E -mail:
Range
• CONTRACTOR Barbecue
Business name: it(� ?jN — ,l', CoN ?7cw'6 f - Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
��3) / 77 pq Fax: ( 7) A-/7_ p es ty Minimum permit fee ($72.50) 7 ,)13
Phone: (
tD ��- 1 ! u O �J ( 7 ! Plan review (25% of permit fee)
CCB lic.: / 33 cri / State surcharge (8% of permit fee) 1
TOTAL PERMIT FEE '*,,,2 Q
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: * Fee methodology set by Tri- County Building Industry Service Board
i.\ Bui [ding \Permits\4MEC- PermitApp.doc 12/03 440 -46I7T (I 1/02 /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
$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
BUILDING DIVISION PERMIT #:M1. – G05
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171Nlu�uq'�h .
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: ( cjtes — TIME: PAGE:
SITE ADDRESS: 7� - fl U -#-200 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
1 PROJECT NAME: C.,0 G � T .
DESCRIPTION: `�
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
W tlittUE_Ct ,
' Corrections /Comments /Instructions:
,lr;
a,i1►
( lkT.'4.-L' V .
PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED
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Inspector: Date: ` 0 7 (O h on e #: (503) 718-