Permit 111
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00190
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/16/2008
PARCEL: 1 S 126CA -00100
SITE ADDRESS: 09225 SW HALL BLVD ZONING:
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: LAROG JEWELERS
Project Description: TI. Valuation: $4,000.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M 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:
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:
> 10000 cfm:
•
GAS OUTLETS:
Owner: FEES
BARRY MENASHE Description Date Amount
621 SW ALDER, STE 605
PORTLAND, OR 97205 [MECH] Permit Fee 4/16/200E $118.50
[MECPLN] Plan Rev 4/16/200E $29.63
[TAX] 12% State Surch 4/16/200E $14.22
Phone: Total $162.35
Contractor:
UNIVERSAL HVAC INC
PO BOX 1950
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 329 -6183
FAX 503- 482 -5895
Reg #: LIC 157483
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 B Permittee Signature: `1 J11
Call 5l 0%• 9.• 175 by 7:00 a.m. for inspections that business day. r
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 OFFICE USE ONLY
• City of Tigard Received
• - 97223 13125 SW Hall Blvd., Tigard, OR 9722 b9 Date/
III
By: �� ��� Permit No.: 7)-2,5-....9_0(3&-_ �` l�
Plan Review
Phone: 503.639.4171 Fax: 503.598. •9S0 ��oa Date/By: Other Permit:61,��� L ��x V
Inspection Line: 503.639.4175 "� 1 vv // vC C J`Z
T,IGARD ■ DateReadyBy: Juris' H See Page 2 for
Internet: www.tigard-or.gov `) �t(3 y r V4otified/Method: Supplemental Information
3 R
.COMMERCIAL FEE *_ SCHED .— `USE.CHECKLIST
TYPE OF. WORK k \ �t \h�.� . : _ ....
❑ 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, ye head, and profit.
- CATEGORY' OF CONSTRUCTION '
Value: $
'.RESIDENTIAL'EQUIPMENT /S ,STEMS FEES*:.
❑ 1- and 2- family dwelling Commercialindustrial ❑ Accessory 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: ) ( / L , ) Air conditioning or heat pump
�� / / �( J (requires site plan showing placement) 14.00
/
City/State /ZIP: !� O 1e Furnace 100,000 BTU (ducts /vents) 14.00
�/ / /�_ Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: V Project name:
Gas heat pump 14.00
Cross street/directions to job site: / Duct work 10.00
A j�_ 1( $ /_ _ Hydronic hot water system 14.00
T'J� l ` 1 �rP�(fJ /.�!/✓ 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 OE WORK .. • Water heater 10.00
. '1( 4) . Gas fireplace 10.00
eidlo cS'f' A 1 G' 4 G, Flue vent for water heater or gas
w _L ' `Z ,�f-- fireplace 10.00
,` V��( '" C�S`Q'�'� Log lighter (gas) 10.00
(-7 I Favl s Wood/pellet stove 10.00
Wood fireplace /insert 10.00
•
''PROPERTY ,OWNER Chimney /liner /flue /vent 10.00
❑ T ENANT.
Other: 10.00
Name: `r( /1/( /�r,SGt.2z_ Environmental exhaust and ventilation
Address: 6 t, /'( 5 , ( �� �� C' C ;c5 qu i phood/other kitchen
1 J wit_/ e u men 10.00
City /State /ZIP: "0r �F�� llr7 Clothes dryer exhaust 10.00
( Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawispace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) F ax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: (
JA `Q�
Clothes dryer (gas)
Vv " � ��� L �e' !-li � � � Other
Address: MECHANICAL PERMIT FEES *.'
City /State /ZIP: efrre - 7 ;%� Subtotal
vw` - ""`t 9 7 / Gl Minimum permit fee ($72.50) if )... S
Phone: ( ea $ Fax: (S Q c _ 5
O $) Plan review (25% of permit fee) , CO3 �
CCB lic.: f 7 D f 1- 3 f? 1 ) 1 (C /r l C� State surcharge (12% of permit fee) /2, a�
TOTAL PERMIT FEE g o -. 5
Authorized signature: This permit application expires if a permit is not obtained within 180
!J i days after it has been accepted as complete.
Print name: . , r"' Date: * Fee methodology set by Tri- County Building Industry Service Board
I:\ BuddingWermits \MEC- PermitApp.doc 01/19/07 440 -4617T (11 /02 /COMJWEB)
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 01/19/07 2
'
CITY OF ��n m w n��m TIGARD
BUILDING DIVISION ~' ' ' ' PERMIT #: &0E<32OD�0l19O
| � �� - � � - - '
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/102008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ,..1-0 ill.
INSPECTION WORKSHEET FOR DATE: 5/1/2008 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 0Q225[W HALL BLVD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LAROG JEWELERS
DESCRIPTION: TI. Valuation: $4.000.
OWNER: k4ENASME.8ARRY PHONE#:
CONTRACTOR: UNIVERSAL HVAC INC PHONE #: 503-329-8183
Inspection Request Scheduled For: Date: 5/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 069174'01 503-329'6183 N
Corrections/Comments/Instructions:
-
IV% dr
fPARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
I I FAIL ri CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
___
|nopectoc ��
Date: � / /��� Phone #: (503) 718-
}'
'~
CITY OF ��nn m ��m nu�m��mm��
BUILDING DIVISION ~�' ^-- PERMIT #: k4EC2OUH-OV19O
| ---'--'-- -'-'-'-''
1 13125 SW Hall Blvd., Tigard i `' ^
.OR072�3 DATE ISSUED: 4/102008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 .44.1 Ail.
INSPECTION WORKSHEET FOR DATE: 4/17/2006 TIME: 7:02AIVI PAGE: 23
SITE ADDRESS US226'8yY HALL BLVD CLASS OF WORK
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LAROG JEWELERS
DESCRIPTION: T|. Valuation: $4.000.
OWNER: MENASHE, BARRY PHONE #:
CONTRACTOR: UNIVERSAL HVC INC PHONE #: 603-329-6103
Inspection Request Scheduled For: Date: 4N7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
625 Duct work 068538'01 503329'6183 Y
Corrections/Comments/Instructions:
.
^ ��N�
���� � ��|ALAPP��L �� NO ACCESS
�
_ / / �� ��
| | FAIL , 0 CALL FOR INSPECTION AOODl•NAL FE S ASSESSED
/
- L -{�
2� �
Inspector: Date: / �' Phone #: 8503\ 718-
/