Permit V 4
CITY TIGARD MECHANICAL PERMIT
A Ali rik DEVE LOPMENT SERVICES PERMIT #: MEC2006 -00099
°' DATE ISSUED: 2/17/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S110DC -01000
SITE ADDRESS: 11295 SW MEADOWBROOK DR 1 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 014 JURISDICTION: TIG
Project Description: Unitl, install dryer vent.
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: 1
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
SUMMERFIELD ASSOCIATES, LLC Description Date Amount
HSC REAL ESTATE [MECH] Permit Fee 2/17/200E $24.25
1500 SW 1ST SUITE 1020 [TAX] 8% State Surchaq 2/17/200E $1.94
PORTLAND, OR 97201
Phone: 503 - 546 - 5712 Total $26.19
Contractor:
SKYWARD CONSTRUCTION
15908 NE 10TH AVE REQUIRED ITEMS AND REPORTS
RIDGEFIELD, WA 98642
Contact #: FAX 360 -546 -1630
PRI 360 -546 -1625
Reg #: LIC 158289
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: Permittee Signature: Mi q
io
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.
02/10/2006 11:50 FAX 5035981960 CITY OF TIGARD t1
Mechanical Permit Application - - roR OFF 1.15r OTi Y. E
Received h I permit No
City of Tigard Date/By: it b ' =VI . , i0 - 'r009
13125 SW Mall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' yn : gi , ll DatcBy: Other Pe ,it: �T
_ „,a> ;'i J+
Inspection Line; 503.639.4175 AN. ` ^ l N Date Ready/By: Yage 2 Por
Internet; www- tigard- or,gov Nuti(icd/Method: In SuppternentalInformation
•
. ,. TYPE OF WORIE ::
:!COMMERCIAL S.CIIED[1LE - USECH ECIfL15T
❑ New construction ❑ irion/alteration / replaeement 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: $
.. RESIDENTIAL' EQUIPMENT/ SYSTEMS FEES” .
❑ 1- d 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For' special information use check /fst. •
lar Auld-family 0 Master builder ❑Other: Description [Qty, Ea. Total
. • JOB SITE. INFORMATION .011 . LOCATION: . . ' H,eatin_ eoolin:
ditioning or heat pump
Job site address: II �C4 �� lain )—if, /}17060 6(.- ppfy�Q, �^ Air conditioning
Elves site plan showingylacernent) 14.00
City /State /ZIP; . G 9 7s7 Furnace 100,000 BTU (ducts/vents) 14.00
C' ,, Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg./apt— no.: L) ii - 1 Project namc51 t hta".t-4 Gas heat pump 14.00
Cross street /directions to job site: D - , ,.{ED ' mite._ Duct work 14.00
i Hydronic hot water system 14.00
_CLEF < , _ cl Ci ►:� i _ Residential boiler (radiator or
• hydronic) 14.00 .
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00 •
Subdivision; Lot no.: I 10,00
_ Other:
Tax map /parcel no,: Other fuel appliances •
DESCRIPTION OF WORK . _Water heater 10.00
•— 1 Gas ft replace . 10.00
I 1 4.3 . -__fr-'-, v , O � f � Flue vent for water heater or s
fireplace 10.00
Dp?---1 aka... l L og lighter (gas) 1 0.00
WOOd /pellet stove 10,00
Wood fireplace /insert • 10,00
^-: Chimney/liner/flue /vent 10.00 • ROPE:RTY OWNER , . • .:. ❑ ;T • .. O t h er. 10 .00
Nan7e5Y o As.....--r...r, ,A-T—,&-.5,, C_ Environmental exhaust and ventilation
/ ��� ,. Range hood /other kitchen
Address: i '0 c t ry Ala. .,"• u (TS u "Zv' equipment 10.00
City /State /ZIP; Po .M 0 c„.,(._ c1 72C i • Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (O3 t , -5 /i 2_ Fax: ( i3 X 54 ,&i ;J5 3 d , toilet comparrrner ts, utility rooms) 6.80
' LLJ'APPLICANT ' • • 1_4 ONTACT ,'PERSON Attic /crawlapace fans _ 10.00 •
Other: 10.00
Business name: j ; �) C�i.;b5- p Th � Fuel •i. ht:
Contact name: Y -7 -7 .A- Q S5.40 for first four; $1.00 for each additional
Furnace, etc. .
Address: Gas heat pump — •
City /State/ZIP: Wall /suspended/unit heater
--• Water heater
Phone: et t)) �„p`'G(4- l <2 Fax ( )
Fireplace
E -mail: Range
CONTRAC2 0R Barbecue
• . Clothes dryer (gas) _
Business name:3 • t..4 x . R , Cc, t-,....( e is i, L - w ,J L - Other: I
Address: t5ge.) 06 c&-i -t 4v . • • .. :. H. ANICALoEit
kto MIT FEES° ..
City /State /ZIP; ;/s ( ,D _ . - — — Ur) ` ,' 13 4 Z- Subtotal
��� Minimum permit fcc (572.50) ROM
Phone: (,,e') --. " t C Fax (34 r) Cj 7 I C2. 0 Plan review (25% of permit fee)
CCB lie.: t a, � State surcharge (g% of permit fee) Ea
' — ^ TOTAL PERMIT FEE •
� - / - +4:C) i4 -a 0) AT . " This permit application expires Ira permit in not obtained w in I SO
Authonled sign Tr ! d - days days after it has been accepted as complete
- �.+� - ' C v-- D a te: . i _ � � * Fee methodology ,4et by TO -County Building industry Service Board
print name:
CITY OF TIGARD f' 'c
BUILDING DIVISION PERMIT #: 1,0 O�' OO d 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 1 N10f1#
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: TIME: 0 PAGE:
SITE ADDRESS: ) / �—�— 0 „�� f CLASS OF
OF WORK: RK:
SUBDIVISION: / / '
PROJECT NAME:
DESCRIPTION:
OWNER: • PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3— — a ce our Time:
Code # Inspection Description Confirm # Contact # Message
I S y 3/ 0 -- 7/?7
Corrections /Co ents /Instructions:
/1,
s
) r
a I FAss- n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Ins a 1. ' m I!/ ` 4. �/� 718- 2— `' r
p ctor: Date: / / Phone #: (503) 718