Permit lh
C ITY OF TIGARD MECHANICAL PERMIT
A'i" DEVELOPMENT SERVICES PERMIT #: MEC2004 -00064
� �' �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/18/04
PARCEL: 1 S 135AB -00100
SITE ADDRESS: 10350 SW LINCOLN ST
SUBDIVISION: TOWN OF METZGER ZONING: R -4.5
BLOCK: LOT: 005 JURISDICTION: TIG
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: El VENTS W/O APPL: VENT SYSTEMS:
STORIES: 2 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: Y 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: L 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm: GAS OUTLETS: 11
Remarks: Installation of gas piping & hydroponic piping for new school.
Project Value: $50,000
Owner: FEES
WASHINGTON CLACKAMAS CO Description Date Amount
SCHOOL DIST 23J [MECH] Permit Fee 2/18/04 $771.50
6960 SW SANDBURG STREET
TIGARD, OR 97223 [MECPLN] Plan Rev 2/18/04 $192.88
[TAX] 8% State Surchar€ 2/18/04 $61.72
Phone: Total $1,026.10
Contractor:
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280 REQUIRED INSPECTIONS
Phone: 244 -1900 Gas Line lnsp
Gas Line Insp
Reg #: LIC 52378 Mechanical lnsp
Final Inspection
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
Issued By: ��r,,L Permittee Signature: A/rA / 1 L1If7LI "
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Fe, : 2004 1: 33PM
0 .
04 12:17 FAX 50359 81 9H8P LASERJET 3200 0 •
CITY OF TIGARD 001
'cat Permit Application
4 111!I
FOR OFFICE USE ONLY
2 p . 2
-..,
City of Tigard
Iteeenned A _ i f I .. .. 4 66
Dates pemit Ha. :MK...400W -- a.)4V4/ 4
13125 SW Hell Blvd., Tigard, OR 97223
Plea Re a
Phone: 503.639.4171 Fax: 503.5911.1960 " 1.' DatifElie. • . I 0 51) OtherPermit
4. --
Inspection Lino; 503.6.V.4175 4 ' A 1 Data • , : y: .'. Set Page ifot
Internet: www.cd.tigard.or. us NotiflatMetboa: 3 up ptemental infarrelot1011
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Mechanical value of thc work
DA Ncw construction 0 AdditiOrlialbetatiOntreRlaCernail permit fees` are based on the
performed. Indicate the value (rounded to the nearest dollar) orali
0 Demolition 0 Other: nechtinical materia/a. equipment labor. overhead, and profit.
'fra.:.4. : /;', . ; ........- rOk Value: S - • •
` .-. o J • ., , r;• . . .. . . .. .
- --..FRNWX,... t/A . A lats•Fr,s,.. • . .
13 I- and 2-family dwelling isiCoiwnervial/industrial 0 Accessory building
For apccial Infonerarion use chenbisg.
0 Multi 0 Master builder 0 Other: Description I Qty. I E. I Total
1',1'::!!!■=ii.:;;;J'i-1100. w.
.,sri . . .Si.ifF : .-. . ; :...:::!!:ir H.D.11.2
c$
, "."-....v..,.:....„ •:., 4 •N •.•
- Air cronditioning or hem pump
lob site address /6/350 c....d ,Li N6a - (requires site elan showing pig:emend 14.00
City/State/W: - 71 oka:h . k 97z7.3 Furnace 100,000 BTU (dusuivaao) 14.00
Furnace 100,000+ BT1.I (duosivents) 17.90
Suite/bldg./apt. no.: Project name: vsNer /5,0‘ EL • inceA Gas beat pump 141)0 •-.....__
Cross Sbnet/direetiOns to job site: a 14.00
ydronic water system j ■1111111=
neat boiler (radiator
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: 1 Lot no.:
I. Other: 10.0D
Tax maptparcel no.; ' fuel Other al appliances
tt,
i ji.:. : = 1 :;:i l .:Ii.iii. : ..if': ; t 1. ...V .7 1:40.004010.0• 11 40 . : - Vtg i.: •:....!-.....:;;;:.,;::;.' ?I. •L: •:: ::' :. !!
,•," Water heater • 10.00
4 4 1 4,46C4r-• lett4..., Gas fireplace
Flue vent ibr water heater or gas 10.00
Cl
? i • t ojoi r .... s tki 11 t.■ 4 LOO fireplace 10.00
Log lighter (gaa)
I 0.00
■ 5 Ec FL!? 2 � 3 . o °s Wood/pal/et stove 10.00
. Wood fiteDlaeennserl 10 00
.
Chimney/liner/flue/vent l0.00
L".: -;.:- ..-;...... . I . . .. -5 ) IA!II,.:..1:1.• • I:'... J 3 . .. .1.4 i . *.. ' 'il i .: T4.1.. ....- • • .1..: Othcr: 10.00 •
911 • rA crt-314.A. ScS....0 4... - briT . . ElIVITOnmental exhaust and vendiadon
Range hood/Dew kitchen
Address: equipment 10.00 .
a ty/Stute/ZIP: . • Clothes dryer exhaust 10.00
- ••••••• SMgle-duct exhaust (bathrooms,
Phone: ( ) . Fax: ( ) toilet compartments, utility rooms) 6.50 .
II 41 -...! !.? liL: 3' .:- .:;..- '..., '.: .; Vi; ili11016:ipilkiiijilioNei:4,, Attie/craw i9ace fans 10.00
•
Other: 10.00 •
Business name: . • : -I piping
Contact name: op $5.40 foe One four; $1.00 (or each addtloao
.
- : eatc. Se
Address •
Gas heat pump
-
City/State/ZIP: . • ..: Walltnaspended/unit healer
Phone: ( ) I Fax: : ( ) Water healer 2.
Fireplace
E-mail: Range 20 .
: ur,",,,,...n.„74.4 ...*..- *. .,
1
..;; . .. .: '':.,:::'•'... Barbecue
6 :;;,!,,::•.. e■ :1:etle ,•• 1.5 : ' •• • " . '., 1 "... , r."'" .11 "'" •7 4 , ' , 1'. , ..- i V. - . •'1 :i . i •: •• '41 ,• •• -
Clothes dryer (Ras)
11 name: - i'o La .4A - :z Ct....3 1 ..i ted . Other 136u, CIL , le •
" dress: 611tan I 1 St..). ok tA ci- t.0 b...ekt... % L IA) . i 'j
city/statvraP: •Rn-r-- c za. C z_7_3 • it Subtotal /..' .
Minimum perm fee (S72.50)
. . ,
Ph?no: (61AS ) -- Z- s lrf-i /op I Fitz: abS ) i-sos-etir Plan review (25% of permit fee) ' / -..-- -W -• 88
a i .
CCB lie.: s 7g. State 'lurch' i a 5% of permit fee)
TOTAL PERMIT FEE 024. IT
Authorized eig . ThIS parmIl opplicodon aspires IS o permit Is noI aslOinejr...... I nu
Print name; Date:
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C /TY IN OF
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. . . ,. • . BUILDING DIVISION I