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Permit C ITY OF TIGARD MECHANICAL PERMIT � � DEVELOPMENT SERVICES PERMIT #: MEC2004 -00306 ..� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 6/7/2004 PARCEL: 1S136CD-00101 SITE ADDRESS: 11675 SW PACIFIC HWY SUBDIVISION: ZONING: C -G BLOCK: LOT: 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: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: 88,000 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: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: 1 Remarks: Replace existing 7.5 ton rooftop unit with same. Project Value: $8,825 Owner: FEES MILLAR, TED L TRUSTEE Description Date Amount BY WILLIAM C FLOBERG [MECH] Permit Fee 6/7/2004 $211.70 834 SW ST CLAIR [MECPLN] Plan Rev 6/7/2004 $52.93 PORTLAND, OR 97205 [TAX] 8% State Surchar€ 6/7/2004 $16.94 Phone: Total $281.57 Contractor: AMERICAN HEATING INC 1339 SE GIDEON STE 1 REQUIRED INSPECTIONS PORTLAND, OR 97202 Mechanical Insp Phone: 239 - 4600 Final Inspection Reg #: LIC 33135 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 UNC by calling (503)246 -6699. Issued By: Permittee Signature: Call (503 6394175 by 7:00 P.M. for inspections needed the nex usiness day / /«S 5tN PACIFIC $LNy • Mechanical FOR OFFICE USE ONLY chanical Permit Application Received �� Mechanical Date/By: 5 (d 5� Permit No.: f * 'Ot 3 Cit of Ti and Planning A.proval Building y g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Other Tigard, Oregon 97223 Date/By: 6 Or70. Permit No.: Phone: 503- 639 -4171 Fax 503 -598 -1960 Post - Review Land Use ti -4 t IA Date/By: (p �7' o ,` � Case No.: Internet: www.ci.tigard.or.us 'e• Contact El See Page 2 for 24 - hour Inspection Request: 503 639 - 4175 Name/Method: _ (taP _ Supplemental Information. -. .. ,. : T,YPE WORK''r_ ' - '.`'. ' . ;- < =;; ; -'; ,- COMMERQAI:LFEE ;. SCHEDULE =: USECHECKLIST _-;i , -; ❑ New construction p Demolition Mechanical permit fees* are based on the total value of the work © Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all w CATEGORY:OF CONSTRUCTIONJ.,- r,: 'i., . .�`: mechanical materials, equipment, labor, overhead and profit. ❑ 1 & 2- Family dwelling �/ Commercial/Industrial Value: S a, F Xfi• ,0 See Page 2 for Fee Schedule . ❑ Accessory Building ❑ Multi - Family '4RESIDE n .EQUIPMENT/SYSTEMSEEE *:SCHEDULE,..:._ Description I Qty I Fee(ea.) I Total ❑ Master Builder ❑ Other: . - Heating/Cooling �: c,ATOB: SITE= INFORMATION -ai dLOCATION` r - -','` ** - � ` Furnace - add -on air conditioning 14.00 Job site address: J j g 5- W pae l F'IC. 14 wi _ Gas heat pump 14.00 Suite #: I Bldg. /Apt. #: Duct work 14.00 Project Name: Wm Co.,.,T f34 A IC Hydronic hot water system 14.00 Cross street/Directions to job site: (for boiler (for radiator or hydronic system) 14.00 ree- 5 AAA4, Unit heaters,(fuel, not electric) (in wall, in duct, suspended, etc.) 14.00 Flue/vent (for any of above) 10.00 Subdivision: I Lot #: Repair units - 12.15 Tax map/ parcel #: Other Fuel Appliances ax ma p p Water heater 10.00 _ CTESCRIPTION OF WORK ` . .,4 - gs.;, • , . "- ;. ^ Gas fireplace 10.00 R ep —iaeF .Awi exlei ilic 1,1,4° TO4 Flue vent (water heater /gas fireplace) 10.00 1. JVJ c LINT UU' T iI N IA - 7..s 704 Log Wood/Pellet a) 10.00 Wood stoove 10.00 �. I IVZiC I4tfi Wood fireplace/insert 10.00 Chimney/liner/flue/vent 10.00 U) M 'P.ROPERTYOWNER ` 'HF -1 4ENANT';: '_' Other: U) Name: C r � _ , C . Environmental Exhaust & • .�.�n1 Address: Range hood/other kitchen equipment 10.00 1 8 Q % Clothes dryer exhaust 10.00 M City /State /Zip: Wu...3aM I Luz Ott 41"1 010- E0 co Single duct exhaust Phone] /L t, 33701 FaX 6 $ 1 3353 (bathrooms, toilet compartments, 'El-APPLICANT • IP • ONTACT-PERSON P'.`,: utility rooms) 6.80 Name: 8013 T :-.1 - - 5 m I t s Attic/crawl space fans 10.00 _ • Other: 10.00 NI Address: 3 9 1 E 6.,,,,44-0,4 S T 3 5 • Fuel.Piping Q City /State /Zip: pGA g... Q Q 1.7 .'t.Q y ••($5.40 for first 4, $1.00 each additional) ((� Phone: Fax: Furnace, etc. ** �J 503- 2a�1•� ^1600 .�3 �f �O� Gas heat pump .* E -mail: 5m criy a•bot„sn,t -0hl i4te:.1brita% .Nt+TT WalVsuspended/unitheater .. , .. • .. "CONTRACTOR :...: _R_'! ,,.=.!,::,-..:',..-;?;...-: ; : Water heater .* Business Name: _Atnrs-Qtc is4 I.IA T, .1NC - Fireplace ** Address: 1334 s 6.,,, & o ,, Range ** City/State/Zip: BBQ ** c\, Y P fJo�TC.•� OR �� � Phone: Clothesdryer I Fax: ,2 = 7 03 S Other: •• Sea 23 �1 46 0 0 _ CCB Lic. #: / 3 t - y— / Total: Authorized Mechanical Permit Fees Signature: /. [. ,� ( ' /Date: ,Z / O ! Subtotal: $ ,� /i • 70 i- ` Minimum Permit Fee $72.50 $ O,Bt1x{ t .. - /j4 ' 'rp I Plan Review Fee (25% of Permit Fee) $ 5a • ? 3 (Please print name) State Surcharge (8% of Permit Fee) $ /6 • vi TOTAL PERMIT FEE $ a 8 / . 57 Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST _- BUP Received Date Requested 7 1 AM PM BUP ,/ Location 5 /9 .. / Suite MEG `f - d 630c Contact Person ' ... ./_ Ph ( ) 793 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner �,((.44z.___ ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes ,, //��//�� - SIT Post & Beam t!.G��Ci�— z4 ' rieft./ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation _ _ _ _ _ ..._ Drywall Nailing £1Q Fire Firewall Fo r r zi� Sprinkler Fire Alarm ` Susp'd Ceiling Roof Other: Final ' I PASS PART FAIL PLUMBING g Post & Beam Under Slab il,� 4 _- Rough -In 1 IT Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain ` Shower Pan Other: ' Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers r PASS PART FAIL ELEC - ICAL Ilan■ fa 4111111mr. Rough -In i�i���1 / _ I _ Low lt AIII1k Vo IIP Low Voltage , T Fire Alarm AV Final Li O Reinspection fee of $ required .efore next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 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