Permit CI TY - o F TIGARD MECHANICAL PERMIT
F yn PERMIT #: MEC2004 -00040
DEVELOPMENT SERVICES DATE ISSUED: 2/3/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY`205
SUBDIVISION: HOFFARBER TRACTS NO. ZONING: C -G
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS WIO 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:
Remarks: Replace existing rooftop unit with new unit of less weight. Project Value: $6,250
Owner: FEES
TIGARD PROPERTIES INC Description Date Amount
2106 SE OCHOCO ST [MECH] Permit Fee 2/3/04 $164.90
MILWAUKIE, OR 97222 [TAX] 8% State Surchar€ 2/3/04 $13.19
Phone: Total $178.09
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED INSPECTIONS
Phone: 503 - 266 - 1249 Mechanical Insp
Final Inspection
Reg #: LIC 14008
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 Not ation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
95 • 1 - 0100. ∎ u may • stain copies of these rules or direct questio C by calling
(- 13)246 -6699.
I sued By: Alt / Permittee Signature:
Call (5o 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application FOR OFFICE USE ONLY
City of
Received
Date/By: , Permit No.: !,
Tigard . — v
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 / /amc I Y \ Date/By:
Inspection Line: 503.639.4175 �J, j. F! Date Ready /By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
. TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction . g
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: - mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 6).5o • 0 0
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling WCommercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
1 ,� IJ Air conditioning or heat pump
Job site address: I I Q `i t✓ S GIN. pA (Ft t:- 1V l , (requires site plan showing placement) 14.00
City/State/ZIP:7' 6 P 0 Furnace 100,000 BTU (ducts/vents) 14.00
t / Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: (9 _
QZ
E s Gas heat pump 14.00
Cross street/directions to job site: N ALL R LV 6. Duct work 14.00
Hydronic hot water system 14.00
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.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
f) Gas fireplace 10.00
RooF Tor t;( -1-/A ")( nU [ - Tel d uL v AA-"-- Flue vent for water heater or gas
`'� J fireplace 10.00
Lo Ld1Al ■ - - 'L D AAA Ll o • Log lighter (gas) 10.00
• Wood/pellet stove 10.00
. Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
,PROPERTY OWNER ❑ TENANT Other: 10.00
Name: jNt1i_."1"c —' K2owt• - Environmental exhaust and ventilation _
Range hood /other kitchen
Address: 1 gay pJG U'(. 99 equipment 10.00
City/State/ZIP: V t c t I ote. J/k5N . 9 ((o Co C Clothes dryer exhaust 10.00
r Single -duct exhaust (bathrooms,
Phone: (5o3 ) 6,(-1. 3 - s i S 7 Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: t4 l-I ( J V Fuel ng t i
P�P�
Contact name: 12_A1.F - E2 , L WA LI. f $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: & 9q d D $Vi,...d i7 Gas heat pump
City/State/ZIP: ri N L. 0 2., q 3 • Wall/suspended/unit heater
I Fax :: (so S) 2 (.e - 3 L g Water heater
Phone: (SO 3)�( ( - 1.1 4 q Fireplace
E -mail: Range
CONTRACTOR Barbecue
'(� Clothes dryer (gas)
Business name:
sAim C A S Az o✓ Other: I .
Address: . MECHANICAL PERMIT FEES* • .
City/State/ZIP: • Subtotal , •, e
Minimum permit fee ($72.50) ($ . 7C
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) r p
CCB lie.: I y' 00% State surcharge (8% of permit fee) /'d. / /
TOTAL PERMIT FEE jai 0
Authorized si atur ��_ This permit application expires If a permit is not obtained within 1 0
...ki days after it has been accepted as complete.
Print name: F L c _ tYe t t, w ,,// A L. Date: „7..( / L+ • Fee methodology set by Tri -County Building Industry Service Board
i:\ Building \Permits\MEC- PermitApp.doc 12/03 440 -4617T(II /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. c�D
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and 3'
$1.80 for each additional $100.00 or �a
fraction thereof, to and including
$10,000.00. /„ 1
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and f� ' 1
$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 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION = b Business Line: (503) 639 -4171 MST
BUP
Received 3 C Re ested f2hJ /4M PM BUP
Location // ? T , 5 3. 7" Suite 400 : VO
Contact Person / Ph (_c50_3) !f yf ' 7 fz-/V PLM
Contractor - Jnii • Ph ( ) SWR
BUILDING Tenant/Owne` ■� /� �` � ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam / '` r
Shear Anchors `f�/
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
- FAIL
• ANIC
• • & Beam
Rough -In
Gas Line
Si oke Dampers
PART FAIL
E - - ICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before 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 94211 11 toil Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL