Permit a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00580
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/20/2006
PARCEL: 2 S 102AC -01701
SITE ADDRESS: 12700 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Furnace upgrade. Valuation: $10,000.
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:
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
CHC ENTERPRISES LLC Description Date Amount
18100 SW KRAMIEN RD
NEWBERG, OR 97132 [MECH] Permit Fee 11/20/20( $231.50
[TAX] 8% State Surcha 11/20/20( $18.52
Total $250.02
Phone: 503 - 516 -9509
Contractor:
R + S HEATING INC
1123 MEADOWVIEW COURT
WEST LINN, OR 97068 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 657 -4137
FAX 503- 657 -4137
Reg #: LIC 70720
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: .1 4
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.
Mechanical Permit Atm Mit OFE i: (11.1 IC I'SL.1
1 City of Tigard �� � � � � � I
Received — ►
q 13125 SW Hall Blvd., Tigard, OR 97223 tc�� 0 Phone: 503.639.4171 Fax: 503.598.196�OV G 1° Plan Review
Date/By. 2006 Other Permit:
TI G A R I� Inspection Line: 503.639 CITY OF TIGARD Date Ready/By. 111,1 la See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
• CI New construction sAddition/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, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: $ / 0 O'0 ()
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 and 2 family dwelling laCommercial/industrial ❑ Accessory building
CI Multi For special information use checklist.
❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling -
Job 0 I� t�1 n /-. Air conditioning or heat pump
obsite address:
/ 9 / 00 s t U.9 • [ I T i /-1 - /(W (/ (requires site plan showing placement) / 14.00
City/State/ZIP: o� t8j G2 r ( Furnace 100,000 BTU (ducts/vents) / 14.00
/ t Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: I Project name:
Gas heat pump 14.00
Cross street/directions to job site: 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
Subdivision: Lot no.: Flue/vent for any of above / 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Ch 14.4v, 4 p (c ?ALS pc/ Z/t> e Le CA Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
PCJKA-/AC e I /; s -eeg "/c_ Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent
10.00
Name: eh j rf !s.kyr C p�.e .e Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone 3) L c? (., .. 476-70 9 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
sl Address:
*`{ Furnace, etc.
Gas heat pump
City / State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax :: ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: Pi S We /4.,Cfil J f'4 T' 0— Other:
Address: / (9 3 y ,. Co C., MECHANICAL PERMIT FEES*
City /State/ZIP: &j re j'T i INA.,) Subtotal
Phone5(J3 ) 6,57 .— y/3 #1 Fax: 03) 6,547 ,. 4 f 3% Plan review (25%0 of permit fee)
CCB lic.: rio ea. o State surcharge (8% of permit fee)
///��� TOTAL PERMIT FEE
� Q n ' _ This permit application expires if a permit is not obtained within 180
Authorized signature: /v" /[�'� / ` • days after it has been accepted as complete.
Print name: Ref SS 0 a /fp ex._ I Date: // / ?0 /O c � Fee methodology set by Tri- County Building Industry Service Board
1:( Building \Pemits\MEC- PennitApp.doc 06/06/06 440.46ITr(11 /02/COMM/W EB)
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 12/30/05 2
CITY OF TIGARD - I -
•
BUILDING DIVISION PERMIT #: MEC2006 -00680
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/20/2006
Phone: (503) 639 -4171 li ;., I �G
Inspection Requests (24 Hrs.): (503) 639 -4175 I ..
INSPECTION WORKSHEET FOR DATE: 1218/2006 TIME: 7 :01AM PAGE: 45
SITE ADDRESS: 12700 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE AGENCY
DESCRIPTION: valuation: $10,000.
OWNER: CHC ENTERPRISES LLC, PHONE #: 503-616-9509
CONTRACTOR: R + S HEATING INC PHONE #: 503-667-4137 ,. - _
Inspection Request Scheduled For: Date: 1202046 0Vr Pour Time:
f
Code # Inspection Description Confirm # Contact # M: -sage
615 Mechanical rough -in 040825-01 503- 805-4408 Y eAcIZ
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
It
f ug /d
Inspector: Date: Phone #: (503) 718- 2- _