Permit o CITY OF TIGARD MECHANICAL PERMIT
e
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00271
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/30/2008
PARCEL: 2S 103D B - 00500
SITE ADDRESS: 11015 SW PARK ST ZONING: R-4.5
SUBDIVISION: MIRA PARK LOT: 001 JURISDICTION: TIG
PROJECT: WASHBURN
Project Description: Installing NC.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 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
RYAN WASHBURN Description Date Amount
11015 SW PARK
TIGARD, OR 97223 [MECH] Permit Fee 5/30/200E $72.50
[TAX] 12% State Surch 51301200E $8.70
Phone: 503- 863 -7493
Total $81.20
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B / i /� ` ■' Permittee Signature: ` %j7/
Call 503 ?'r 5 by 7:00 a.m. for inspections that busine%s day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
MAY-30 -2008 01:21P FROM: TO:5035981960 P.1
. Mechanical Permit Application D� FOR OFFICE. t SF ONI.V
I I City of Tigard RECEIVE" Received emit No.:
• n 13125 SW Hall Blvd., Tigard, OR 97223 Pl �l! ,1$ lam
Phone: 503.639.4171 Fax: 503.598.1960 Plaa Review Other Permit:
DateBy:
r l c. A Ic l� Inspection Line: 503.639.4175
MAY 2008 Dy Ready/By: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: NVI Supplemental Information
CITY OFTIGARD
TYP OF W J 1LDING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
1:3 New construction X Addition/alteration/replacement
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"
I - and 2-family dwelling ❑ Co
Master b i ui ld stria) ❑ Accessory building For special Information use checklist.
Multi - family ❑Master blder ❑Other: Description Qty. Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 11015 r V sired- Air conditioning or heat pump '
'' (requires site plan showing placement) 14.00
City/State/ZIP: 1I�(� 1 25 Furnace 100,000 BTU (ducts/vents) 14.00
U " Furnace 100,000+ BTU (duets/vents) 17.90
name:
Suite/bldg. /pt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Flue /vent for any of above 6.80
Subdivision: • Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater _ 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
1yroj jM 1 air a/'o f -o rt/' fireplace 10.00
,�F'+�[CU/ 1I�V41 l Uu �.v �ln V 1 l� rf Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWN R ❑TENANT Other: Chimney/liner/flue/vent 10.00
W her: 10.00
Name: roma 1 Et Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
n ) -7
Single-duct exhaust (bathrooms,
Phone: Fa x: ( ) c
toilet compartments, , utility rooms) 6.80
%APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: Other: 10.00
I IW I t M �1 Fuel P i p ing _
Contact name: 55.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) F x:: ( ) Water heater
Fireplace
E-mail: Range
I CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: -nr) / � �, 1 , p, Other:
Address: 13 15 6� . y `( MCL5 VC 1 Y v MECHANICAL PERMIT FEES*
City/State /ZIP: C. V el 1 C II Og-54:11345 Subtotal
Phone: ( 'r, 56/ , r Fax: ( S7 QQ,q Minimum permit fee ($72.50) ---7)-\ 52
Plan review (25% or permit fee) 7
CCB lie.: 72.4 State surcharge (12% of permit fee)
TOTAL PERMIT FEE �t�
Authorized signature:
Thi permit a pplication expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: '� ('A Date: " 0 j Fee methodology set by Tri•County Building Industry Service Board
t•l auitdieglperm,u\MEC•PermilApp.doc 01119/07 440- 4617T(11 /02/COM/WEB)
•
MAY 30 -2008 01:21P FROM: 70:5035981960 P.2
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.CITY OF TIGARD
BUILDING DIVISION ,. - PERMIT #: MEC200B -00271
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2008
Phone: (503) 639 -4171 :TV
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 6/18/2008 TIME: 7:02AM PAGE: 62
SITE ADDRESS: 11015 SW PARK ST CLASS OF WORK:
SUBDIVISION: MIRA PARK LOT #: 001 TYPE OF USE:
PROJECT NAME: WASHBURN
DESCRIPTION: Installing NC.
OWNER: WASHBURN, RYAN PHONE #: 503-863-7493
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503 - 557 -2220
Inspection Request Scheduled For: Date: 6/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 071513 -01 503.557 -2220 Y
Corrections/Comments/Instructions:
r ,09,G,,,,,, , / , /0 l -
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ;NO ACCESS
AIL 1XLALL FOR INSPECTION ❑ ADDITIONAL FEES SSESSED
Inspector: ' f,k✓' ) Date: Phone #: � / 'd
P � Co 6 (503) 718 -
�
v
Mt OF TIGARD
BUILDING DIVISION PERMIT #: MEC200B -00771
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2008
Phone: (503) 639 -4171 ;�i1l
Inspection Requests (24 Hrs.): (503) 639 -4175 _ s __..
INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7:01AM PAGE: 57
SITE ADDRESS: 11015 SW PARK ST CLASS OF WORK:
SUBDIVISION: MIRA PARK LOT #: 001 TYPE OF USE:
PROJECT NAME: WASHBURN
DESCRIPTION: Installing NC.
OWNER: WASHBURN, RYAN PHONE #: 503- 863 -7493
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503-557-2220
Inspection Request Scheduled For: Date: 6/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 071604 -01 503.863 -7493 N e Th
Corrections /Comments /Instructions:
S 6L c-, Zi4 4- � -(.- Y.r'✓°) "V li ak/L� /55 " S
❑ PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: G-- --ov Phone #: (503) 718 -