Permit •'
� ► , CITY OF TIGARD MECHANICAL PERMIT
i� DEVELOPMENT SERVICES PERMIT #: MEC2003 -00728
��� ..� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/8/04
PARCEL: 1S135DA-01000
SITE ADDRESS: 08530 SW PFAFFLE ST
SUBDIVISION: METZGER ACRE TRACTS ZONING: C -P
BLOCK: LOT: 020 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: 1 BOILERS /COMPRESSORS HOODS: 1
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 162,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 4
> 10000 cfm: GAS OUTLETS: 4
Remarks: TI mechanical for kitchen. Value: $4,350.00
Owner: FEES
DAVE DALTON Description Date Amount
17930 SW MCEWAN [MECH] Permit Fee 3/8/04 $127.70
TUALATIN, OR 97062 [MECPLN] Plan Rev 3/8/04 $31.93
[TAX] 8% State Surchar€ 3/8/04 $10.22
Phone: 503 267 - 4419 Total, $169.85
Contractor:
MANFORT HEATING /AIR CON
PO BOX 30431
PORTLAND, OR 97230 REQUIRED INSPECTIONS
Phone: Gas Line Insp
Hood Inspection
Reg #: LIC 00057455 Misc. Inspection
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 -0010 through OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699
Issued By: I0)' , /L/ ,_ _ '�I Permittee Signature (�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
es -sw prA 'c6
Mechanical Permit 441 ;A i ., tion FOR OFFICE USE ONLY
G� Received • • Mechanical /� - �,,,,,,
DateB a
: , 'j P3 •• Permit No.: 003 "oa -
City Tigard Ti d �� PlanningAp�rova Building
• g Op3 DateB : Permit No.: A 13125 SW Hall Blvd. C Plan Review ` Other
Tigard, Oregon 97223 �� ARC
Date/B y : — '0 / / Permit No.:
Phone: 503- 639 -4171 Fax: (0'00Cl t t' 1� Post- Review / • Land Use
Date/B : Internet: www.ci.tigard.or.us "�((S�ONG' , ,t � � it Cont _ , . `'f � ur , � A
Case No.:
24 -hour Inspection Request: W )3 9 -4175 ' " " "- " " Name/Me od: / �is " Su See Page 1r / / Su . � lemental for
r
Information.
/Y
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
IAAddition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical mate 'als, equ tent, labor, overhead and profit.
❑ I & 2- Family dwelling Commercial/Industrial Val $ 3S8 Y See Page 2 for Fee Schedule
El Accessory Building Multi- Family RESIDE AL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning** 14.00
Job site address: is - 3 0 S . cJ • /9 -p/ f 5r" Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Residential boiler
• Cross street/Directions to job site:
1 (for radiator or hydronic system) 14.00
D i' / Unit heaters (fuel, not electric)
// G C 66°0 (in wall, in -duct, suspended, etc.) 14.00 -
/l/ Flue /vent (for any of above) 10.00
Subdivision: Lot #: Repair units ' 12.15
#: Other Fuel Appliances
Tax map/parcel
Water heater 10.00
DESCRIPTION OF WORK ,,, Gas fireplace 10.00
() .:7 1 16)2cl, _ 4-/A-1& M arca Aft- Flue vent (water heater /gas fireplace) 10.00
s Ozai Gam e �� - Cl1 Log lighter (gas) 10.00
(zi,--V, 9 0 UV, LL Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
(OA* &el O S �-
c wt Chimney/liner /flue/vent 10.00
❑ PRO ER OWNER TENANT Other: 10.00
Name: DiaVe 1) 4'i-45"-I Environmental Exhaust & Ventilation
Address: g' (3 S, LA) , P,`��Sd Range hood/other kitchen equipment 10.00
Clothes dryer exhaust 10.00
City /State /Zip: 7- -0.AP Qyed,✓ 97223
l / Single duct exhaust
Phone: ) C39 _ z4 ( Fax:S -63- 61.)- 9 / z (bathrooms, toilet compartments,
❑.APPLICANT ❑ CONTACT PERSON utility rooms) 6.80
Name: Attic /crawl space fans 10.00
Address: Other: _ 1 0.00
Fuel Piping
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Phone: Fax: Furnace, etc. ••
Gas heat pump ••
E -mail: ' i • WalUsuspended/unit heater ••
CONTRACTOR . A Water heater ••
Business N : P1c9 V 317b'' 4 ' 'i ie- ' G'`'J Fireplace ••
Address: PO (So 30 L/3 / p Range ••
BBQ ••
City /State /Zip: �0 Lq„ . ci 72 3 O Clothes dryer (gas) ••
Phone:5D3-7� -5705 Fax / p a O ther: ••
CCB Lic. #: ,„ pin Total:
Authorized Mechanical Permit Fees* O
Signature: Ati��, Date�L��o } Subtotal: $ / 2.
Minimum Permit Fee $72.50 $
r- Dig-L4e---0-- Plan Review Fee (25% of Permit Fee) $ 3 ( .'3
(Please print name) State Surcharge (8% of Permit Fee) $ JO . Lt.-
TOTAL PERMIT FEE $ / ( , . 8 f
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.
is \Dsts\Permit Forms\MecPermitApp.doc 01/03
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.
$100,001.00 and up $1,396.50 for the first $100,000.000 and
$1.10 for each additional $100.00 or fraction
thereof.
All New Commercial Buildings require 2 sets of plans.
•
is \Building \Permit Forms \MecPermitAppPg2 09- 01- 03.doc
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received - f (4 � �� Date Requested J — 2 �) / AM PM BUP
Location P -1�� Suite MEC -0 (S 72 -P 7 '
Contact Person Ph ( ) PLM
Contractor 1 �Ph�( ) SWR
/
BUILDING Tenant/Owner �F J (2 :�r(/1A e-P.l PA o ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes 4 G � SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
ti hri
Insulation
Drywall Nailing i� 1 ■ ,I /1L ii . i/ �, GI/
Firewall
Fire Sprinkler A/f't1 t k. I -Q eA-)
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
PART FAIL
CRANK
Post & Beam
ough -In
Gas me
Smoke Dampers
�• S PART FAIL
CTRICAL
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA a
Approach/Sidewalk Date Inspector # Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL