Permit - _ 4
C ITY OF TIGARD • MECHANICAL PERMIT
�Ar DEVELOPMENT SERVICES PERMIT #: MEC2004 -00741
,.J�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/12/2004
PARCEL: 2S101 DD -00100
SITE ADDRESS: 07000 SW SANDBURG ST
SUBDIVISION: ZONING: I -P
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:
ELE 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 ws air conditions unit with ductless split system.
Value $4975.00
Owner: FEES
PAPE' PROPERTIES + Description Date Amount
PAPE', TERRANCE /TOOKE, DIAN +
[MECH] Permit Fee 11/12120( $141.50
PAPE', SHIRLEY N [TAX] 8% State Surcharl 11/12/20( $11.32
EUGENE, OR 97440
Phone: Total $152.82
Contractor:
TEMP CONTROL MECHANICAL SERVIC
4800 N CHANNEL AVE
PO BOX 11065 REQUIRED INSPECTIONS
PORTLAND„ OR 97211 Cooling Unt Insp
Phone: 503 258 - 6139 Final Inspection
Reg #: LIC 103165
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 B
y � � , �! Permittee Signature �� 120 5 '
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
M echanical Permit Application 1:012 r)F1 lc;I: USU. O\L1
ed
Date/By:
Cit of igard Received /A 4, • / Permit No. _ o- -- CC IV/
/
13125 SW'ti-lall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /a,. r� Date/By: other Per
Inspection Line: 503.639.4175 _s J �•1 Date Ready/By: IffiM ®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
N ew construction
❑ [ pAddition /alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other:
mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ if I 7 S`
❑ 1- and 2- family dwelling (21 Commercial/industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Accessory b uilding
For special information use checklist.
❑ Multi- family ❑ Master builder
❑ Other: Description
Qty. I E. I Total
JOB SITE INFORMATION AND LOCATION p
Job site address: 7000 5( SPu.p6ORs. sr; Air con ' A �'
owing placement) ) 14.00
City/ State/ZIP: T f 6D O , Ot• Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU ( ducts/vents) 17.90
PAS NRTe,IGrAt+ 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
poGG Pt,g € 1sruss v15 AI (L comoinal LNG mil- (I 1/ MEW Gas fireplace ent 10.00
F.� ` Flue vent for water heater or gas
fyom ��+ � G� c ur sysTsn fireplace 10.00
Y Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
IN PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
Other 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ® CONTACT PERSON Attic/c1>Iwlspace fans 10.00
Other
Business name: 10.00
Fuel piping
Contact name: MI Le RA/ OLD $5.40 for first four; $1.00 for each additional
Address: 475a N • ciowakitt. Furnace, etc.
Gas heat pump
City/ State/ZIP: POQTLJLt3D ,012,, WalUsuspended/unit heater
Phone: (503) 79 3 , -44 II Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: - TEMP apt, MgtsfAikhc 4, 5epatick, Clothes dryer (gas)
Other:
Address: if 75D N. 011%1144d MECHANICAL PERMIT FEES*
City/ State/ZIP: -.ammo J 1a- q7aI ( Subtotal ii.//..577 Phone: (43)b) 2SB' i34 I Fax: (B )735-34:10 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 10516,5 J(/� ` 3 f) t State surcharge (8% of permit fee) l� .32...
�'' TOTAL PERMIT FEE 151. gt
Authorized signature: 0111
'.w /,� This permit application expires if a permit Is not obtained within 180
Q • days after It has been accepted as complete.
Print name:i1Ki 1.D I Date: I4trilDi • Fee methodology set by Tri -County Building Industry Service Board
i:\ Building \Pennds\MEC- PrnnitApp.doe 12/03 440.4617r (1 trovCOM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / I — Z Z AM PM BUP
Location - 7 0 b .�t l /? Suite M EC 2 O 7 ( //
Contact Person /►/l J Ph ( )o 0 9 -' a (4c.6 PLM
Contractor Ph ( ). SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspectio Notes: / }� � ' . SIT
Post & Beam s 0 1 1 .-
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm / �
Susp'd Ceiling , V
Roof Nwor-
Other: I V /
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
S * ampers
- ASS' "ART FAIL .,
LECT - CAL
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 El Please ca for reins -ction RE: Unable to inspect - no access
Fire Supply Line ®) �
ADA 40. �
Approach/Sidewalk Date In spector / Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL