Permit CITY OF TIGARD
MECHANICAL PERMIT
g� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00454
r�J!I DATE ISSUED: 7/28/2005
13125 SW Ha Blvd., T OR 97223 503 - 639 -4171
PARCEL: 2S101 DC -03800
SITE ADDRESS: 07190 SW SANDBURG ST 10 ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Mechanical TI, gas packs and duct work (1 -new, 2- changeouts)
Project Value: $8,500
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:
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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
MCCORMACK, WILLIAM L + DARLENE T Description Date Amount
7415 FAIRWAY LOOP [MECH] Permit Fee 7/28/200; $129.70
WILSONVILLE, OR 97070 [MECPLN] Plan Rev 7/28/200: $51.88
[TAX] 8% State Surchar€ 7/28/200! $10.38
Phone: Total $191.96
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Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062 •
Phone: 692 - 1565
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Reg #: LIC 5193
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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
throu • • • R • :41-0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 800 - 332 -2344.
Iss edB : / /. ; Permittee Signature:
Y � � _ _ � �I
Call 503- 639 -4175 by 7:00 a.m. for inspections that b . =- s • .
This permit card shall be kept in a conspicuous place on the job site un completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechzcal Permit Application FOR OFFICE USE ONLY
City of Tigard ved
`'f g DateBy: 7,z‘ Dc- Permit No.: v— v ) -Of) i g i t
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 k.., ?r, ' dK Date/By: Other Permit:
Inspection Line: 503.639.4175 - - II ..•' I i Date Ready/By: Faris: ta See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction - [t Addition /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: $ $So n
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2-family dwelling ® •Coin iercial/industrial ❑ Accessory building
❑ Multi- family _ _ . _ -__❑ Master builder ❑ Other: For special information use checklist.
Description , I Qty. I Ea. I Total
• JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
. 7) 90 so S A>J bz,u E( S T EE j (requires site plan showing placement) 14.00
City / State/ZIP: 7/44-7...› i e 9 u3 Furnace 100,000 BTU (ducts/vents) 14.00 •
Furnace 100,000+ BTU (ducts/vents) 17.90
_Suite/bldg. /apt. no.: 40 - - - -- - -- I Project name: M e cortol/C 3 i C∎ Gas heat pump 14.00
- Cross street/direction—s— to job site --- - __ - - Duct work 14.00
2?� Hydronic hot water system 14.00
E t...3 a AS ? A G - e - - S - A L ' � (,( 7 £ O K Residential boiler (radiator or
n 1r_,� hydronic) 14.00
l w o� .. C�OI.I.Tj Unit heaters (fuel -type, not electric),
in -wall, in duct, suspended, etc. 10.00
Subdivision: .. - . I Lotno.:
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
Flue vent for water heater or gas
fireplace 10.00
Log lighter (bas) 10.00
- - - Wood/pellet stove 10.00
Wood fireplace/insert 10.00
I Chimney/liner /flue/vent 10.00
- -- ' 'PROPERTY OWNER_ - ❑ TENANT Other. 10.00 _
- Name: (Mga_, Cm (Lt.{ p AA L.A. (.. j R M Environmental exhaust and ventilation
Address: ^` 1 Range hood/other kitchen
7� ! 5 ` - R. {Lw Ary I•.oa ^ P equipment 10.00
City/State/ZIP: W- 1 .415 t�(�l l.L1 _ 0 a_ 9 707 D Clothes dryer exhaust 10.00 -
t Single -duct exhaust (bathrooms,
.. Phone: ( it ,-O 90 Fax: ( ) toilet compartments, utility rooms) 6.80
_ - ® APPLICANT El CONTACT PERSON Attic/crawlspace fans 10.00
Other 10.00
Business name: Ci - ) G i mo i c , _
/1 g Fuel piping
Contact name: Ja o- ay EL-4,),J $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
/ 6t.i 7 ciAl Tlx) IF '014! f� Gas heat pump
City/ State/ZIP: r J,44 04_7I,1 6 9 7 tf)4. Z. Wall/suspended/unit heater
- -Phone: ( 0..33) < c;t- / ..5-‘— S - Fax:: ( 5 o 3 ) 6//- / ? 7 S Water heater
Fireplace
E -mail: Range
-
• CONTRACTOR Barbecue
`.0 !>� Clothes dryer (gas)
Business name:
Other:
Address: MECHANICAL PERMIT FEES*
City/ State/ZIP: Subtotal
Phone: Minimum permit fee ($72.50)
( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
Mechanical Permit Application - City of Tigard
Page 2 Supplemental Information •
Commercial Fee Schedule:
Total Valuation: - Permit Fee:
$1.00 to $2,000.00 4 •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
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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.
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$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.
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i:1Building\Permit&MEC- PermitApp.doc 12/03 2
G R O U P
- 17 A C K E N Z I E
0690 SW Bancroft Street /PO Box 69039 • Portland, OR 97239
TEL: 503.224.9560 • NET: GRPMACK.COM • FAX: 503.228.1285
Letter of Transmittal
16721 -1
Date: August 3, 2005 Project Number: 2020950.05
To: City of Tigard
13125 SW Hall Boulevard
Tigard, OR 97223 -8199
Attention:
4 /1/419J‘9j1).
Project Name: 10200 5Linc n #400 00/600 - Norpac
Enclosed: Quantity Medium Description Comment
2 Bond Full Permit/Review Set: 7 -25 -05 For your review
Remarks:
•
Signed: Joshua Tapp
Transmitted Employee Delivery (JKT)
Via:
If enclosures are not as noted, kindly notify us at once.
•
CITY el
TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00454
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/28/2005
Phone: (503) 639 -4171 wl
Inspection Requests (24 Hrs.): (503) 639 -4175 `:
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 4: 11PM PAGE: 52
SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCCORMACK BUILDING
DESCRIPTION: Mechanical TI, gas packs and duct work (1 -new, 2- changeouts) .
Project Value: $8,500
OWNER: MCCORMACK, WILLIAM L + DARLENE T, ' PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692-1565
Inspection Request Scheduled For: Date: 10/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 019611 -01 503-632 -1565 Y
Corrections /Comments /Instructions:
ilfW
lil FOMFMN. UM I LI r —
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ,, ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ---- Inspector Date: 1 " - � Phone #: (503) 718 -
L_ -
r
CITY OF TIGARD `'
BUILDING DIVISION PERMIT #: MEC2005 -0Q454
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/20/2005
Phone: (503) 639 -4171 ,y�, g:
l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/4/2005 TIME: 7:08AM PAGE: 73
SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK: ___
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCCORMACK BUILDING
DESCRIPTION: Mechanical TI, gas packs and duct work (1 -new, 2- changeouts)
Project Value: $8,500
OWNER: MCCORMACK, WILLIAM L + DARLENE T, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 8/4/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 012798 -01 503-692-1666 N
Corrections /Comments /Instructions:
t AL /. I
wirril. wertimiold ,,_ op./Ai,-
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
__ :_c_ D r 4 zo
Inspector: Date: olqi____
Phone #: (503) 718-
CITY ..OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00454
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005
Phone: (503) 639 -4171 4 py ,, l I 11°
Inspection Requests (24 Hrs.): (503) 639 -4175 .��- `:_..
INSPECTION WORKSHEET FOR DATE: 8/12/2005 TIME: 7 :06AM PAGE: 83
SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCCORMACK BUILDING
DESCRIPTION: Mechanical TI, gas packs and duct work (1 -new, 2- changeouts)
Project Value: $8,500
OWNER: MCCORMACK, WILLIAM L + DARLENE T, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 8/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 013382 -01 503 -692 -1565 N
Corrections/Comments/Instructions:
•
f J\ re ,
I/ _ ...ft, 1
C f
•
,
ate PARTIAL APPROVAL
111 CANCEL ❑ NO ACCESS
❑ FAIL ❑ C , LL FO • INSPECTION ❑ ADDITI a NAL F - • S ASSESSED
Inspector: I ' Dat- • Z ' Is■ Phone #: (503) 718 -
CITY Of TIGARD MEG200500454
BUILDING DIVISION PERMIT #: 7/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 F:_
10/24 /2005 7:02AM 55
INSPECTION WORKSHEET FOR DATE: TIME: - PAGE:
07190 SW SANDBURG ST 10
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: MCCORMACK BUILDING LOT #: TYPE OF USE:
PROJECT NAME: Mechanical TI, gas packs and duct work (1 -new, 2- changeouts)
DESCRIPTION: Project Value: $8,500
MCCORMACK, WILLIAM L + DARLENE T,
OWNER: ARROW MECHANICAL PHONE #: 692 -1565
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
CV% # tr ageh c gaPr e otO t ri on � � Set511665 Me
Corrections /Comments/ Instructions:
COVE
lilt • KEW • Lit IllarreMaivA
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO AL FE S ASSESSED
Inspector: di1, Date: frD lJ P hone #: (503) 718 -