Permit ,...,
::_.
CITY TIGARD MECHANICAL PERMIT
I4. DEVELOPMENT SERVICES PERMIT #: MEC2004 -00218
.,1, 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/6/2004
PARCEL: 2S 103AA -00101
SITE ADDRESS: 10865 SW WALNUT ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 3
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of VAV boxes, ductwork & hot water mechanical piping.
Project Value: $250,000.
Owner: FEES
SCHOOL DISTRICT NO 23 J Description Date Amount
13137 SW PACIFIC HWY [MECH] Permit Fee 5/6/2004 $3,046.50
TIGARD, OR 97223 [MECPLN] Plan Rev 5/6/2004 $761.63
[TAX] 8% State Surchart 5/6/2004 $243.72
Phone: Total $4,051.85
Contractor:
COLLINS MECHANICAL
PO BOX 2800
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Heating Unt Insp
Reg #: LIC 146993 Duct Inspection
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) 6699.
Iss ed By: 0 ; A � ! \ y� 1 1 ,// /! •. Permittee Signatur•• _jr _, 1/ , /
Call (503 639 -4175 by 7:00 P.M. for inspections needed the next business day
108C6 joy avALaUv? fT
Mechanical Permit Ai 1 • , il\ ED FOR OFFICE USE ONLY
Cit of Tigard 23 iW Received
13125 SW Hall Blvd , Tigard, OR 97223 0 Date/By ,a7 ac/ ell Permit No y _ �� Ma / Q \�
Plan Review c vv V
Phone: 503.639 4171 Fax: 503.598.1960 ! �d �' /,3e1 Date/By j .....3 d �j Other Permit
Inspection Line. 503 639.4175 I \ &k.1 ,7 1 I Date Ready/By. See Page 2 for
Internet: www.er.tigard.or.us 01\I o� O ,� - -- Notified/Method Supplemental Information
ENO \�- 3
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST T...
❑ New construction Mechanical permit fees* are based on the value of the work
Addition/alteration/replacement
performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical matenals, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION -
Value. $ 2 SO ada• ><1
❑ I- and 2- family dwelling Ea ❑ Accessory building RESH)ENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi- family ❑ Master builder ❑ Other For special information use checklist
Description Qty I Ea Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / Q i " � / 6 , / . I c Air conditioning or heat pump Z�.
l l� r ` 4 / , (�-� , �( , n V t1 / S r (requires site plan showing placement) E 14 00
City/State/ZIP: 776 f) R.,0 ew 9 7 z 13 Furnace 100,000 BTU (ducts /vents) 14.00
r V r ou 4. 1..,‹ en,' V L E SC/�Osc Furnace 100,000+ BTU (ducts/vents) 17 90 \
Suite/bldg. /apt. no.: Project name: /h �Ji 6- Al" L Gas heat pump 14 00 >
Cross street/directions to job site: Duct work ` 14 00
R.
Hydronic hot water system I 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 O F WOR Water heater 10 00
n Gas fireplace 10.00
/�.57 fr L L- A l G./ () AV 3t0)‹.5 £ X� U er6J 0leit Flue vent for water heater or gas
/for tcl 9r1-A c .9' - P < /4"/G- _ _ fireplace 3 10 00
/ __ Log lighter (gas) 10 00
Wood /pellet stove 10.00
Wood fireplace /insert 10 00
Chimney /liner /flue /vent ,/ 10 00
• ❑ PROPERTY OWNER ' , _ - _ ❑ TENANT - '
, / - Other 10 00
/I
AD 7 / R D - 7 4( firiA ' .5 dOC- s Environmental exhaust and ventilation
o Range hood /other kitchen
Address:
6 1 60 ts CJ /1� S� e 046- 5 r equipment 1000
City/ State/ZIP: 7'(G4i 19 0,e t —2 Z �3 Clothes dryer exhaust 10 00
Single -duct exhaust (bathrooms,
Phone: Ccd2 43 ( — !'C 0 0 Fax: ( ) toilet compartments, utility rooms) / 6 80
❑ APPLICANT ❑ CONTACT PERSON' , Attic /crawlspace fans 10 00
Other 10.00
Business name:
co L L „,,<- , 6 / /,4, „ ed e_ rte ° Fuel piping
Contact name: 0gti/ (v O LG /w5 $5.40 for first four; $1.00 for each additional
Address: P- Q r&J X � a 0 Furnace, etc.
Gas heat pump
City/State /ZIP: 6 to I (' 0 1- o 4 " 7 OK Wall/suspended /unit heater
Phone: (S 7 Z 3- d ( 3 et Fax: . (-,53) G / -6 ..(4 .. 2 Water heater
l Fireplace
E - mail: C / f7 /N e _ 0 /9 _ 7 .- rt . f' ' /
Range
CONNTRACTOOR - Barbecue
/21 ge 4( "
Clothes dryer (gas)
Gi �
Business name: G //ti S ( , , , /N ‹ r Other
r
Address: 5 fF 5 , . ga ) ' ' MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal 3 0 o 446. 50
Phone: ( ) Fax: ( ) Minimum permit fee ($72 50)
Plan review (25% of permit fee) ' 76, / , 63
CCB lic.:/ t ( t f 9 State surcharge (8% of permit fee) 2 t .4.Z
(( �� 1 TOTAL PERMIT FEE �D s/ ,
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: i Q f f e.1 <f'L a. COL C- /— f Date: " 7-6 • Fee methodology set by Tn- County Building Industry Service Board
i \Buiiding\Permits\MEC- PemutApp doc 12/03 440 -4617T (1 I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
T;o'tal ; _.. 7.'"„ e rm it Fee. e, ,: '41
$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- PermutApp doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION bIVISION Business Line: (503) 639 -4171 MST
BUP
Received /' Date - ' Re nested AM PM BUP
Location (09 �✓ 0 Suite MEC ?I
Contact Person 2PI4A-CL)Ph ( ) YVI 4 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ��
Fire Alarm
Susp'd Ceiling
Roof � 1�., iA �
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
• ther:
ALZIare
• S AIL
Post & Beam
Rough -Ins. .I
Gas Line
S. • -mpers •
•
- SS - ART FAIL
EC • ICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection -e of $ required before ext inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call f• reinspec on RE• /N El Unable to inspect — no access
Fire Supply Line
ADA ,1
Approach/Sidewalk • Date Inspector Ext
Other:
Final • DO NOT EMOVE this inspe • n record from the Job site.
PASS PART FAIL