Permit 4 CITY OF TIGARD MECHANICAL PERMIT
0 ,,A, DEVELOPMENT SERVICES PERMIT #: MEC2005 -00634
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/6/2005
PARCEL: 1S126BC-01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 480 ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: TI, project value: $7,800
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: 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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WYSE INVESTMENTS Description Date Amount
111 SW 5TH AVE SUITE 1100 [MECH] Permit Fee 10/6/200° $191.80
PORTLAND, OR 97204 [TAX] 8% State Surchar€ 10/6/200; $15.35
[MECPLN] Plan Rev 10/6/200E $45.79
Phone: 503 294 - 0400 Total $252.94
Contractor:
REITMEIER MECHANICAL INC
7051 SW SANDBURG ST STE 400 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223 -8011
Phone: 603 - 0205
Reg #: LIC 153770
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 -3
Issued = � Permittee Signature: X
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business 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.
Mechanial Permit Application FOR OFFICE USE ONLY
Received
City of Tigard
Plan Review 1, (p Permit No HGC/��S� 6, `,l[ -
Phone 503.639.4171 Fax: 503.598.1960
13125 S W Hall Blvd , Tigard, OR 97223 � E C , i T
�� ! ' ' Date/By. Renew
�� I � � DateBy. Other Permit
Inspection Line: 503.639.4175 i Date Ready/By 0 See Page 2 for
Internet: www.ci.tigard.orus . �1- 0 � - - 1r Notified/Method /0 , Supplemental Information
TYPE OFart1OF - TIGA R , D�� - COMMERCIAL FEE* SCHEDULE --USE'CHECKLIST
❑ New construction [(Addition/��IQcemsnt�v 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 matenals, equipment, labor, overhead, and o g .t-
' CATEGORY OF CONSTRUCTION : - -- . • - Value $ 7 BM
- - RESIDENTIAL EQUIPMENT / S YSTEMS FEES*
❑ 1- and 2- family dwelling [ ' Commercial/mdustrial ❑ Accessory building '
For special information use checklist
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. Ea Total
. ''JOB SITE INFORMATION AND LOCATION __ . - Heating/cooling
Job site address: -1 b 2p 5V WAS It t p & f') I"'" S Gl RC
Air fires site plan conditioning o ingg placement) 14 00
� (requires site l showing lacement
City/ State/ZIP: 'p p (Z.0 L p 0 DI Q R 91 Furnace 100,000 BTU (ducts/vents) 14 00
Furnace 100,000+ BTU ( ducts/vents) 17 90
Suite/bldg. /apt. no.: - 44 ' Project name:
n1U C gIV(hi4 -s5 S y Gas heat pump 14 00
Cross street/directions to job site: Duct work 14 00
5 G els FEaR p- 14A L 1 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 WO Water heater 10 00
� f ' Gas fireplace 10.00
AJ 5 TA-11 4 fan) sp/ / 51-S PA Flue vent for water heater or gas
Aj G Co �Iy fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10 00
Wood fireplace /insert 10 00
.�J PROPERTY OWNER - ❑ TENANT : Chimney/liner/flue/vent 10 00
- - - - Other. 10 00
Name: it)y,ce 01J (E S t E-1uA Environmental exhaust and ventilation
Range hood /other kitchen
Address: //^^e 5t�t) i'� *OE' ,-,,,Y 't equipment 10 00
City/State /ZIP: /'/V /? TyA_N.L7 OR. 9'73.1 3.1 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( 5 ) a C 4 ....0400 Fax: ( ) toilet compartments, utility rooms) 6.80
. / ❑ A - ' 0. CONTACT PERSON : • ' Attic /crawlspace fans 10.00
Other 10 00
Business name:
Fuel piping
Contact name: t/! ` /< 41 2 / 2_ $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: , / / Wall/suspended /unit heater
Phone: (503 ) P, 7 7 _ 8 3 t,/- Fax:. ( ) Water heater
r' Fireplace
E - mail:
Range
- , . C ONTRA CTOR ; Barbecue
Business name: IRE , fm. E G � mec tlA lU Q � Clothes dryer (gas)
I Other
Address: 7 .sty SAt4.0 ;3ue9 S1', 51�I 'l oto _ - ... MECHANICAL PERMIT FEES*
City/ State/ZIP: 1 i °_ 1 frig n , o , 7 2 _5 Subtotal
q Fax: Minimum permit fee ($72 50)
Phone.
(��!/) &‘,42;) Q�. ®; ) ®� ° I Plan review (25% of permit fee)
CCB lic.: /537 0 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: ��t This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name \ 7 1 k — n4- RA_ Date. /0.. - 0 5 • Fee methodology set by Tn- County Building Industry Service Board
I \Buiding\Pemits\MEC- PermitApp doc 12/03 440 -4617T (i I /02 /COM/WEB) 2• I Y
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
T Y.4lW-Wil at><on a1M1 f erm><t le r . = '��'��ggy
$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- PermitApp.doc 12/03 2
CITY CAF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00634
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/612005
Phone: (503) 639 -41711
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I
INSPECTION WORKSHEET FOR DATE: 12/1/2005 TIME: 7 :08AM PAGE: 41
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 480 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: UNITED HEALTH
DESCRIPTION: TI, project value: $7,800
OWNER: WYSE INVESTMENTS, PHONE #: 503"2840.400
CONTRACTOR: REITMEIER MECHANICAL INC PHONE #: 603 - 0205
Inspection Request Scheduled For: Date: 1211/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 022740 -01, 503.888 -0235 Y 'FM
Corrections /Comments /Instructions:
•
4 1 . -
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITION FEES ASSESSED
Inspector: Date: / ' Phone #: (503) 718 -
.