Permit C ITY F TIGARD MECHANICAL PERMIT
Ik DEVELOPMENT SERVICES PERMIT #: MEC2005 -00339
r• DATE ISSUED: 6/14/2005
'`'-` :` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 113AD -01800
SITE ADDRESS: 16798 SW 72ND AVE B14 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 011 JURISDICTION: TIG
Project Description: Demo AC unit. Move around ducts and air supplies.
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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 6/14/200E $72.50
PORTLAND, OR 97224 [TAX] 8% State Surchar€ 6/14/200E $5.80
Total $78.30
Phone: 503 624 - 6300
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97222
Phone: 233 - 6911
Reg #: LIC 38868
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 - 332 - 2344.
Issued By: ,k�6.2;vL << ,;��L, Permittee Signature
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.
Mecl "lea 1 Permit A 1icatlon' FOR OFFICE USE ONLY . ,. . •
City o Tigard Received / � •
13125 SW Hall Blvd., Tigard, OR 97223 ���� Date /By: 5 ht, i11[ ,9
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
t Date /13y:
Inspection Line: 503.639.4175 al A I Date Ready/By: ® Sec Page 2 for
Internet: www.ci.tigard.or•us CITY ®P e Notified/Method: Supplemental Information NM BUILDING DIVIS ON
TYI'E OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value or the work
❑ New construction [Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 4.4
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling IXommercial /industrial ❑ 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: Air conditioning or heat pump
f/ �(� 7 e)� 4 .Le (requires site plan showing placement) 14.00 -
City/State /ZIP: 041",j a Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: C eto/66 rJ C on ex'^%Y 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ / Gas fireplace 10.00
lae.4I® P ds/ - (/A i t 71,0a d (iJ ,/, Flue vent for water heater or gas
(� c fireplace 10.00
4- ,/Nit/.'_ L) t��� a -r ' . Q/ Le-- . ( iA°ti`-- Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name:
2 Of Environmental exhaust and ventilation
Range hood /other kitchen
Address: equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Pitt) ��/fre d - L 5- , 66.407-----e_ Fuel piping
Contact name: 2r1
' uc t 6 $5.40 for first four; 51.00 for each additional
Address: , Furnace, etc.
T S r r , � /'r rf " - — Gas heat pump
/atn 9,22_2_1_ Wall /suspended /unit heater
Phone:) 67 1„G"7 eQ Fax: : ) 3 r,� 7 e, Water heater
Fireplace
E - mail:
Range
CONTRACTOR Barbecue
Business name: � � Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) -),2
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.� U V (O O State surcharge (8% of permit fee) / , 60
TOTAL PERMIT FEE 7. �Q
; e This permit application expires if a permit is not obtained within 180
Authorized signature: e,„
days after it has been accepted as complete.
Print name: 434UL ° Qum t, Date6� y,.. — Fee methodology set by Tri- County Building Industry Service Board
is \ Building \Permits \.MEC- PermitApp.doc 12/03 440 -4617T (II /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00339
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2005
Phone: (503) 639 -4171 �/u"�m�l�!��Irl
Inspection Requests (24 Hrs.): (503) 639 - 4175. n,
INSPECTION WORKSHEET FOR DATE: 7/7/2005 TIME: 7 :10AM PAGE: 86
SITE ADDRESS: 16798 SW 72ND AVE 1314 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE:
PROJECT NAME: COOKSON
DESCRIPTION: Demo AC unit. Move around ducts and air supplies.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503.624 -6300
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 233 -6911
Inspection Request Scheduled For: Date: 7/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010869 -02 503- 519 -6199 N
Corrections /Comments/ Instructions:
1 I III/I , SAf
ea
V , 1 4
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITI NAL F ES ASSESSED
1 0 I• A 4 Inspector: ector: Dater 7 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 00339
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/14/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/7/2005 TIME: 7:'IOAM PAGE: 87
SITE ADDRESS: 16798 SW 72ND AVE B14 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE:
PROJECT NAME: COOK SON
DESCRIPTION: Demo AC unit. Move around ducts and air supplies.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503- 624 -6300
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 233.6911
Inspection Request Scheduled For: Date: 7/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
625 Duct work 010869-01 503-519 -6199 Y
Corrections /Comments /Instructions:
•
rd,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F•R INSPECTION ❑ ADDITIO AL F S ASSESSED
Inspector: Date: Phone #: (503) 718-