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Permit CITY OF T G A R MECHANICAL PERMIT mil" DEVELOPMENT SERVICES PERMIT #: MEC2005 -00340 r��'' DATE ISSUED: 6/14/2005 W . 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 112DD -00200 SITE ADDRESS: 15618 SW 72ND AVE ZONING: I -P SUBDIVISION: OREGON BUSINESS PARK III LOT: JURISDICTION: TIG Project Description: Install ductless AC split system. 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: 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 6/14/200: $141.50 PORTLAND, OR 97224 [TAX] 8% State Surchar€ 6/14/200f. $11.32 Total $152.82 Phone: Contr to l REQUIRED ITEMS AND REPORTS — Phone: Reg #: 3 6 $ 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: / „AS_ _1: 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. n Mechanical Permit l pplication FOR OFFICE USE ONLY CIt y 4 of TIp� b ar(1 Received t /e No.: --06 rt�J � ; ` V.r e Permit 13125 SW Hall Blvd., Tigard. OR 97223 Plan Review � �� Phone: 503.639.4171 Fax: 503.598.1960 I Other Permit Date /13y: Inspection Line: 503.639.4175 - a „ 0 / Date Ready/By: ..1 r s ® See Page 2 for Internet: www.ci.tigard.or.us � g °' � 1 " " --.' Notified/Method: 9 Supplemental Information r -- Vi �, 50isj- 'WORK COMMERCIAL FEE* SCHEDULE — USE CIIECKLIST Mechanical permit fees* are based on the value of 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: $ r � ®� a) RESIDENTIAL EQUIPMENT /SYSTEMS FEES* ❑ 1 - and 2 family dwelling / II:I- Commercial /industrial ❑ Accessory building Mas builder For special information use checklist. Multi -famil ❑ Multi-family ❑ ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: J ,5 G o Air conditioning or heat pump L) L,J 7 Iij , �/L - , (requires site plan showing placement) 14.00 — City /State /ZIP: 7-75 . ©� Furnace 100,000 BTU (ducts yens) 14.00 _ Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: 4i ,.. Project name c m " 4 co ..711 �r` 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 Gas fireplace 10.00 /A/� it i) (Jc- L(? f- 'I1: ,,cp4 / ,r ,, 4 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00. Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 pi, PROPERTY OWNER ❑ TENANT Other. 10.00 Name: / e rA,isr" --- Environmental exhaust and ventilation Address: Range hood /other kitchen 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: PA.Ol t��y0 AsfJ a J- Fuel piping Contact name: ggoc_.e_ Q ,./fir, $5.40 for first four; $1.00 for each additional Address: 9 7 p g2 Le /) 2 4,41 Furnace, as heat pump p Gas heat City /State /ZIP: 6AZiLi-f/ A 72 2_4_2_ Wall /suspended /unit heater / Water heater Phone: (�) �--�` �,e's+ 9 Fax:: k ) �8,."? 7 g 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) /4/.50 Phone: ( ) Fax:( ) Plan review (25% of permit fee) CCB lic.:.Z (8 h State surcharge (8% of permit fee) ,/ ..3� TOTAL PERMIT n FEE 8 This permit application expires if a permit is not obtained ed wi thin in 1 ] 0 Authorized signature: days after it has been accepted as complete. Print name: 8 P ) _ .g 0 �, , Date: J/C/ Le- ' Fee methodology set by Tri- County Building Industry Service Board Building \ P \ is \ermits MEC- PermitApp.doc 12/03 44 4617 (11 I / /COM /WEB) CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2005.00340 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2005 Phone: (503) 639 -4171 ! i� �ti. i Inspection Requests (24 Hrs.): (503) 639 -4175 °'I :. INSPECTION WORKSHEET FOR DATE: 8/4/200 TIME: 7 :08AM PAGE: 82 SITE ADDRESS: 15618 SW 72ND AVE CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK III LOT #: TYPE OF USE: PROJECT NAME: TECHNOCOM INC DESCRIPTION: Install ductless AC split system. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 233.6911 Inspection Request Scheduled For: Date: 8/4/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 012770 -01 503-519-6199 -- Corrections/Comments/ Instructions: 1ec k ,,, , \ A-■ l.,lz ( - or ) NPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ----- dc))40 Inspector: Date: g Phone #: (503) 718-