Permit i_;..
A CITY OF TIGARD MECHANICAL PERMIT
1. DEVELOPMENT SERVICES PERMIT #: MEC2005 -00071
*rt lll� DATE ISSUED: 2/22/2005
. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S113AD -01900
SITE ADDRESS: 16600 SW 72ND AVE B10
SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: F2 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU:" <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of vent fan for oven in engineering area. Project Value: #3,860
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 2/22/200E $116.20
PORTLAND, OR 97224 [TAX] 8% State Surchar€ 2/22/200E $9.30
Phone: 503 624 - 6300 Total $125.50
Contractor:
ACCURATE HEATING, INC.
P.O. BOX 2276 REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
1
Phone: 650 - 1229
Reg #: LIC 88423
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 : is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules ado. ed in •- Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001-01110 thro - ::.•Jew :52- 001 -0100. You
may • • ain cop of these rules or direct questions to OUNC by �al ('•03) - ;699. ■
/, Pe rmittee Signature: Issue By: .r �. .� << _ 9 Aft.
o
- Call (503) 639 -4175 by 7:00 P.M. for inspections neede• the ne t business day
N Permit Application ' „- — ' ..,,. . : rowor.Ficy usE t)N I:,
R eceived
Ci of Tigard / /,l Permit No.: f ,.� L .e� 7/
131 Hall lvd., Tigard, OR 97223 Date/By�� / r t G �� //
g Plan Review RSV �7 ether Permit:
Phone: 503.639.4171 Fax: 503.598.1960 !Arcot �^ � ? , Date/By: , � 2
Inspection Line: 503.639.4175 ,...4,1 n��� - Date ReadyB : Mil See Page 2 for
S
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ 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: $ 3s.(pQ -_
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/ /� y� Ste) Air conditioning or heat pump
Job site address:
l.0 (p 0 V -7 z � (requires site plan showing placement) 14.00
City/State /ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name: I t t c Furnace 100,000+ BTU (ducts/vents) 17.90
S� �yNsrvh' 3 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
` / N� C. Gas fireplace 10.00
V e J d V f\ 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
❑ PROPERTY OWNER G TENANT
Chimney/liner/flue/vent 10.00
Other: 10.00 _
Name: CZ-0e ict, -.m-t1 La ) )1 *■` / Oi ;/n 7 --1P 77 1'c S Environmental exhaust and ventilation
Range hood/other kitchen
Address: /6, 6, ex) St,J 72' 'r equipment 10.00
City/State /ZIP: -7/ e& fe/( ( 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: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: WalUsuspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
^ Clothes dryer (gas)
Business name: Az-e,” J it t_ g l� C Other:
Address: /p0 Z ($ Z Z 7 MECHANICAL PERMIT FEES*
City/State /ZIP: C Subtotal
vQ a %Pri')"r � S , G Q Minimum permit fee ($72.50)
Phone: (Se 3 )6„,s- -/Z 2.2 Fax: 463 ) 65 ' Sq s Plan review (25% of permit fee)
CCB lic.: 0 d , 2 3 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
d ays a i t has been accepted as complete.
Print name: kt ' �
p Date: 0 �02 - • Fee methodology set by Tri- County Building industry Service Board
t G,/1s� P DliA lc�yiw.
i:\Building\Pennits'NEC- PermitApp.doc 12/03 440- 4617T(11 /O7JCOM/WEB)
CITY .OFFIGARD
BUILDING DIVISION PERMIT #: MEC2005 00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/22/2005
Phone: (503) 639 -4171 ,i
Inspection Requests (24 Hrs.): (503) 639 -4175 � .. : .. N __..
INSPECTION WORKSHEET FOR DATE: 3/24/2005 TIME: 7:09AM PAGE: 88
SITE ADDRESS: 16600 SW 72ND AVE B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: FLIGHT DYNAMICS
DESCRIPTION: Installation of vent fan for oven in engineering area. Project Value: #3,860
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300
CONTRACTOR: ACCURATE HEATING, INC. PHONE #: 650 -1229
Inspection Request Scheduled For: Date: 3/24/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 002576 -01 603- 317 -9097 N
Corrections /Comments/ Instructions:
4 pp/Zovc RovG-0 -/IL/ f /AJ9
V #; - TO THL- e` XT /OA-
3 -/ / .. ,7
r e-- ) \
,..,
XPASS ❑ PARTIAL APPROVAL ❑ CANCEL ` NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I) I /9/J LAI- ` Date: 3 — L z - ' DY Phone #: (503) 718 - 2 77-51