Permit A Si.
* /. ray CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00072
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 2/12/2008
PARCEL: 1S135BD
SITE ADDRESS: 09735 SW SHADY LN ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TIGARD MEDICAL
Project Description: Replace 3 ton rooftop HVAC with same. Value: $7200.00
CLASS OF WORK: OTR 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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
HAZEL INTERNATIONAL, INC AND Description Date Amount
HIGASHIYAMA HIGHLANDS CO, LTD
BY NORRIS + STEVENS REALTORS [MECH] Permit Fee 2/12/200E $181.10
PORTLAND, OR 97204 [MECPLN] Plan Rev 2/12/200E $45.28
[TAX] 12% State Surch 2/12/200€ $21.73
Phone: Total $248.11
Contractor:
WILLAMETTE HVAC SERVICE
3075 SW 234TH AVE. #206
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 628 -6841
FAX 503- 848 -2597
Reg #: LIC 56951
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: ` .. � „ �_ Permittee Signature: -�% i 6c,.--
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.
•
a CITY OF TIGARD J MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00072
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/12/2008
PARCEL: 1S135BD-00300
SITE ADDRESS: 09735 SW SHADY LN ZONING: C -G
SUBDIVISION: _ _ _ LOT: JURISDICTION: TIG
PROJECT: % TIGARD MEDICAL
\
Project Description: Replace 3 ton rooftop HVAC with same. Value: $7200.00
CLASS OF WORK:
OTR 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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
HAZEL INTERNATIONAL, INC AND Description Date Amount
HIGASHIYAMA HIGHLANDS CO, LTD
BY NORRIS + STEVENS REALTORS [MECH] Permit Fee 2/12/200E $181.10
PORTLAND, OR 97204 [MECPLN] Plan Rev 2/12/200E $45.28
[TAX] 12% State Surch 2/12/200f $21.73
Phone:
Total $248.11
Contractor: � o -_. q U Q o ? ,` , / " 5/' (/o 0 (I L�l 3
WILLAMETTE HVAC SERVICE
HILLS ORO OR -&—t-&—tie � VE. #206 � O Y-7 ', / V tS
���� REQUIRED ITEMS AND REP RTS
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Contact #: . 4, •,.0 . t:� , :. �.:c ' -�,� CO
PRI 503- 628 - 6841 y:K " `�i� ; 1
FAX 503- 848 - 2597
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Reg #: LIC 56951• I� "` +
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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:' , rj _ �,,_ Permittee Signature: e9Vtji i ' !)'? !
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.
CO 67L-
•
SPRING ISOLATOR ( >5 TONS)
OR VIBRATION PAD (4) PLATED #10 TEK
(4) PLATED #10 TEK X 3/4" SCREWS
X 3/4" SCREWS
• 16 GA X 6" SEISMIC CLIP
1112165 EACH SIDE (TOTAL 4)
NAILER STRIP . . 1 SEE ARCH. DWGS.
UNIT CURB 1 FOR FLASHING.
" 1 1/2" RIGID IFS CANT STRIP
14 INSULATION
#10 SCREW ® 24" O.C. �; ?;;,,.., EACH SIDE OF RTU
MIN 1.5" IMBED �L�� "• ATLERNATE: 4 4
#10 SCREW ® >w�', 6�.w�.�y. }s.�.,
12" O.C. PT LEVELER ,
\ X\_ .
.ROOF OPENING
2X4 W/ Z -CL1P
(2) 2X6 W/
SIMPSON HANGERS
(E) JOIST .
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NO RI ALE UCUIR5 AND SEISMIC DETAIL
C O(-1-/R)e_e___
City of Tigard
1- 3-00 ( ,yip., ov -. Plans f
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Date e
m .C_ ;:)-c2 c(� -- 0 coo 7 2-
OFFICE COPY
Mechanical Permit Application roll oFrlc F. 1 SE O.NL1
City of Tigard R E C E I V •ers '
. • 13125 SW Hall Blvd., Tigard, OR 97223 y Permit N. — - ��l• 0 0 0
m Plan Revi
Phone: 503.639.4171 Fax: 503.598.1960 �ate/gy Omer Perm; •
. � G A R O Inspection Line: 503.639.4175 FEB 12 2008 Date Ready/By: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Will Supplemental Information
CITY OF TIGA'
TYPE OF woRBUILDING DIVISION COMMERCIAL FEE* SCHEDULE — USECIWCKLIST
Mechanical permit fees* are based on the value of the work
El 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: $ 57,200.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family 0 Master builder ❑Other;
Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9735 SW Shady Lane Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP: Tigard OR 97223 Fumace 100,000 BTU ( ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: >1 Project name: Tigard Medical 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
Replace old 3 ton unit with new unit of the same capacity 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
0 PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 10.00
Other. 10.00
Name: 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
Business name: Other. 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump _
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
1 Fireplace
E -mail: Range
CONTRACTOR` Barbecue
Business name: Willamette HVAC Clothes dryer (gas)
Other:
Address: 3075 SW 234 ave 112.9(1 MECHANICAL PERMIT FEES*
City / State/ZIP: Hillsboro OR 97123 Subtotal , 1. jO
Phone: (503) 628.6841 Fax: (503) 848.2597 / Minimum permit fee ($72.50)
( ) ✓ Plan review (25% of permit fee) � y $ ry �
CCB tic.: 56951 State surcharge (12% of permit fee) • 73
TOTAL PERMIT FEE a Leh
Authorized signature: ' ' i 1 , This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
1 •111 ,% MO 1 * RP.. mnhhn,Inlnm, enf by Tri- rn,mt., R..ihiino In,i,.,rn, Grui Rnarrl
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: & 1- REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description PASS Date By I ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation I 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain _ 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors _ 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel • 195 Misc. inspection: _
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit
280 Insulation _ 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
7 2/7116-4".
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire. damper
_ 299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
X 699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
L 915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression tip test
310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Spunkier final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footin drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
198 Grading final _ _ 595 Misc. inspection:
490 Final inspection 599 Final inspection
I \ Building \ Forms \InspCard- AOP- Blank.doc 02/02/07
CITY OF TIGARD
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BUILDING DIVISION PERMIT #: I�1f C2t�Of3 0(;072
13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 2/12/2008
Phone: (503) 639 -41711
Inspection Requests (24 Hrs.): (503) 639 -4175 �' `' I..
INSPECTION WORKSHEET FOR DATE: 2121/7008 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 09735 SW SHADY LN CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD MEDICAL
DESCRIPTION: R 3 ton rooftop HVAC with same. Value: $7200.00
OWNER: HAZEL INTERNATIONAL, INC AND, PHONE #:
CONTRACTOR: WILLAMETTE HVAC SERVICE PHONE #: 503-628-6841
Inspection Request Scheduled For: Date: 2/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 065342 -0 . 503975.9277 N
Corrections /Comments /Instructions: , I '/ Wog g ('o> _N /6/22/x( �
NO V ion l.Lo ii5 lc
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
V q-EAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v Date: Z /Z � / o P hone #: (503) 718 - 2--4 27?
CITY OF TIGARD
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BUILDING DIVISION PERMIT #: MFC200R -00072
13125 SW Hall Blvd., Tigard, OR 97223 ,Il DATE ISSUED: 2/1212000
Phone: (503) 639 -4171 �Uu'I —
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/21/2008 TIME: 7:00AM PAGE: 49
SITE ADDRESS: 09735 SW SHADY LW CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD MEDICAL
DESCRIPTION: Replace 3 ton rooftop HVAC with same. Value: $7200.00
OWNER: HAZEL INTERNATIONAL, INC AND, PHONE #:
CONTRACTOR: WiLLAIMIETTE HVAC SERVICE PHONE #: 503 - 61341
Inspection Request Scheduled For: Date: ::12.1noo8 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6Th IVIochanical rough-in %5342 -01 5039759277 N
Corrections /Co ent /Instructions:
V Uc -� — Uk
T -1•- 1 s , - -
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
V 2-- LIZ— : Inspector: Date: / Phone #: (503) 718 -Z4 21'