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Permit ''A CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00320 TIGAARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/6/2007 PARCEL: 1S136DD-04100 SITE ADDRESS: 11850 SW 67TH AVE 100 ZONING: MUE SUBDIVISION: TIGARD TRIANGLE COMMONS LOT: 007 JURISDICTION: TIG PROJECT: AMERICAN FAMILY INSURANCE Project Description: TI - HVAC Project Value: $142,000 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: 2 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: H 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: 2 <= 10000 cfm: OTHER UNITS: GAS OUTLETS: > 10000 cfm: 2 Owner: FEES PACIFIC NW PROPERTIES Description Date Amount 6600 SW 105TH SUITE 175 BEAVERTON, OR 97005 [MECH] Permit Fee 6/6/2007 $1,858.50 [MECPLN] Plan Rev 6/6/2007 $464.63 [TAX] 8% State Surchar€ 6/6/2007 $148.68 Phone: 503 -626 -3500 Total $2,471.81 Contractor: PROTEMP ASSOCIATES INC 9788 SE 17TH AVE PORTLAND, OR 97222 REQUIRED ITEMS AND REPORTS Contact #: PRI 503 -519 -6199 FAX 503- 238 -9767 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 B : 6 Permittee Signature: Call 503.639.4175 by 7:00 a.m. for inspections that business day. This permit card shall b a 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. Mechanical Permit Application FOR OFFICE USE ONLY _ }y Tigard R eceived -( / 'f 1/ L 00 O6 Q City of Ti and ((/ (Q V Permit No.: C �7 (,t•J J q 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: I:: Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Permit: Inspection Line: 503.639.4175 DateBy: T I G A R D Date Ready/By: Juns: la See Page 2 for Internet: www.tigard - or.gov Notified/Method: 1 (C Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ew 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: $ / '1 Z f oo 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. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 1 / 8S &,,,,) g >"' A Air conditioning or heat pump i7 f/„t. (requires site plan showing placement) 14.00 City /State /ZIP: ) 4 Off, ) 2.2 L Furnace 100,000 BTU (ducts /vents) 14.00 J t f / Furnace 100,000+ BTU (ducts /vents) 17.90 Mph Ck Suite/bldg. /apt. no.: /00 Project name: v 41 as pump 14.00 Cross street/directions to job site: Duct work 10.00 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. 14.00 Subdivision: I Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 �j I Gas fireplace 10.00 /2,4.-r r t l of Cadri4J 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 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 _Other: I 10.00 Business name: P - e C f n t ` Fuel piping Contact name: itc) P Z. 9� � $5.40 for first four; $1.00 for each additional Address: !? in s e /?Ill Furnace, etc. o < _ Gas heat pump City /State /ZIP: 7 ��" Q J 0,_ Wall /suspended/unit heater Phone: 6 ) s / ' c`j . 1 ''��`" Fax: : (j 03) . c , 76 7 Water heater �/ Fireplace E -mail: Range CONTRACTOR Barbecue _ Business name: n,� Clothes dryer (gas) M �� A"VJve.-- Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Minimum permit fee ($72.50) Phone: ( ) Fax:( ) Plan review (25% of permit fee) CCB lic.: jtea j F - e , ‘ , ? - S/ g /6 Cf _ State surcharge (8% of permit fee) ( TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. ...e.A.4-------- Print name: / , Lit _ t) . . Date: * Fee methodology set by Tri- County Building Industry Service Board I:\ Building\ Permits \MEC- PermitApp.doocc 01/19/07 440- 4617T(1I/02 /COM/WEB) 11 Mechanical Permit Application - City of Tigard ; : 1 Page 2 - Supplemental Information Commercial Fee Schedule: Total; Valuation: ;. Permit Fee: 1, - $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 01/19/07 2 CITY OF TIGARD 1 _ BUILDING DIVISION ' ,, PERMIT #: MEC2007 -00320 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2007 Phone: (503) 639 -4171 k i ,,�, l � l Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/23/2007 TIME: 7:OOAM PAGE: 33 SITE ADDRESS: 11850 SW 67TH AVE 100 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE: PROJECT NAME: AMERICAN FAMILY INSURANCE DESCRIPTION: TI - HVAC Project Value: $142,000 OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626-3500 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 519 -6195 Inspection Request Scheduled For: Date: 8/23/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 054525 -02 503 - 572 -7305 N Corrections /Comments/ Instructions: L MCI() # liiiilliz d 0 4 --,, , r s , PARTIAL APPROVAL 11] CANCEL 111 NO ACCESS x _p_Ass ❑ FAIL dr CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector s Dater/ A ?Phone #: (503) 718 - �-- lb CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007- 00320 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2007 Phone: (503) 639 -4171 11411111 Inspection Requests (24 Hrs.): (503) 639 -4175 . . INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 7 SITE ADDRESS: 11850 SW 67TH AVE 100 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE: PROJECT NAME: AMERICAN FAMILY INSURANCE DESCRIPTION: TI - HVAC Project Value: $142.000 OWNER: PACIFIC NW PROPERTIES, PHONE #: 503.626 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-519-6199 Inspection Request Scheduled For: Date: 7/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # Mess - - 615 Mechanical rough -in 053096 -04 503 - 519-6199 Corrections /Comments/ Instructions: / F czn ( Z C_(.9 M ....,&- [V G_ = , l� - l/l n PASS J. PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / ._____ //: & Inspector: 1 ■ Date: £ 0 Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007 -00320 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/612007 Phone: (503) 639 -4171 ''��„� ,, a � t Inspection Requests (24 Hrs.): (503) 639 -4175 ':� INSPECTION WORKSHEET FOR DATE: 7/20/2007 TIME: 7:03AM PAGE: 53 SITE ADDRESS: 11850 SW 67TH AVE 100 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE: PROJECT NAME: AMERICAN FAMILY INSURANCE DESCRIPTION: TI - HVAC Project Value: $142,000 OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626 -3501) CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503. 5 -6199 Inspection Request Scheduled For: Date: 7/20/2007 Pour Time: Code # Inspection Description Confirm # Contact # Mes - 615 Mechanical rough -in 052433 -01 503 - 519 -6199 Corrections /Comments/ Instructions: 0 P P ( -- (..___tN9 te n :-. 7.- 1--0--N 1-1 r /- PASS i n 'r'RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL II p L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ �� Date: y 2O ; Phone #: (503) 718- ZO 41 CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007- 00320 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2007 Phone: (503) 639 -4171 ',,�r�IIA, • Inspection Requests (24 Hrs.): (503) 639 -4175 —- INSPECTION WORKSHEET FOR DATE: 6/11/2007 TIME: 7:OOAM PAGE: 3 SITE ADDRESS: 11850 SW 67TH AVE 100 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE: PROJECT NAME: AMERICAN FAMILY INSURANCE DESCRIPTION: TI - HVAC Project Value: $142,000 OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 -519 -6199 Inspection Request Scheduled For: Date: 6/11 /2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 049981 -02 503-572-8347 N Corrections /Comments /Instructions: (.?C-k__ WO iCK___ otPft- -4K ic-- o ‹... _ PASS R, 'A RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL % ' L FOR INSPECTION n ADDITIONAL FEES ASSESSED inspector: _ - = (q _ Date: / //07 Phone #: (503) 718 - ��CJ i • CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2007- 00320 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2007 Phone: (503) 639 -4171 : tl Inspection Requests (24 Hrs.): (503) 639 -4175 . "''L. INSPECTION WORKSHEET FOR DATE: 6/11/2007 TIME: 7:OOAM PAGE: 4 SITE ADDRESS: 11050 SW 67TH AVE 100 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE: PROJECT NAME: AMERICAN FAMILY INSURANCE DESCRIPTION: TI - HVAC Project Value: $142,000 OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 -626 -3500 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503- 519 -6199 Inspection Request Scheduled For: Date: 6/11/2007 Pour Time: - Code # Inspection Description Confirm # Contact # Message 610 Gas line 049981 -01 503-572-8347 N Corrections /Comments / Instructions: 1/4 ........_ ❑ PASS ❑ PARTIAL APPROVAL 7 CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION II ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718-