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Permit - - CITY OF TIGARD MECHANICAL PERMIT . o, DEVELOPMENT SERVICES PERMIT #: MEC2003 -00119 �'� li 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/22/03 PARCEL: 1S136AD-06505 SITE ADDRESS: 10998 SW 68TH PKWY SUBDIVISION: WAY LEE ZONING: C -G BLOCK: LOT: 003 JURISDICTION: TIG CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 3 OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: 2 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 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: 1 AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN > =100K BTU: 2 <= 10000 cfm: GAS OUTLETS: 3 > 10000 cfm: Remarks: Mechanical work associated with new office building. Owner: FEES BANK OF SALEM Description Date Amount PO BOX 847 SALEM, OR 97308 [MECH] Permit Fee 4/22/03 $72.50 [MECPLN] Plan Rev 4/22/03 $18.13 [TAX] 8% StateTax 4/22/03 $5.80 Phone: 503 - 585 - 5290 Total $96.43 Contractor: MONTAG OF SALEM INC 101 UNION ST NE SALEM, OR 97301 REQUIRED INSPECTIONS Phone: Gas Line Insp Mechanical Insp Reg #: LIC 00000531 Final Inspection 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 -669 . --�r�- Issued By: a A_J( 1 [AT Permittee Signature: 6n 01) t Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day J 0 qq � ,;5W GO n PAIZV w� 6 0 P ).00). - 00 39 b -C9/1— .. - MechanicalPermitApplication 1(:l: US1.: ONLY Date received: g /? D�- Permit no.: Flf.�3'�llq 4 : 1 -,i City of Tigard ,i' Project/appl. no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd, Tigard, O Phone: (503) 639 -4171 i Date issued: By: Receipt no.: Fax: (503) 598 -1960 �� r1O13 Case. file no.: Payment type: Land use approval: � % w ld i ng permit no.: 1:309 Z00 - co 39 b r *. , A\ \ O ❑ 1 & 2 family dwelling or accessory �Commercialy641&rial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alration/replacernent ❑ Other: .IOK s I I: INEOR lATION CO!V1Ni1:RCIAl. V: LIJ:VIION SCIIEI)Ul.k: A Job address: 10qq6 so (,S+ 1)wwvNA / Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ IS 761. • loo rG Z ? Lot: Block: I Subdivision: / *See checklist for important application information and Project name: L a _ 0 s 2 ' 1. i j) • : ‘-D jurisdiction's fee schedule for residential permit fee. City/county: ZIP: I S 2 FA\III.V DWI :III : \G 1'1:1011i FI:l: St 111.111:1.1 E1.1:: . - AND CO%l'% ItI(::U. /I\` UCSI RI :Al I:QUll'1I:: \ 'I SCI11:1)11 1 Description and location of work on premises: .., CySi76/11i - IA -m?.J a IN1ET -1-I i • Fee (ea.) Total Est. date of completion/inspection: (1o)f is -5 Description Qty. Rea only Res. only Tenant improvement or change of use: HVAC: I ,3 d Z Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit �i� CFM 3 space insulated? ❑Y es ❑ No Air conditioning (site plan required) 3 Is existing sP ' Alteration of existing HVAC system Nil:(,I1ANIC: I. ((l)N I 12ACIOR Boiler /compressors State boiler permit no.: #1 Business name: I J t(, OF S ftu t v4I 1 u(_ HP Tons BTU/H Address: I 0 I ll►.) ID►) - N) F Fire/smoke dampers/duct smoke detectors City: , ALE yl/1 State ry ZIP: • 30 Heat pump (site plan required) — Phone:5,5 6 639f Fax: SAS /147 E -mail: MI rep ace Irrr47 . timer BT T Including ductwork/vent liner ❑ Yes ❑ No CCB no.: 531 Install /replace /relocate heaters - suspended, City/metro lic. no.: wall, or floor mounted Name (please print): Q D SC to it,_) Vent for appliance other than furnace (ON - IACF PERSON Refrigera on: Absorption units BTU/H Name: S 1'0 7C .li . / IV1t11J 1 AEG 0, cAc esev1 (/1(. Chillers HP Address: to ( l)/1t0) S rJ Compressors HP Environmental exhaust and ventilation: City: SALDO I StattC2) I ZIP: 0 )13 © I Appliance vent Phone: ' Fax:%r)4 E -mail: Dryer exhaust Hoods, Type U IUres. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) 3 Mailing address: Exhaust system apart from heating or AC City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets) Type: LPG ✓ NG Oil 3 Phone: Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Name: Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: 1 State: 'ZIP: Insert - type ukii Phone: I Fax: I E -mail: Woodstove /pellet stove PP signature: kih � ( � 41 .. / / Other: — A licant's si nature: I Date:3 I't O�i ` Other. Name (print): Sip �,,,j - Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ Notice: This permit application Minimum fee $ ❑ Visa ❑ MasterCard Credit card number. / / expires if a permit is not obtained Plan review (at %) $ p w i t hi n 180 days after it has been Expires y State surcharge (8 %) .... $ Name of cardholder as shown on credit card accepted as complete. TOTAL. $ $ Cardholder signature Amount 440 -4617 (6 /00 /COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 - INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 7 AM PM - BUP Location / q g 62 g Suite 3 -0.0 I q Contact Person Ph 1 93P. - 13S Contractor Ph ( ) SWR BUILDING. Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: l 9_ 01°624 SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING r7L _ _ Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P PAR FAIL CHANICAL _ sT&eeam Roug -In Gas Line Smoke Dampers tir=h PART FAIL ICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ? ADA D 7/0 2 6'/ Ins Inspector Ext Approach/Sidewalk p Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL