Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00212
rl II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/27/2005
PARCEL: 1 S136DA -02600
SITE ADDRESS: 11140 SW 68TH PKWY ZONING: C -G
SUBDIVISION: MLP1999 -00011 LOT: 002 JURISDICTION: TIG
Project Description: Mechanical work for new veterinary clinic. Project Value: $118,000
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 12
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 ?: Y 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 5 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: 5 < =10000 cfm: GAS OUTLETS:
> 10000 cfm: 10
Owner: FEES
WEBSTAR VI, LLC Description Date Amount
610 GLATT CIR. [MECH] Permit Fee 7/27/200E $1,594.50
WOODBURN, OR 97071 [MECPLN] Plan Rev 7/27/200f. $398.63
[TAX] 8% State SurcharE 7/27/200f. $127.56
Phone: 503 981 - 0155 Total $2,120.69
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265 REQUIRED ITEMS AND REPORTS
CANBY, OR 97013
Phone: 503 266 - 1249
Reg #: LIC 14008
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 • • = • - :11 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1-80o-332-2344.
Issue. By: I Lai 1 4.4/ Permittee Signatu :
all 503 - 639 -4175 by 7:00 a.m. for inspections that b ess da .
This permit card shall be kept in a conspicuous place on the ' i e until completion of the project.
Approved plans are required on the job site at the time of each inspection.
UN) o g h- ? 4r4 JeL
1fl chanical Permit Application ` FOR on ICI:, usl o
City of Tigard , / n 7 DateBy: 6 o j 0 Permit No.: M - , 2_
13125 SW Hall BI L 11. r E8 { � s-+ u �`J ,�/ Plan Review
Phone: 503.639.41 - 1 6 -- Ua+. I I \ �' Other Permit:
Inspection Ins Line: 503.639.4175 �V ° ■ J. I , I DateB Date/By: /
-
P _ Date ReadyBy: tur+s: ® See Page 2 for
Internet: www.ci.tigard•q�,Ftgy o 5 2005 Notified/Method:7 T /I/ /� Supplemental Information
/ � r r
• .: R1 CiITY ( F WORK �' i ' OR. :mss •• CQM1��R � �' .SCH)I;DuLE :USE CHECKLIST
'New construct t6tl ' tC'D�N 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: $ 7/ /3 000, OD
RESIDENTIAL EQUIPMENT / S FEES*
❑ 1- and 2- family dwelling >E- Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description
Qty. i Ea. [ Total
. '• JOB SITE INFORMATION AND LOCATION .
Job site address: -1-1--- D Air conditioning or heat pump
S (a ` (requires site plan showing placement) 10 14.00
City/State /ZIP: �` ith . -( 7 Zz3 Furnace 100,000 BTU (ducts/vents) fir 14.00
Furnace 100,000+ BTU (ducts/vents) .5 17.90
Suite/bldg. /apt. no.: Prolec name:
�'y � Gas heat pump 14.00
Cross street/directions to job site: ((y1 Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
6e0(6– � , ;� n _ �y Q Unit h e 14.00
at
J7/►t Vr ool / [� Unit heaters (fuel type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I 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
��
t 1-1(14 Gas fireplace 10.00
ii PPAA — s757 e rh s _1 5 O� pO Flue vent for water heater or gas
1 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: c.coLit, VaiklikiNiOthi ko n t" Environmental exhaust and ventilation
Address: vj Range hood/other kitchen
�y p equipment 10.00
City/State /ZIP: ✓ - Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility moms) /A 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. /0 _
Gas heat pump
•
City/State /ZIP: V Wall/suspended/unit heater
Water heater
Fax: Phone: ( ) ( ) Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Ayi,' ( _Qotk/7' Clothes dryer (gas)
Other.
Address: Pp / h- / 21,6 CA
MECHANIL PERMIT FEES*
City/State /ZIP: ea 0 3 9 70/ - Subtotal
( /�) Z 1(a -( 2 q (5t / 1 _ �' 7 Minimum permit fee ($72.50) 15911, 5
Phone: [v I Fax: U , ) 2 C� Plan review (25% of permit fee) S4 G 3
CCB lic.: / I-100 er State surcharge (8% of permit fee) i 21. so
(7r TOTAL PERMIT FEE 9/ 24.47
This permit application expires if a permit is not obtained within 180
Authorized signature: S days after it has been accepted as complete.
1 Print name: `/ jot ot, YYlO'� I Date: , C.( --) k5 • Fee methodology set by Tri -County Building Industry Service Board
i:\ Building \Penmits\MEC- PermitApp.doc 12/03 440- 4617T(IIUO2 /COM'WEB)
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00212
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/7005
Phone: (503) 639 -4171 niloy I
Inspection Requests (24 Hrs.): (503) 639 -4175 . I I
INSPECTION WORKSHEET FOR DATE: 6/7/2006 TIME: 7:O6AM PAGE: 9
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999-00011 LOT #: 0Q2 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project Value: $118,000
OWNER: WEBSTAR VI, LLC, PHONE #: 503- 981- 0155
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266.1249
Inspection Request Scheduled For: Date: 6/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 031282-01 971-235-1353 N
Corrections/Comments/Instructions:
/� _ A.
ir
\k - U ( Wkc--
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: A/ Da te: T Phone #: (503) 718 - 2 4 2.
CITY OF TIGARD - _
BUILDING DIVISION PERMIT #: MEC200 =, 00212
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/271200;x'
Phone: (503) 639 -4171 u
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/26/2006 TIME: 7 :00AM PAGE: 43
SITE ADDRESS: 11140 SW Gt3TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999 -00011 . LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project. Value: $118,000
OWNER: WEBSTAR VI, LLC, PHONE #: 503 - 9131 - 0165
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 2661219
Inspection Request Scheduled For: Date: 5/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
631'i Smoke detector shutdown 030672 -01 503-849.2171 N
Corrections/Comments/Instructions:
gaA.01,4,e_ 6 t_- , c--( _.-1 .,
(tap)
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 7 / Date: 5 1oZ.. f 4 co Phone #: (503) 718- 7 I d..3
,
CITY OF TIGARD '
BUILDING DIVISION PERMIT #: MEC2OW, 00212
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7127/2005
Phone: (503) 639 -4171 a�
Inspection Requests (24 Hrs.): (503) 639 -4175 .� ' I �
INSPECTION WORKSHEET FOR DATE: 5/26/2006 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 11140 SW $8TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999.00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE. VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project Value: $118,000
OWNER: WEB STAR VI, LLC, PHONE #: 503 - 901 -0155
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266-1249
Inspection Request Scheduled For: Date: 5/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
630 File damper 030672 - 02 \\ 503 - &'9.21711 Y
Corrections /Comments /Instructions: A V' D to Vt-c) 2% ' tv O 0 In
tip6 TO Situ1 , U
kN viekTrzi :
❑ P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR\INSPECTION ❑ ADDITIONAL FEES ASSESSED
lAft
Inspector: r� Date: 5 i�(.0 / 0 6 Phone #: (503) 718 - 0. 9.23
p l
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MFG "200.(1011:7
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/27/200x,
Phone: (503) 639 -4171 Avutt l
Inspection Requests (24 Hrs.): (503) 639 -4175 '11.
INSPECTION WORKSHEET FOR DATE: 5/26/2006 TIME: 7:03AM PAGE: 65
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999 -00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project Value: $118,000
OWNER: WEF3STAR VI, LLC, PHONE #: 503- 901 -0165
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503-266-1249
Inspection Request Scheduled For: Date: 51 512006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 030562 -01 50 -849 -.1171 N
Corrections/Comments/Instructions:
I ! e- S 1 S /rl o lC� o) e Tc G ✓' S 4 r-A. T d 0 [,vrn s A' mi .
f-1 (Svc 1)6_c__
4/o 04-it o r is S Gi e t
❑ P ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
.1
Inspector: Ab Ill'
I I . D ate: SIA S / 0 [o Phone #: (503) 718 -v2 , /. 3
IM
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Mr C 00 00 ?1.?
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2O0!i
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 W :. .
INSPECTION WORKSHEET FOR DATE: 5/3/2006 TIME: 7:08AM PAGE: 97
SITE ADDRESS: 11140 SW 60TH PKW'( CLASS OF WORK:
SUBDIVISION: M1..P1 999 -000 1 1 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project Value: $118,000
OWNER: WEB STAR VI, LLC, PHONE #: 503 - 981 - f!=
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 603.266 - 1249
Inspection Request Scheduled For: Date: 5/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # . Message
630 Fire damper 0291119 -01 503-569.7350 Y
Corrections /Comments /Instructions: )1ciTi 1S)rtt?ti — I fe u''ve_ a 4- o b e
prcSe -N• 5 i ✓e c, ctI1 -+ 3vP�n)
❑ PASS El PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ri; ALL FOR IN ECTION ❑ ADDITIONAL F ES ASSESSED
/KA �
Inspector: , Date: e , Ph one #: ( 503 ) 718- -
_w 1
CITY .OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00:212
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7127/200;
Phone: (503) 639- 4171� I I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/3/2006 TIME: 7 :08AM PAGE: 98
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: IviLP199R.00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project. Value: $118,000
OWNER: WEi3SrAR VI, LLC, PHONE #: 503-981-0155
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 -26 -1249
Inspection Request Scheduled For: Date: 5/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
635 Smoke detector shutdown 029117 -01 503 - 569.7350 N
Corrections /Comments/ Instructions:
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 51 5 / 0 ( Phone #: (503) 718- of oZ 3
GITY.OF TIGARD
BUILDING DIVISION PERMIT #: MEC200h 00212
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2006
Phone: (503) 639 -4171 qu il
Inspection Requests (24 Hrs.): (503) 639 -4175 : �'+�
INSPECTION WORKSHEET FOR DATE: 4/14/2006 TIME: 7:07AM PAGE: 88
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MI91999- 00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project Value: $118,000
OWNER: WEI3STAR VI, LLC, PHONE #: 503 - 981 -0165
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503- 266.1249
Inspection Request Scheduled For: Date: 4/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 027799-01 603-559 -73;0 ,, AA PCTT
Corrections /Comments /Instructions:
6QEA-TrcP--Ryp__F.
6.17•, _ 11 4 --rp-f--eh.
a_1(-4U6'
--�
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
IL ❑ CA L FOR 1 SPECTION ❑ ADDITIO AL FEES ASSESSED
44 i .. pro —�
• Inspector: Date: / ®7 Phone #: (503) 718- Zi `r
car ;OF TIGARD
BUILDING • '■
BUIL • #: MF:C2006 00212
13125 SW Hall Blvd., Tigard, OR 9722 DATE ISSUED: 7 /:?7 / ?00h
Phone: (503) 639 -4171 ' m 1 , n ��
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'!+� F__..
INSPECTION WORKSHEET FOR DATE: 2/21/2006 TIME: 7:02AM PAGE: 90
SITE ADDRESS: 11140 SW 60TH PKWY CLASS OF WORK:
SUBDIVISION: Ml.P1999.00011 LOT #: UO2 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project'Vaiue: $118,001)
OWNER: WEE3STAR VI, LLC, PHONE #: 603- 981 -1)165
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 50 )66,. 1249
Inspection Request Scheduled For: Date: 2/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough - in 027197 - 01 603 -659 - 7351) Y I A i
Corrections /Comments / Instructions: /V `
l.} -Aep 0 b (iurS
if I I'
0_,fJ u tu '-' v
. j
®r d
141 - ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL . ON L FOR INSPECTION ❑ ADDITIO AL F ES ASSESSED
dir W� Date: �-v [) hone #: (503) 718- ` %� "
Inspector: �� ( )
- ♦ i
CITT F TIGARD
BUILDING DIVISION PERMIT #: MEG2005.00212
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 :-
INSPECTION WORKSHEET FOR DATE: 12/12/2005 TIME: 7:02AM PAGE: 62
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999-00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Mechanical work for new veterinary clinic. Project Value: $118,000
OWNER: WEBSTAR VI, LLC, PHONE #: 503-981-0155
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266 - 1249
Inspection Request Scheduled For: Date: 12/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 023267 -01 503-849 -7914 N
Corrections/Comments/Instructions:
/- 7 -„,
LO- CD 03 -E-cy4-2.- IA/
. •
m i'�tIL%11L
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: t 2j hone #: (503) 718-
1.