Permit '�
r .
CI TY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00132
' � f � � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/24/03
PARCEL: 2S 101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 401
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
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: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: TI: VAV boxes and Grilles.
Owner: FEES
TIGARD TRIANGLE I LLC Description Date Amount
4650 SW MACADAM AVE STE 220 [MECH] Permit Fee 3/24/03 $108.98
PORTLAND, OR 97201 [TAX] 8% StateTax 3/24/03 $8.72
Total $117.70
Phone:
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202
Mechanical lnsp
Phone: 239-4600
Final Inspection
Reg #: LIC 33135
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 -001-00
Issued By: 0e , �e1 4\41_41) Permittee Signature: ,a4/0
i :.
Call (503) 639 -4175 by 7:00 P.M. for inspections neede the,- -xt business day
A Mechanical Permit Application OFFICE USE ONLY 4
Date received: 3 -t /-O3 Permit no.: m6Coo3_6 6 f3 -
�� i y City of Tigard .41 �'� � y g Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: _ Payment type:
Land use approval: Building permit no.: Au p- ZO03 -o d oS 7
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory ) Commercial/industrial 0 Multi - family Al(Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: /3aa / .S x.i 68"A , 0 - e'.e c&A, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 7r/e $ky I Suite no.: 5 /a.1lh2 value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 7 360 • o0 •
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: »Q, //a weaq 2, ,L, e„ 7L.5 jurisdiction's fee schedule for residential permit fee.
City /county: 7 — i ct - I Z IZ P: 1 & 2 FAMILY DWELLING PERMIT FIE SCHEDULE
Description and location of work on premises: //U•96 7 a.#77‘ AND COMMERICALIINDUSTRIAL EQUIPMENT SCIEDULE
.2 . — yrs4 "/e Fee (ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
HVAC:
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned? Iles 0 No Air conditioning (site plan required)
Is existing space insulated? %Yes 0 No Alteration of existing HVAC system
AIECIIANICAL CONTRACTOR Boiler /compressors
Business name: tate boiler permit no.:
American Heatir> Inc. InC HP Tons BTU/H
Address: 1339 SE Gideon St. Fire/smoke dampers/duct smoke detectors
City: Portland 'State: OR 1 ZIP:97202 -2418 Heat pump (site plan required)
Phone: 239 -4600 I Fax: 239 -70381 E -mail: Install/replace furnace/burner BTU/H
CCB no . Including ductwork/vent liner 0 Yes 0 No
13135 Installreplace/relocate heaters — suspended,
City /metro lic. no.` wall, or floor mounted
Name (please print):e i•,-,mg Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: / e • an-' e . Chillers HP ,
Address: . /3 3 , S6- 6./ o1e ev, sa", Compressors HP
Environmental exhaust and ventilation:
City: — j /- ct...2ci Istatec;leiziP:97Z02. Appliance vent
Phone: z39— 6ce Fax: 3 7a E -mail: Dryer exhaust
OWNER Hoods, Type I/ II/res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: 1 ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E - mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Number of outlets
Name:
.i?7 s ea," e'_` '7i'fa* 7✓ Other listed appliance or equipment:
Address: ./. 7 3 9 Se , / ciP ,,, , Decorative fireplace
City: l 1`t n0/ I State:QB I ZIP: g742tP Insert — type
Phone�?,39- -A44 1 Fax0.3 f 7 1 E -mail: Woodstove/pellet stove
/ Other: _
e ,
Applicant's signature: ,.4✓ a�� ;,/ ate: 3/45 ;4 ? Other: ,
Name (print): / ,4,4
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ /0 �O
Notice: This permit application Minimum fee $
0 Visa 0 MasterCard
/ expires if a permit is not obtained Plan review (at %) $
Credit card number: b
d
w ithin 180 days after it has been
Expires y State surcharge (8%) .... $ 2. i 49 -
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 1/ '
$ 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 u^ BUP
Location / 3 a ' � `) Pik' Suite V'? / MEC 3 J O) / 3 2
Contact Person r(,[ ' - ,441-N Ph ( ) 239- 1 /‘0 , 00 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ,
Int Sheath/Shear •
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm •
Susp'd Ceding
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service -
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS
PAT' FAIL
C
Post & Beam
Rough -In
Gas Line
Smoke Dampers
4 1f PART FAIL
E RICAL
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 0 Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line .� / ADA C —?))11
D a t e / 7 '
Approach/Sidewalk I nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL