Permit C ITY OF TIGARD MECHANICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00585
Ai
° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 9/23/2004
PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 460
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:
ELE 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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: HVAC modification for TI.
Project Value: $26,283.
Owner: FEES
L & B TRIANGLE CORPORATE PARK INC Description Date Amount
1120 NW COUCH STE 610 [MECH] Permit Fee 9/23/200 $451.55
PORTLAND, OR 97209 [MECPLN] Plan Rev 9/23/200 $112.89
[TAX] 8% State Surchar€ 9/23/200 $36.12
Phone: Total $600.56
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202 Duct Inspection
Phone: 239 -4600 Duct Inspection
Reg #: LIC 33135 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 -6699.
Issued By: Permittee Signature:
, /t/l i,ic 4 c
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
113ZZ I Sw , 98 ti
Mechanical Perm k cation FOR OFFICE USE ONLY
Ci of Tigard . Received o
13125 SW Hall :W / . Plan Revte Permit No,: 00 O�g
ocV 97223
Phone: 503.639. Fax: 503.5P8`'t 41/� t /,FA Other Pemtit:
pMt Date/By: y ' � �
Ins ection Line: 503.6 ' 7 �,,
P i 1� s rt. W Date Ready/By: 944, /pt/ 1uris: See Page 2 for
Internet: www.ci.tigarr ��® s i d/Metho Supplemental Information
�vc7'ioN poly ��� . ®� ��'..._ U al/ 7-7, 7
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0 s, E OF WORK ; r .COMMERCIAL FEE* -SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor verhead, . • • profit.
' "-' CAT0ORY OF CONSTRUCTION = ; '-' Value: $ b4Ce �p : P •
,: RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2 family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family Master builder ❑ Other:
Description 1 Qty. I Ea. I To .l
#. ;;a _i. :._ 'JOB SITE INFORM_ ATION AND:LOCATION , ,. Heating/cooling
/�,.) Q �i� Air conditioning r heat um
Job site address:
JW ��/ <� (requires site plan showing placement) '14.00
Ci /State/ZIP: ‘70.).- a •• d OlZ Furnace 100,000 BTU (ducts/vents) 14.00
Fumace 100,000+ BTU (ducts/vents) 17.90
Suit Idg. /apt. no.:
'9 D 1 Proj name: g��� 0 n 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
7 t .; "' w= Water heater 10.00
•� �.. ..._ .. -.... w .DESCR�1'I¢N -WQRK ` , -,... "� �.. ., . •
Gas fireplace 10.00
J �� } Flue vent for water heater or gas
I� VAC- m badi 4 Ca -T)d1 £2 j 7i I. dace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
• Wood fireplace/insert 10.00
/ • ' PERTi� bWNER " - Chimney/liner/flue/vent e/vent 10.00
.,,. ti + l : '. . TENANT :- ` _ Chimney/liner/flue/vent
y
p 10.00
p� Other:
Name: { , Ql '"l t /tA( o ' ( ,t„ Co AP. P s Environmental exhaust and ventilation
' Range hood/other kitchen
Address: `` � l ota
L � �w tJ�.C. 4 � equipment 10.00
City/State/Z1P: O� 91 ao9 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax ( ) toilet compartments, utility rooms) 6.80
a.. •` ' x; { } P4 t. c 1 • t C_ ONTAC' ' P00O_ N Attic/crawlspace fans 10.00
Business name: YCQ n �ea�7 i z C. Other: 10.00
c�° Fuel piping _
Contact name: ji' �a. /7'7 7 e $5.40 for first four; $1.00 for each additional
Address: / 39 SE��ileo� , ..55 1 . Furnace, Gas heat etc.
u
City/State/ZIP: `
pump
Ci
t5r pI -74/�� d 9 7aa 2 W alVsus pended/unit heater
Phone: ) y000 Fax: . ..rea ) 039 -7038 Water heater
Fireplace
E -mail: Range
U '. .1 t' r , - "'CONTRACTOR- .. ~ i ? U'r .' Barbecue
Business name: A9m off. j� iVC ' G Clothes dryer (gas)
_ Other:
Address: / 2 _see / ��0� S �' ;' ;. 11IECHANIL PER
C AMTT FEES•
City/State/ZIP: /?0•"--1-k,.)0/ O / _ 972e9 Z Subtotal 951 5 S.-
Minimum permit fee ($72.50)
Phone: L*3) 62 Fax: ')3 23, Plan review (25% of permit fee) / / Z .89
CCB lic.: 33/3 S State surcharge (8% of permit fee) 3G . /2.
/, �, TOTAL PERMIT FEE 4 . S�
Authorized signature: (�I//J T his permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name: /G' a " ) , ry , e-744* I Date: /(i/ Q Fee methodology set by Tri- County Building Industry Service Board
i:\Building \Permits \MEC -PamitApp.doc 12/03 440 4617T(11 /02/COM/WEB)
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 / ?J I fo Okt, Suite 4 /6 • t'v � 6'6"110 MEC
Contact Person Ph ( ) O PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner - _ " ... ,tai ELC
Footing
ELC
Foundation .
Access: , ......
Ftg Drain ELR _ r
Crawl Drain
Slab Inspection Not SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear 7
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: _ 401
PASS Final
PASS PART FAIL vlll'
PLUMBING i I:I . l4i
Post & Beam
W
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
S � -,.'ampers
PASS PART FAIL
ELE " ICAL
ervice
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 El Please cal or rei • pection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA 1,
0•
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL