Permit CITY TIGARD MECHANICAL PERMIT
f� � DEVELOPMENT SERVICES PERMIT #: MEC2004 -00362
,.� �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/28/2004
PARCEL: 25101 DA -00101
SITE ADDRESS: 13190 SW 68TH PKWY 200
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: C -P
BLOCK: LOT: 003 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: 2 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: 2 OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install (2) 3 -ton comp. rm. AC units. Value: $12,000.
Owner: FEES
SCHNITZER INVESTMENT CORP Description Date Amount
PO BOX 10047 [MECH] Permit Fee 6/28/200 $168.50
PORTLAND, OR 97296 [MECPLN] Plan Rev 6/28/200 $42.13
[TAB] 8% State Surchari 6/28/200 $13.48
Phone: Total $224.11
Contractor:
ALLIANT SYSTEMS LLC
1600 NW 167TH PL, STE 330
BEAVERTON, OR 97006 REQUIRED INSPECTIONS
Phone: 503 - 230 -8991 Cooling Unt Insp
Final Inspection
Reg #: LIC 153420
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.
r ?h't i
Issued By: 41 �`- Permittee Signature:A" / `l/ ►"
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
13/q SW 6&T" PKWY NE Mechanical Permit A !.� >v- i FOR OFFICE USE ONLY •
_
City of Tigard fICG Gon ` Received/] Permit No. �jy�,/
13125 SW Hall Blvd., Tigard, OR 97223 cg
Date/By: ve VV 4"cRax 0 6 3 - .
Phone: 503.639.4171 Fax: 503.598.1960 6„I�- 1 \ V\� ` J 41.7.11,!:,,,,101; Plan Revte, ' Z f ' "O Other Permit
DDate/By: Inspection Line: 503.639.4175 f r••f 1 Date Read B i 0 v Juris: ® See Pa e 2 for
Internet: www.ci.tigard.or.us 0 � 1 `� Ready /By: `%� Page
2� 0 11 ^ ®�� Notifie� rf-I r Supplemental Information
J
X c��v `-�
' TYPE OF W ORK RCTAL FEE* S — USE CHECKI IST
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, overhead, and profit.
• CATEGORY OF CONSTRUCTION Value: $ 1�D0� , )
. RESIDENTIAL EQUIPMENT / SYSTEMS. FEES*
❑ 1- and 2- family dwelling ommercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /� //��,,���� kw�`'f Air conditioning or heat pump
�� 1 ` W �Pn1� (requires site plan showing placement) 14.00
City / State/ZIP: / i 7 01 ( 1 - , a v 0 0` 2-2-3 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: ,/ Project name: �FL 0 t� . 1�y�A Furnace 100,000+ BTU (ducts/vents) 17.90
r'1 l Gas heat pump 14.00
I
Cross street/directions to job site: .J:20 v C , � • } Duct work 14.00
• II . 4 / 1 4 Hydronic hot water system 14.00
—1 t �0 Residential boiler (radiator or
6 .
Cat— hydronic) 14.00
t— Lt9i2T . r d�O Unit heaters (fuel -type, not electric),
_Q __ I, �b 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
• I)
DESCRIPTION OF WORK • Water heater 10.00
tIV7V0
•
` L ' T o N C n n Gas fireplace 10.00
I '�+ . 1�(,� AG the•X 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 Chimney/liner /flue /vent 10.00
❑ TENANT Other: 10.00
Name: � r�G 6 •v t 1 Nf CIS A fa Environmental exhaust and ventilation
Address: \'' i toq f tckm Range hood/other kitchen
vv ^'" equipment 10.00
City/ State/ZIP: O 1r,'t 0 Clothes dryer exhaust 10.00
/ Sin le -duct exhaust (bathrooms,
Phone: (Sp�j) �g- Z � ! � /�:1( v , -33� � (� Q • toilet compartments, utility rooms) 6.80
' PLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
/�-1 /� y Other: 10.00
Business name:
'" ` 11 V1,t/VI �7 �Q/Ail S 1,1/6f Fuel piping
i
Contact name: tell 1 W! $5.40 for first four; $1.00 for each additional
Address: [von, A w 1, 62 leVi /At., b Furnace, etc.
Gas heat pump
City/ State/ZIP: 'Qjea.V 6V rp Q , «'1 00,6 Wall/suspended/unit heater
Phone: ( (1). 1,27D g/at 1 Fax: : (�(5 )v ` � g Water heater
t Fireplace
E -mail: Range
• CONTRACTOR Barbecue
Business name: Al( lav r / &I-e, 5 Clothes dryer (gas)
� Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 14 g, SO
Phone: ( ) F ax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee) `1L . /3
CCB lic.: 1 12 /4/,.0 State surcharge (8% of permit fee) _j 3 . Y1
�
/j �� This TOTAL PERMIT FEE 2 a r //
Authorized signature: J • •rla VV r� p application expires if a permit is not obtained within 180
L>n /� V ' / days after it has been accepted as complete.
Print name: �ie�' / i1 at (,e_ ) I� Date: (o13 r p q, ` Fee methodology set by Tri- County Building Industry Service Board
i:\Building\Permits C- PemtitApp..doc 12/03 4404617T(1I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$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 12/03 2
CITY OF TIGARD 24 -Hour
BuILDI G Inspection Line: (503) 639 -4175
INSPECTIOIVISION Business Line: (503) 639 -4171 MST
BUP
Received -, ?--- 3 Date Requested -°� AM PM BUP
/
Location l 3/ C ID (o Q 4 ' 4 -- PkW Suite 246 MEC U q- d a 36.Z._
Contact Person Ph ( 7 / ) a 3S 3735" PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner S I-CC. ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: i SIT
Post & Beam '�J aA/L'CLllr--
Shear Anchors /1 `
Ext Sheath/Shear �
Int Sheath/Shear
Framing
Insulation � -r` i. ) i10 . 1 I
Drywall Nailing _
Firewall
Fire Sprinkler 2
Fire Alarm I ` ,;• . ' 1sr r . Mi
Susp'd Ceiling
Roof _
Other: �� jir
_ Final ig 11
AMIN" 1 M ------ 7& = =
-
PASS PART FAIL
PLUMBING
Post & Beam i � �� :1 i�
Under Slab
i t // I �l i I F
Rough -In
Water Service
Sanitary Sewer
Rain Drains 0
Catch Basin / Manhole
Storm Drain /T L:
Shower Pan i —`
Other: _ AO !
Final _ ,-
PASS PART FAIL 1 d WffAP T •
MECHANICAL _ I .d,, Post & Beam 1111Frif A. _ Rough -In ) i
Gas Line
Smoke Dampers
PART FAIL
E 4 -
' RICAL
ice
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: 0 Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL