Permit CITY TIGARD MECHANICAL PERMIT
,; 1 A DEVELOPMENT SERVICES PERMIT #: MEC2004 -00465
�, II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/15/2004
PARCEL: 2S 101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 120
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:
> 10000 cfm: GAS OUTLETS:
Remarks: New VAV box for server room.
Project Value: $3,180 •
Owner: FEES
TIGARD TRIANGLE I LLC Description Date Amount
4650 SW MACADAM AVE STE 220 [MECH] Permit Fee 7/15/200 $99.64
PORTLAND, OR 97201 [TAX] 8% State Surcharl 7/15/200 $7.98
Phone: Total $107.62
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202 Mechanical Insp
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 -01 I • •u•h OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(50 " 6 -6699.
I- ued By: k - �� .d Permittee Signature: \ �„
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mec .. Permit Application FOR OFFICE USE ONLY
City 4 1.gard Received Pemut No.:
13125 SW Hall Blvd., Tigard, OR 97223 y ®� ���� i/ /
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /�ina I ; Date/By: Other Permit:
Inspection Line: 503.639.4175 ' Date Ready/By: Juris: See Page 2 for
Internet: www.ci.tigard.or.us 5 ® Notified/Method: / t Supplemental Information
. „ .. TYPE OF WORK ; •• . ' . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Addition/alteration/replacement 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: $ 80
' ` RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling V Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. 1 Ea. I Total
?, JOB SITE INFORMATION AND LOCATION .. Heating/cooling
Job site address: ) Sam, 6 7iR � i, _ „Q f� Air conditioning or heat pump
3aa a ".. _ (requires site plan showing placement) 14.00
City/State/ZIP: •7 >' J are Furnace 100,000 BTU (ducts/vents) 14.00
��� • / Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: A /4 Project name: /cs , g,;, T 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
•° S .DESC'RIPTION "✓ OF W ORK Water heater 10.00
Y ,� ij,Q , A
/ ,- Gas fireplace for 10.00
/Y (/ L°/vL°�L D �+'1 Flue vent or water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
.Y. 0 PROPERTY OWNER r , I " • _ ' . :; TENANT'.. O Chimney/liner/flue/vent 10.00
�- , I Other: 10.00
Name: / Q �._L_C . Environmental exhaust and ventilation _
"� ,, �] Range hood/other kitchen
Address:
i 7- n�9 -r�l � equipment 10.00
City/ State/ZIP: 9‘7a0/ Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
- :APPLICANT.: -', !.` . CONTACT PERSON Attic /crawlspace fans 10.00
/ Other: 10.00
Business name: ,/2h-, e i - / Lori' /7'« i/ h
Fuel piping
Contact name: �Q, /G A , „ e $5.40 for first four; $1.00 for each additional
Address: /3 ? 9 se / 'E ,') Si-- Gas h ea t etc.
Gas heat pump
City/ State/ZIP: r }JanOJ1 e ze 9 72Q L Wall /suspended/unit heater
) _4449 (93 z9 -7a3 g Water heater
Phone: Fax:
Fireplace
E -mail: Range
' CONTRACTOR': ". Barbecue
Business name: Clothes dryer (gas)
J Other:
Address: 1339 .g'( c 'o /2 j V"
ME'CHANICAL'PERMIT FEES*
City /State/ZIP: r'Tjlfl4J 77 t� Subtotal W. 4 f
C.t✓G Minimum permit fee ($72.50)
Phone: ) j39.'6/®® Fax:g3) 20,v3
Plan review (25% of permit fee) 7, 9q
CCB lic.: O3 ) 3 State surcharge (8% of permit fee)
TOTAL PERMIT FEE /07' a-
This permit application expires if a permit is not obtained within 180
Authorized signature: d ays after it has been accepted as complete.
Print name: � /e a ` el Date: 7/4/ V • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Pemtits \MEC- PennitApp.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 R quested AM PM BUP
Location l3a0 c� Suite /c7Z) MEC c=20?, D'D5/
Contact Person 503 7 `��� 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 Ceiling ��
Roof i Wry
Other: ✓ } ± ., Final
PASS PART FAIL
\i
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: __
Final
PASS ART FAIL
HANICA
LPost -&Beam
Rough -In
Gas Line
Smoke Dampers
'�iri�
• FAIL
• = AL L � tr -.- Service �� �
UG/Slab Mi !MEI Rough -In ��•L������.� /I��
_ � - , r �
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 call for reinspection RE: 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