Permit ' CITY OF TIGARD MECHANICAL PERMIT
t)' DEVELOPMENT SERVICES PERMIT #: MEC2005 -00522
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/2/2005
PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 100 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: HVAC modification. Valuation: $4118.
CLASS OF WORK: OTR 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:
Owner: FEES
TIGARD TRIANGLE I LLC Description Date Amount
4650 SW MACADAM AVE STE 220 [MECH] Permit Fee 9/2/2005 $123.10
PORTLAND, OR 97201 [MECPLN] Plan Rev 9/2/2005 $30.78
[TAX] 8% State Surchar€ 9/2/2005 $9.85
Phone: Total $163.73
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST, STE. 1 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Phone: 503 239 - 4600
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 -0010
through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: J Permittee Signature: 4
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
17,9:)..t 6eQw1,09
Mechanical Permit A lica • 1 - FOR OFFICE USE ONLY
r Received r - _ q �
\ I L ` (J/ n '� Date/By: i 5 I f Perot No. .. 4s � 0C� t7QJ J7!'�"
City of �gard �? \-,-I' � n '� � � � � 1V/"
13125 SW Hall Blvd., Tigard, 0123 J Plan Revi Other Pernik:
503.639.4171 Fax: 503.598.1960 t > /� I3' ,' �� Date/By: QS •
Inspection Line: 503.639.4175 i;! ,a °i 4 0 W' ,�jj. rt�l � I Date Ready y: lug: ® See Page 2 for
Internet: www.ci.tigard.or.us `l` Notified/Method:9 J -a /�e (— Supplemental Information
Ilg MrS 'ajW 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.
Value: $ 7 1/1?, GD
4 CATEGORY OF CONSTRUCTION , , /
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 and 2 family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description Qty. 1 Ea. 1 Total
t • s ' JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: A as f .6 8 AR,.,dj • Air conditioning or heat pump
/
(requires site plan showing placement) 14.00
City /State/ZIP: T j -, G / 1j /z. 97243 Furnace 100,000 BTU (ducts/vents) 14.00
fit ed
Furnace 100,000+ BTU (ducts/vents) 17.90
bldg./apt. no.: M Project name: �rt e Gas Gas heat eat u m 14.00
Cross street/directio o. 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
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
Water heater 10.00
` i DESCRIPTIQN.•UF Vi'ORI`C .'
� I � Gas fireplace 10.00
/— v 4a ` W, d - j r3 ,e,.. R.A- t 'l R Flue vent for water heater or gas
+t f / fi --�- 1 fireplace 10.00
OCr/ �'C;.:t ./c_ ?ilS 1 , °f t.' " ' .''I7 Log lighter (gas) 10.00
`01<,.. / i ,,,e7 ,d€4././c/..h•
GS./ J /,. q Wood/pellet stove 10.00
j f Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
❑ k- ROPERTY.•OWNER I '..`❑: TENANT Other: 10.00
Name: Environmental exhaust and ventilation
Range hood /other kitchen
Address: • • equipment 10.00
City/ State/ZIP: 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: A e .,,,_,/ ear .. ) � j, .z,,' Fuel piping
Contact name: ,, aj /4 m /v2 e• - $5.40 for first four; $1.00 for each additional
y ,, f Fumace, etc.
Address:
/9 C�J /ciGPJ/7 si- Gas heat pump
City/ State/ZIP: .. t v,,1� / 0/ 0 920122- � j Wall /suspended/unit heater
Phone: 03) a+ / 460 � Fax: : .I ) Z — 7a 9 Water heater
Fireplace
E -mail: Range
'" -''' " CO C1`OIt Barbecue
Business name: Clothes dryer (gas)
� mt!, # v ,, « 1 L Other:
Address: / 339 ss CT / G " „5-0/- MECHANICAL PERMIT FEES* .
City/ State/ZIP: •,..� /egdodj e)g #7�2- Subtotal
t f Minimum permit fee ($72.50) /43, /Q
Phone: � � '6'O Fax:, 3) e39,20:28 Plan review (25% of permit fee) e), 7 r
CCB lic.: ,23133-- State surcharge (8% of permit fee) 9 ff s
M f 3.73 180 lication expi res if a permit is not obtain w thin
Authorized signature: day app a fter it has TOT AL b een a ccepted as IT compFEE lete.
� /
Print name: (GL/G � /2e 1� Dater Za Q,� This permit • Fee methodology set by Tri-County Building Industry Service Board
i:\ Buildin s\Pcimits \IvrEC- PennitAPP.doc 12/03 440-4617T (1 I /02/COM/WEB)
•
CITY OF TIGARD i " --
BUILDING DIVISION PERMIT #: MEC2005 -00522
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2/2005
Phone: (503) 639 -4171 //,u � �yp'0i ,? ; 1\
Inspection Requests (24 Hrs.): (503) 639 -4175 _..
INSPECTION WORKSHEET FOR DATE: 9/8/2005 TIME: 7 :O9AM PAGE: 80
SITE ADDRESS: 13221 SW 68TH PKWY 100 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: CADENCE
DESCRIPTION: HVAC modification. Valuation: $4118.
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: AMERICAN HEATING INC PHONE #: 503-239-4600
Inspection Request Scheduled For: Date: 9/8/2005 Pour Time:
fr
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 015098 -01 503-793 -2260 CD
Corrections /Comments /Instructions:
e ______ _
f i ,
c/& .‘,_
(:)
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4 . Inspector: V`"�� Date: 9/1-76( Phone #: (503) 718-