Permit CITY TIGARD MECHANICAL PERMIT
r� DEVELOPMENT SERVICES PERMIT #: MEC2000 -00184
,��! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/6/00
PARCEL: 2S101 AA -09100
SITE ADDRESS: 12259 SW 69TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 030 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Tenant improvement: Install a 3 HP or less absorbtion unit to 100K BTU.
Owner: FEES
TIGARD CORP CENTER Type By Date Amount Receipt
LTD PARTNERSHIP PRMT GEO 6/6/00 $50.00 0002723
ATTN: GREG SPECHT PLCK GEO 6/6/00 $12.50 0002723
BEAVERTON, OR 97006 5PCT GEO 6/6/00 $4.00 0002723
Phone: Total $66.50
Contractor:
COMMERCIAL REFRIGERATION INC
5920 SE GLISAN STREET
PORTLAND, OR 972133790 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 234 -6445 Final Inspection
Reg #: LIC 65271
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 -0080.
You may obtain co 'es of t a ru „ -'or direct questions to OUNC by calling (50 .6 -9189.
Issue By: % i'1Permittee Signature: i
Call (503) 639 75 by 7:00 P.M. for inspections needed the next business day
ti: PlanC -ck# :d
CITY OF TIGARD , Mechanical Permit Application Recd : 1/
13125 SW HALL BLVD. Commercial and Residential (pU Date Rec �� /
d 0 `�'
TIGARD, OR 97223 • OU O Date to P.E. S- /(i -od
(503) 639 -4171, x304 1 POD Date to DST .rf /�//D�
id
Print or Type Permit #ft/.0 Roar -0049y
Incomplete or illegible applications will not be accepted Called 5- 4-7 AO icy o
Name of Development/Project Description
Ilex) A- i $54,/cz- Perri( 11u Table 1A Mechanical Code Qty Price Amt
Job Street Address uite# A) Permit Fee l' : i. , "; . 16.00
Address l 2a„ 56 6 q 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 9.65
Bldg# City/State Zip 2) Fumace 100,000 BTU+
including ducts & vents see footnote 1,2 12.00
Name (or name of usiness) 1- 3) Floor Furnace
f > <},Q� c j E �� including vent see footnote 1,2 9.65
Owner
�O 4) Suspended heater, wall heater
Mailing Address
n o y or floor mounted heater see footnote 1,2 9.65
,&Jb PaTAJEL // � / �111i-)40,. &xi-r5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: oiler Heat Air
TX) O `� `s'®,� 1 `B
For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
• 100K BTU ` 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100js to 500k BTU 17.65
City /State Zip 1 Phone 8) 15-30 HP; absorb
unit .5 -1 mil BTU 24.15
9) 30 -50 HP; absorb
Contractor Name unit 1 -1.75 mil BTU 36.00
('n 1 ,. t t j Q&( /01- f , ,icoo2�q. mew 10) >50HP; absorb unit
Prior to permit 1p au i+n Address / . 0 ✓ >1.75 mil BTU 60.15
issuance, a copy A, J 6r�Se9.t> 11 Air handling unit to 10,000 CFM
of all licenses state Zip Phone 7.00
are required if ft- -- Qn/ 3 7,3i/-6t/e/..5 12) Air handling unit 10,000 CFM+
expired in COT regon ConSt. Cont. Boajd Lic.# Exp. Date 11.85
database Gc 5--------7 / �{ i O2 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct
or Mailing Address 4.75
. 15) Ventilation system not included in
appliance permit 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
12.00
New 0- Repair 0 Replace with like kind: Yes O No O 18) Commercial or industrial type incinerator
Residential 0 Commercial 0 48.25
19) Repair units •
Additional information or description of work: 8.40
20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL
I hereby acknowledge that I have read this application, that the information 7% SURCHARGE VD
giv- is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL l .
the owner, that :. n ubmitt are in compliance with Oregon State laws. Required for ALL commercial permits only
. C 67a 16 d TOTAL
Si. =t - o ' er /Agent Date
O ther Inspections and Fees:
4 -e-tc - ( tC £A, f,l c//_ ,-�uU� 1. Inspections outside of normal business hours (mininum charge -two
Contact Person / Name Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical State Contractor Boiler Certification required
units.
"Residential A/C requires site plan showing placement of unit
I:\mechperm.doc rev 7/19/99 _