Permit • CITY OF RD
/4 DEVELOPMENT S Hall Blvd., Tigard, OR T , -h• �' 11E97_0314 02 97
PARCEL: 2S1814A -09800
SITE ADDRESS...: 12578 SW 69TH AVE 9103
SUBDIVISION....: I4.P95-8913 ZONING: MUE
MEW LOT :' 1 JURISDICTION: TI6
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE :CON UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:8 VENTS WO APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 8
FUEL TYPES 0-3 HP • 8 DOMES. INCIN: 8
:GAS 3 -15 HP • 8 COML. INCIN: 8
MAX INPUT: 0 BTU 15-38 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30-59 HP : 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP • 0 ILO DRYERS..: 0
NO. OF UNITS- ------ AIR HANDLING UNITS OTHER UNITS.: 1
FUIB4 (109K BTU: 8 (= 10009 chi: 0 GAS OUTLETS.:
FURN ) =180K BTU: 0 ) 1' „..;, cfm: 0
Remarks: Paragon Business tenant improvement to new commercial building.
Owner: FEES
J T ROTH JR type amount by date recpt
12600 SW 72ND STE 200 PRMT $ 25.00 BON 08/13/97 97- 298231
TIGARD OR 97223 PLCK $ 6.25 BON 08/13/97 97- 298231
5PCT $ 1.25 BON 08/ 13/97 97- 298231
Phone #:
Contractor:
TRI— COUNTY TEMP CONTROL /HEATNG
13651 SE AMBLER RD
$ 32.50 TOTAL
CLACKAMAS OR 97015
Phone #: 654 -3115
Reg #..: 000007
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 188 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952491-8010 through OAR 952-091 -0089. You may
obtain copies of these rules or direct questions to ODU(C by calling
(503)246-9187.
Issue By: 6. Permittee Signature: ante
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Mecnanlcal t'ermit Application Recd By !t1J.l
13125 SW HALL BLVD. Commercial and Residential i Date Recd 4', g _c,
TIGARD, OR 97223 6 ( 1 Date to P.E. C' -39?--
(503) 639 -4171, x30 4 p 1 Date to DST
A / „ i C / 7i Print or Type Permit # j nCC -p3 /y
1 � Called oS0g 9 ? c
Incomplete or illegible applications will not be accepted 5 4„J A /a--1.
'e of Devew uP man ie Description
t �(f Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suitdf A) Permit Fee - • -0- -0- 10.00
Address / Sc) ) OS • /c3
eider City/State Zip 1.) Fumaoe to 100,000 BTU 6.00
aZ. 4 7 including duds 8 vents
Name (or name business u 2.) Furnace 100,000 BTU+ 7.50
Owner 7 (Z including ducts 8 vents
Mailing Address "Al vk 3.) Floor Fumace 6.00
/-21.000 Su) 72 - Zoo including vent
city/state zip I Phone ., s�q 4.) Suspended heater, wall heater 6.00
t O� • '3i ZA$ i or floor mounted heater
(« of easin
ess) ) 5.) Vent not included in appliance permit 3.00
araCtlti �- c„f' /ral �/vr� f
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT"
City /State Zip I Phone 7.) Boiler or comp, heat pump. air cond. 11.00
3-15 HP: absorb unit to 500K BTU"
Contractor .7i--; •-�` ,�� 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to G / -p � -ka / 15-30 HP; absorb unit5-1 mil BTU"
issuance Marling Address ^^ !! Q 9.) Boiler or comp, heat pump, air cond. 22.50
applicant / , s/ SW /46 ie 30-50 HP; absorb unit 1- 1.75mit BTU"
must provide all C� M1A r 0 /L. z I on e 3 �� 5 10.) Boiler or comp, heat pump, air cond. 37.50
contractor > 50 HP; absorb unit 1.75 mil BTU**
license Oregon Const. Cont Board t.ic.re Ex D 11.) Air handling unit to 10,000 CFM 4.50 •
information 12h 2 -3 D �7 •
for COT COT Busness Tax or Metro a 12.) Air handling unit 10,000 CFM 7.50
database). //14, 7
Architect Name AtA /,� „!� 13.) Non-portable evaporate cooler 4.50
f'Z kJ Or Mading Address J � J K 14.) Vent fan connected to a single dud 3.00
•
Engineer Cit taee e /�,_ zip 15.) Ventilation system not included in 4.50
fgy" Lq�tpr (�7K, appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work7- r 17.) Domestic incinerators 7.50
£L- 0 - a7' cLKe 9 r�41 r fo
18.) Commercial or industrial type 30.00
LS 73 f (J /4-4..t • Incinerator
Existing use of / - 19.) Repair units 4.50
building or property fl .� 1 t•S I � �"
20.) Wood stove 4.50
Proposed use of ' i 21.) Clothes dryer, etc. 4.50
building or property e.-e- L.vlAA- N't Q - tGt.al'
22.) Other units 4.50
Type of fuel - oil 0 natural gas ®t LPG 0 electric 0 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Sig re of r /Agent ,/ Date 'SUBTOTAL
5% SURCHARGE 1.
� c""` G ,'y 3// s 1 ...
ontact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL P.)
TOTAL eti
32- -
i:\dstlrnechpmtdoc (rev 9 'Minimum permit fee is S25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit.
•
OVER - THE - COUNTER (OTC)
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Permit #: Date: F-oir9 7
Project Name: a.r'c9an S/ S5
Site Address: /25 70 5W 6 / sZ Se-LA-A /03
771aw�!
Description of Projec : : r� /• : _ ,., e.4.4/ aJ
Class of Work: t/ r Floor Furnace: Evap Coolers:
Type of Use: ('owt Unit Heaters: Vent Fans:
Occupancy Grp: Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3 - 15 HP. Wood Stoves: •
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: < = 10000 cfm: Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn > =100k Btu:
NOTES: 1€ n, j11 Px I J s'3
F ;:;•::COIf�MERCW::::INSPEGnON:: ACTIONS:::>:::::::<:::::::.:>: .........:.:...:::::::::: :.�:.�::::: ::::::.:�.�::::::::.
Permit Extension , c-- -- "Permit Fee
Gas Line Inspection I4YPIan Review
✓ Mechanical Inspection / 5% State Surcharge
Heating Unit Inspection Supplemental Permit
Cooling Unit Inspection Additional Permit Fee
Shaft Inspection Additional Plan Review Fee
Hood Inspection Inspection Fee
Fire Suppr Inspection Miscellaneous Fee
Duct Inspection
Fire Alarm Inspection
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
Fire Alarm Inspection
✓ Final Inspection
... OFF .U.i O. . ...... ...............................
:;TYPE OF• USEOPTIONS
:: CIASS:.OF OPTIONS: FOR`AU.. P. ERMJTS:: : new ADD =: additions ALT: = aitera6ori 'AC = acci�sso •::
P40 = foundatioors OTH .= other.; DEM = demolttio REP. =`repair: FPS= fire protection system. NOTE =USE OTH FOR FENCES
RETAININGWAU ..DETACHED DECKS SIGNS. AWNINGS; CANOPIES}: >::`
is \ovrcntr.doc (dst) 2/97
1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 7-0 —q 7 A.M. P.M. MST:
Location: 1 5 7 C) ..S,t.0 6 q ft , BUP:
Tenant: Suite: /03 Bldg: MEC: % 7- 03 1 4
Contractor: J 7 Phone: 7 to 3 q- O4 3 9 PLM:
Owner Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING (MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFUSlab • ough -In Ceiling Water Line
Slab Framing Top Out . me Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved r o Approved Approved
Appr /Sdwlk Not Approved Not Approved proved Not Approved Not Approved
FINAL FINAL / F u r proveIN FINAL FINAL
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
In spector: ? Date: / g ` - / d ` 7 7 Page of