Permit L_D 6 6\1 +_ 3--6,440 r
CITY TIGARD MECHANICAL PERMIT
i ;� DEVELOPMENT SERVICES PERMIT #: MEC2003 -00236
-F`" ., I ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/8/03
PARCEL: 2S101 DC -00300
SITE ADDRESS: 13535 SW 72ND AVE
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT: 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: GAS OUTLETS:
> 10000 cfm:
Remarks: Relocate ducts and grilles, add (2) additional ducts for tenant improvement.
Project value: $1,000.
Owner: FEES
PACIFIC NW PROPERTIES LP Description Date Amount
9950 SW ARCTIC DR [MECH] Permit Fee 5/8/03 $72.50
BEAVERTON, OR 97005 [TAX] 8% StateTax 5/8/03 $5.80
Total $78.30
Phone:
Contractor:
OREGON HEATING + A/C INC
PO BOX 397
DUNDEE, OR 97115 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 538
Duct Inspection
Reg #: LIC 125815 Final Inspection
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
require to rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001-00
• I
Pu Pte l,' i .
Is ed By: \_- um 1 Permittee Signature:
Cali (503) 63' 175 by 7:00 P.M. for inspections needed the next business day
MecWanical Permit, • et:L FOR OFFICE USE ONLY
, . , ] Received Mechanical
` ✓ Date/By: 5 4 0-5 Permit No.: H MJ ' 5 _
City of Tigard Planning Approval Building
MAY 0 i Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF T AR 8 Date/By: Permit No.:
Phone: 503 -639 -4171 Fax: 503 -5 letANG '4yo� >; Post - Review Land Use
w; Contact Case No.:
Internet: www.ci.ti ard.or.us �' �_� ,
I
Date/By: r_ Contact J El See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: / / • Supplemental Information.
- —. ,00/7 �
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
J o Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF C ONSTRUCTION
mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling 2-Commercial/Industrial Value: $ (/ 000 See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description 1 Qty 1 Fee(ea.) 1 Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: / 15 - 3 3 5 - S to 7214d A ve" Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name: /-jjq Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
/J 5 f b oa N 1 - Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: I Lot #: Repair units 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
Flue vent (water heater /gas fireplace) 10.00
�� / / ��� Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
o PROPERTY OWNER 1 ❑ TENANT Other: 10.00
Name: Environmental Exhaust & Ventilation
p C* r /!� �� �� Range hood/ot kitchen equipment 10.00
Address:
9(,(e5 56t, 4/i_ 54e /�< Clothes dryer exhaust 10.00
City /State /Zip: 13 ,/ ',/ /7'&4 7 Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
:7 APPLICANT ] CONTACT PERSON utility rooms) 6.80
Name: G(i2, T / /_ [� ln Attic /crawl space fans 10.00 Address: gy Z. k y e Other:
Fuel Piping 10.00
City /State /Zip: A i �, � , � 4✓ 4 , // c * *($5.40 for first 4, $1.00 each additional)
Fumace, etc. **
Phone: Fax: Gas heat pump **
E -mail: Wall /suspended/unit heater **
CONTRACTOR Water heater **
ki Business Name: o , /J' ,_ r. Fireplace **
Address: 99 7, 16,44i 0994/ Range **
BBQ **
City /State /Zip: j /o / 1/ 97//3 Clothes dryer (gas) **
Phonetb3)S ! 1 Fax: Other: **
CCB Lic. #: / 7.., $5f j'c Total:
Mechanical Permit Fees*
Authorized $
Signature: Date: `'
S �/ Minimum Permit Fee $72.50 $ 7, •
CA' . hill Z... Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ 5 $U
TOTAL PERMIT FEE $ 78- - 3e
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri-County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information " • --
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or •
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
Assumed Valuations Per Appliance:
Value Total
Description: Qty (Ea) Amount
Fumace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1-4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
is \Dsts\Permit Forms\MecPermitAppPg2.doc 01/03
CITY OF TIGARD 24-Hour ti
BUILDING, Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 417 MST
-1
BUP
Received Date Requested — 3 0 AM PM BUP
Location / 3 X 3 ,5 'o? 4141-- Suite MEC j - 0 v ., 3
Contact Person . Ph ( ) PLM
Contractor / Ph ( ) g qq'l SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
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
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
- 4RT FAIL
EL ..-4 ■ 1 L
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ • required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA SI 3 0/o3
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING , Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested S J °� A M PM BUP
Location /35 MEC 3 '0
Contact Person Ph ( ) ' ( PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 66 SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
•
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
)2_/
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL .
Post & :eam
Gas Line
Smoke Dampers •
Th PART FAIL
x RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 5 (3 t) 3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
t 1 . Date Requested (17 AM ( PM BLD
Location l3 S l 2 .. 7 ) Suite MEC
Contact Person Ph o� � (t loc7act PLM
Contractor jqro a el uia y - Co ch r� h / OWI) Ph 1 � � -7.3 6 O SWR
'BUILDING Tenant/Owner o C_ - AV L[.1 ELC 40/ —
Retaining Wall ELR
Footing Access: •
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: �
Slab ( SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear 1 /�
Framing / )0 l`O �o �17)//i/E ) Y >"�d —
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
•
Fire Alarm
Susp'd Ceiling /3 0 0
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam �7
Under Slab / �/f /— 4 ��
Top Out .
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL •
MECHANICAL
Post & Beam •
Rough In
Gas Line
eD
Smoke Dampers
Final
PAS • - FAIL
Ei]!N •"
service
Rough In
UG /Slab
Low Voltage
��Fi��r ' larm
...106 PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ j Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date ` � ` Inspector / Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.