Permit ! • 4 CITY OF TIGARD MECHANICAL PERMIT
`� COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00592
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/19/2007
PARCEL: 2S112DC - 00100
SITE ADDRESS: 15675 SW 72ND AVE ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK III LOT: 002 JURISDICTION: TIG
PROJECT: NIKE SOCKS
Project Description: TI Project Value: $8,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: 1 VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: 1 BOILERS /COMPRESSORS HOODS:
• FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 10/19/20C $195.50
[MECPLN] Plan Rev 10/19/20( $48.88
[TAX] 8% State Surcha 10/19/20C $15.64
Phone: Total $260.02
Contractor:
APOLLO SHEET METAL INC
2300 SW 1ST AVE # 104
PORTLAND, OR 97201 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 222 -6343
FAX 503- 222 -2935
Reg #: LIC 56241
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.
0j1U1111 ��
Issued B iI iJ I / / Permittee Sig ure /�
Call 503.639.4175 by 7:00 a.m. for i pectin s that bu . iness day.
This permit card shall be kept in a conspicuous plac on the job site til completion of the project.
Approved plans are required on the job -le at the tim - • f each inspection.
1 3 P .t &l) 2 2 00 "7 co s- ( s5 7 (c.k5 72_
Mechanical Permit Application 1.()R c) r 1 1(:1. l;; r ( ):N 1. v
City of Tigard nay: / / d 3%I Permit No.: ) / , r ....•• - y'�
111111 • 13125 S50 Hall Blvd., Tigard, OR 97223 Plan Revie i► 1 0
I Phone: 503.639.4171 Fax: 503.598.1919 60 I Other Pmt:
ion
Ins Line: 503.639.4175 Da r y :
T I G �� is I
Inspection Re Date Ready : y: ��9'J IN See Page 2 for
Internet: www.tigard -or.gov Notified/Method:I% G ( G. Supplemental Information
TYPE OF WORK OMMERCIAL FEE* 1 DULE - U ` CHECKLI
❑ 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, 1: . r overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ ,it era
RESIDENTIAL EQUIPME SYSTEMS FEES*
❑ 1 - and 2 family dwelling Commercialindustrial ❑ Accessory building
For special information use checklist.
❑ Multi- family Master builder ❑ Other:
Description Qty. I Ea. I Total
/670 7 JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: L.A...? 7 Z N A u . Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/ State/ZIP: - r) ( i� O.L Furnace 100,000 BTU (ducts/vents) 14.00
l s 1 Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg./apt. no.: I Project name: Js j b co r2- P Gas heat pump 14.00
Cross street/directions to job site: t t 5 a -S R4 b t t Duct work 1 14.00 14- -
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric), op
in -wall, in -duct, suspended, etc. 10.00 1 b
Subdivision: I Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
A4-1.0 Gas fireplace 10.00
J N) ( p Tr..) Flue vent for water heater or gas
tL.A.,) (L (C1�\Aj V SE• sPPrr-e. 12.£ - Al fireplace 10.00
Log lighter (gas) 10.00
gf1 - 1 iJ OS 1Z- a� i ZJ
Q`P t-) N i 1 A D i Wood/pellet stove 10.00
iiyt -O r ST • r) c / 1•J t i 0-1 • )1'• L ( Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 1 10.00 / b
Other: 10.00 errs
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/ State/ZIP: Clothes dryer exhaust l 10.00 1 O °1)
Single -duct exhaust (bathrooms,
Phone: ( ) I Fax: ( ) toilet compartments, utility rooms) 6.80
Af-APPLICANT %CONTACT PERSON Attir/crawlspace fans 10.00
Business name: A Pv Lk O t N STZ• • C /L U l �� Other: 10.00
Fuel piping
Contact name: �AJA. e (Lioc-c) •,,/ $5.40 for first four; 51.00 for each additiona
Address: 7 Svc) 1 . 1- S ...Lt -r-s_ ( 4 Furnace, etc.
Gas heat pump
City /State/ZIP: ('fNL - V , L C1 Z d ) Wall/suspended/unit heater / 5-q0 5 .1-11.1
Phone: (5'7) l 2,2_ (034 3 1 Fax:: (373 2.72_ 25 '3C- Water heater
Fireplace
E -mail: S gyt -A i'rZ.. IAA S---C.. I4 • LQ1ti• Range
CONTRACTOR Barbecue
.- �� e _ %. Clothes dryer (gas)
Business name: Other:
Address: MECHANICAL PERMIT FEES*
Subtotal 3
City/ State/ZIP: Minimum permit fee ($72.50) 7 . C
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) Y /3
CCB lic.: 570 2 U State surcharge (8% of permit fee)
TOTAL PERMIT FE1 i .
This permit application expires if a permit is not ob ed within 180
Authorized s'. , �' / days after it has been accepted as complete.
Print name��� 7 / , " Date: 'f 0 ,) ,7 • Fee methodology set by Tri-County Building Industry Service Board
L\Buildin&- :1.1 PermitApp.doc 04/06/06 440.4617T (11/02/COM/WEB)
CITY OFTIGARD
BUILDING DIVISION PERMIT #: MFC2007 -00592
13125 SW Hall Blvd., Tigard, OR 97223
if DATE ISSUED: 10/19/2007
Phone: (503) 639- 4171 0, , f
Inspection Requests (24 Hrs.): (503) 639 -4175 �! �' ,- I i
INSPECTION WORKSHEET FOR DATE: 10/23/2007 TIME: 7 :OOAM PAGE: 51
SITE ADDRESS: 15675 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 002 TYPE OF USE:
PROJECT NAME: NIKE SOCKS
DESCRIPTION: TI Project Value: $8,000
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: APOLLO SHEET METAL INC PHONE #: 503 - 222-6343
Inspection Request Scheduled For: Date: 10/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa•
6'39 Mechanical final 058117 -01 503545 -0337 Y &°
Corrections /Comments /Instructions:
PASS %a PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL % CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: 0 t 0 Phone #: (503) 718- ,49
.
•