Permit .r
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2002 -00281
` I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/2/02
PARCEL: 2S1 12 D D -00200
SITE ADDRESS: 15862 SW 72ND AVE 150
SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Relocation of ductwork for tenant improvement.
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 7/2/02 $72.50 2720020000
PORTLAND, OR 97224 5PCT CTR 7/2/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Duct Inspection
Phone: 453 -4822 Final Inspection
Reg #: LIC 62196
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
Utili o i c inn Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
95 - 001 -0080. Thu may obtain copies of these rules or direct questions to OUNC4 calling
1124R -CAI RCA
Is ue By: , • � g , t ;� i /� � Permittee Signature: i /J� z ,( / 4,, 0
Call (503) 6 9-4175 by 7:00 P.M. for inspections needed the next business day
- = 1. MechanicalPermit Applicati n _ ' .'
Date received: ? Permit no.: it ,,,, ,, 8 /
.,4‘- u
' Ci of Ti and
City Tigard no Aiiii date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: / Receipt no.:
Phone: (503) 639 -4171 ,
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
,,. 'Ty;I'L'OI ;ma I `' , ,... '
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family Tenant improvement
0 New construction ❑ Addition/alteration/replacement ❑ Other:
JOB`SI1E'IINFORMAT ION , COMMLRCIAI xVAI UA1ION'SCHEDULE
Job address: / _i, . 4, 2 • .e S'Q' Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanicil materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ ?/ ,
Lot: Block: Subdivision: *See checklist for important application information and
Project name: _ - ,,ya jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: Tit. 2I 1MILY 131111111 N PLRr%111 TEE SCIILDULL , '
Description and location of work on premises: ouc.J wR/' AND COMMFILICAL /INDUSTRIAL1QUIPI11EN1 SCIIEDULE1
glatZ.Ocin/DA[�S Fee(ea.) Total
Est. date of completion/inspection: 7 -S O7� Descri i on Qty. Res. only Res.only
Tenant improvement or change of use: 14 iAC:
' O Is existing space heated or con' itioned ?Yes ❑ No Air handling unit CFM
Is existing space insulated? ►' Yes ❑ No ` Air conditioning (site plan required) —
Alteration of existing HVAC system
, Ni IV11 CII i
ANICAL CONTRACTOR a # Boiler /compressors
ea name: C ds1 I
Business name: GL/ Ni sf GOA/ 01. HP Tons BTU /H
State boiler permit no.:
Address: /65-a* I 2 - ;� c Fire /smokedampers/duct smoke detectors —
City: '"'p3 , p OM ZIP: - 2 Heat pump (site plan required) 1.11
InstalUreplacefumacelburner BTU /H III Phone:sp - 5 ; L �� E -mail: - .
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: , Z - b Install/replace/relocate heaters -suspended, ■ --
City/metro lic. no.: N - wall, or floor mounted
Vent for a..liance other than furnace iii
Name (please print): iv fylsll� z � elingerahon: _
(ONx l a l' L I2SON .,: Absorption units BTU/H III _
Name: ilJ ' ` IP//,tll71- Chillers HP MI
Address: Compressors HP iii
vironmental exhaust and vent . lion: II
City: State: ZIP: Appliance vent
Phone: , 3 • Fax E-mail: Dryer exhaust
t OWNER i Y Hoods, Type 1/1I/res. kitchen/hazmat ■ _ —
: . ,_.
hood fire suppression system
leM ia Exhaust fan with single duct (bath fans) -
Mailing address: p j 1 O/ • / - %' ' Exhaust system a, art from heating or AC MI
Statte'IQ' . ErliN=i= Fuel piping an , , ution up to 4 outlets ■
Type: LPG NG Oil
Phone: ' . , —63G0 Fax: E -mail: Fuel pi .ing each additional over 4 outlets I=
, :, 'I NGINLLI2' ` ` y ' ; t rocess (schematic required) -
Name: ;y
Number of outlets
®t i er appliance or equipment: ■ -
Address: Decorative fireplace
City: State: ZIP: Insert - type
Woodstove/pelletstove —
Phone: � Other: ilii
:
Applicant's signature: /fi '1�� � Date: 7 ff ® Other: I=
Name (print): 1Z( 0 irMilliMMIIIIIIIII =
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ 7A •
Visa ❑MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained P lan review
Credit card number: / J at to ) $
Expires within 180 days after it has been State surcharge (8 %) .... $ ... Sa
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 7g• 3d
$ Cardholder signature Amount
440 -4617 (6 /00 /COM)
MECHANICAL PERMIT 1 FEES r - • - -•
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: PriCe Tot
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code QtY (Ea) Arr
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Fumace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2 ) Fumace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wail heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00.for the first $50,000.00 and Check all that apply: Boiler , Heat Air •
$1.20 for each additional $100.00 or For items 7 -11, see or . Pump, Cohd
fraction thereof. footnotes below. Comp* 14 .
7) <3HP;absorb unit
to 100K BTU 14.00
•
ASSUMED VALUATIONS PER APPLIANCE: 8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60.
Description: Qty (Ea) Amount 9) 15-30 HP; absorb
Fumace to 100,000 BTU, including 955 unit .5 -1 mil BTU 35.00
ducts & vents 10) 30 -50 HP; absorb
Fumace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
ducts & vents 11) >50HP: absorb
Floor furnace including vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not included in applicance 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955
•
10.00
to 100k BTU 15) Vent fan connected to a single duct
3 -15 hp; absorb. unit, 1,700 6.80
101k to 500k BTU 16) Ventilation system not included in ,
15 -30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served, by mechanical exhaust
30 -50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU 18) Domestic incinerators
>50 hp; absorb. unit, 5,725 17.40
>1.75 mil. BTU 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves
Non - portable evaporate cooler 656 10.00
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656' 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656 • 8% State Surcharge $
inserts, etc.
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minir
charge -one -half hour) $72.50 per hour
* State Contractor Boller Certification required for units >200k BTU.
"Residential A/C requires site plan showing placement of unit.
is \dsts \formsvnech - fees.doc 10/11/00
CITY OF TIGARD 24 -Hour 33c
BUILDING Inspection Lioe: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested � ,3 .� v AM PM BUP
Location /,) a. z- 5 r-✓ 7 Z- - G g'`-/ Suite / 5-0 I �v z, °4;6 2,
Contact Person f / e ✓ /'"`' Ph ( ) 3 - '' L z ' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner _ ELC
Footing
Foundation ELC
Ftg Drain A ccess: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam dk■e-A441— Shear Anchors 7^ J
Ext Sheath/Shear '
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof AOF,-
Other: frr/
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
CH ►1t.,.._
Post& Bea. -
Rough-In
Gas Line
Smoke Dampers
F
PA PART FAIL
CTR
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: 111 Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector We Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
l i t — i —. — — I il U 1 1
I 5 TON 1 I if
0 1 '
tl ll/ i ic ,.. 1
( ll 9
1 w I 41 g 41
of .. r .
1?-" Ltd 0 ■ 1_160 - I
6
to ll I
ti4 0 12 y
3c.o„, L‘i. 4 • I I
1
11
„tt ts
12.4 11
(2.4 igit 1
I 1
■ •■•• 1.1 ......
1 1 ( I ilDr 4 : I
0 rAl
El P‘A 11,4q:57-'° 11° .3Z CI d.
3 2) F alit
...
_
, .
I ibrf g A ' c 1
44 _____ _____
IL
to
I 1 I 1 1
ir (
i
‘3"---r----417 T AICI(i s : pt ig °C °II- 2' I
I I
! 1
: I
U /
1 8 ko % (2, 4 I 1 1
: I 1
1 315-cF"
ii ,S 111 44, 1 0 2- \,
, -
1
1 \
i 1
1
- 1 r-- •
1 _ i
-------
NvA c FLOC PC. litki V& ) PoRIE F. IN R- A I c&
I Si 62-
5ut7e..." 15
- T1 4.A-P n <3 P . 019 711