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Permit A CITY OF TIGARD MECHANICAL PERMIT tt� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00588 rv - II 1312 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005 PARCEL: 2S 112DD -00400 SITE ADDRESS: 15912 SW 72ND AVE B17 ZONING: I -L SUBDIVISION: OREGON BUSINESS PARK I LOT: 017 JURISDICTION: TIG Project Description: HVAC Value: $10,500 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: 1 TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1 OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: ELE 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: 0 AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: 11 <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Owner: FEES . PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 [MECH] Permit Fee 10/3/200; $238.25 PORTLAND, OR 97224 [MECPLN] Plan Rev 10/3/200E. $59.56 [TAX] 8% State Surchar€ 10/3/200: $19.06 Phone: 503 624 - 6300 Total $316.87 Contractor: PROTEMP ASSOCIATES INC 9788 SE 17TH AVE REQUIRED ITEMS AND REPORTS PORTLAND, OR 97222 Phone: 503 -519 -6199 Reg #: LIC 38868 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. Issued By: Permittee Signature�'� , Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. `nica a It Applies 1011 i L 1 OFFicl: I NI.: ()Ni.N of Tigard Reot i " I o/a / I ' Permit No.: DatDate/By M44,.°..'v`J a, r ag SW Hall Blvd, Tigard, OR 97223 o Plan , • w I .ne: 503.639.4171 Fax: 503.598.1960 f .. x ; 4 0 ` O t h er P em u t: IQ p� �� , , Date/By. q r w • o 4196 .spection Line: 503.639.4175 - I I , Date Ready ® See p ady y: age 2 for tternet: www.ci.tigard.or.us SEP 2 .J...14-':,, 00 Notifi ethod: �/ �� Ai Supplemental Information / 11 (hrg•R TYPE CHOPMEOF r twint) COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction rdditiorEgtgarnetilMeyek Mechanical permit fees* are based on the value of the work performed Indicate the value (rounded to the nearest dollar) of all CI Demolition ther: mechanical materials, equipment, labor, overhead, and profit. , 5 ea $ / A CATEGORY OF CONSTRUCTION Value: RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Ma ster builder ❑ Other: ❑ Multi- family Description 1 Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling L C Air conditioning or heat pump Job site address: J � 1 / Z 5 fil 72,44,0 (requires site plan showing placement) 14.00 City / State/ZIP: ..�� _ y Furnace 100,000 BTU ( ducts/vents) 14.00 o`� �� 2 ? ` Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no. J% / & f / 7 Project name: (nQ / i c _ Le� Gas heat pump 14.00 Cross street/directions to job site: Dud work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in-duct, suspended, etc. 10.00 Subdivision: 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 / — / / Gas fireplace 10.00 iv eJ t- E---- O� 1-,, ®� 'it;[ )/.. 1 ( f p `o LA r 0 I ih Flue vent for water heater or gas 10.00 00J ;1 �i[ — Ivp,,.f�,,_, 1 — // Rot. F ,/ Exkl At) S / 1 /►:� Re roCaC 2 / Log lighter (gas) 10.00 / < DD tLF/!1 .�ii4r- �/'a.V -ice L��✓ Room Wood/pellet stove 10.00 � Wood fireplace/insert 10.00 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen equipment 10.00 City /State/ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) I Fax: ( ) toilet compartments, utility rooms) 6.80 "APPLICANT "CONTACT PERSON Attic/crawlspace fans 10.00 ..nn Other: 10.00 Business name: �iP01 1y �7��OCs4 � . Fuel piping Contact name: IQRl /C ,L 3 � $5.40 for first four; $1.00 for each additiona Address: y` 8p s, / j/ Furnace, etc. �t Gas heat pump City / State/ZIP: fl),(7L,44,4 ®,rte_ 9- 2 22_ Wall/suspended/unit heater Phone: 03) 6 .--6 joci Fax: : 6 - e ) z_33.-- 2 2 C. ? Water heater r Fireplace E -mail: Range CONTRACTOR Barbecue Business name: S'� Arx- Ot dryer (gas) �� Other: Address: MECHANICAL PERMIT FEES* City /State/ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) �J4. Plan review (25% of permit fee) s?.. CCB Iic. (3 $ e6 State surcharge (8% of permit fee) /� .S 0 1 TOTAL PERMIT FEE 'wt k7 Authorized signature: g2 /^ _ — This permit days after has been accepted as complete. within 180 Print name: -e O — . () , AJ - [ Date: 7 • - /L �.S_ • Fee methodology set by Tri-County Building Industry Service Board is\ Building \PennitsvMEC- PennitApp.doc 12/03 440 -4617 (11/02/COM/WFB) ra- Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: • $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and • $1.g0 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\ Building \Permits\MEC- PennitApp.doc 12/03 2 CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2005 -00586 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005 Phone: (503) 639 -4171 v a„ I l i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 101 SITE ADDRESS: 15912 SW 72ND AVE B17 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE: PROJECT NAME: COOKIE LEE DESCRIPTION: HVAC Value: $10,500 OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624 -6300 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-519-6199 Inspection Request Scheduled For: Date: 10/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 019481 -01 503-519-6199 N Corrections /Comments /Instructions: a i Y . .., _ . _A. . i�`� VV. . 0 0 . ' '''.- ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL , M CALL FOR I SPECTION ❑ ADDITIONAL FEE ASSESSED 0 de* t b z Inspector: 1 Date. . 7 6) Phone #: (503) 718- .CITY QF TIGARD BUILDING DIVISION PERMIT #: MEC2005 -005B8 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/4/2005 Phone: (503) 639 -4171 Aau , � +� Inspection Requests (24 Hrs.): (503) 639 -4175 "' I.. INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 11 SITE ADDRESS: 15912 SW 72ND AVE 617 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE: PROJECT NAME: COOKIE LEE DESCRIPTION: HVAC Value: $10,500 OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624 -6300 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 5136199 Inspection Request Scheduled For: Date: 10/13/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 018272 -02 503 - 519 -6199 N Corrections /Comments/ Instructions: san----- vs.1 40eJ-f-- ous-ritc.e___ yE7-- 4 _, . 1 ,SAN i t (10 d ❑ PASS ❑ PARTIAL APPROVAL 111 CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: �C ` Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2005 -00588 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005 Phone: (503) 639 -4171 �aredmw Inspectic:i Requests (24 Hrs.): (503) 639 -4175 '' INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:OOAM PAGE: 84 SITE ADDRESS: 15912 SW 72ND AVE 13•7 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE: PROJECT NAME: COOKIE LEE DESCRIPTION: HVAC Value: $10,500 OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503- 624 -6300 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 519.6199 Inspection Request Scheduled For: Date: 10/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough -in 017457 -01 503-519-6199 N Corrections /Comments/ Instructions: r A ,. t 1 N i 1 1 WV ∎ ' r F PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FoR INSPECTION ❑ ADDITIONAL F ES ASSESSED Inspector: Pa Date: 10 " Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2005- 00588 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/4/2005 Phone: (503) 639 -4171 ti a' rl Inspection Requests (24 Hrs.): (503) 639 -4175 111. INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:OOAM PAGE: 83 SITE ADDRESS: 15912 SW 72ND AVE 1317 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE: PROJECT NAME: COOKIE LEE DESCRIPTION: HVAC Value: $10,500 OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503-624 -6300 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 - 519.6199 Inspection Request Scheduled For: Date: 10/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 625 Duct work 017457 -02 503- 519.6199 N Corrections /Comments /Instructions: ■ 11/1PAELS00 . 1 ,:: --- i ,WW NW A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR SPECTION ❑ ADDITIONAL FEES ASSESSED - Inspector: Date: CC) #: (503) 718 CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2005.00588 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005 Phone: (503) 639 -4171 42,E 111 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:OOAM PAGE: 80 SITE ADDRESS: 15912 SW 72ND AVE B17 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE: PROJECT NAME: COOKIE LEE DESCRIPTION: HVAC Value: $10,500 OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503- 6246300 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503. 519.6199 Inspection Request Scheduled For: Date: 10/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 017465 -01 503- 519.6199 N Corrections /Comments /Instructions: r ._ ' i, - aliz---- fp I AI Iiri PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED Inspector: 4-4 J Date: �� v6hone #: (503) 718-