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Permit I IA C ITY OF TIGARD MECHANICAL PERMIT ,l.. r, DEVELOPMENT SERVICES PERMIT #: MEC2001 -00162 �' ��- 13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/16/01 PARCEL: 2S 113AA -00400 SITE ADDRESS: 16290 SW 72ND AVE B -02 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L BLOCK: LOT: 018 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: 1 FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: 0 > 10000 cfm: Remarks: Mechanical tenant improvement, relocating grilles and ducts. Owner: FEES PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt 15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 5/16/01 $72.50 2720010000 PORTLAND, OR 97224 5PCT CTR 5/16/01 $5.80 2720010000 Total $78.30 Phone: Contractor: PROTEMP ASSOCIATES INC 807 NE COUCH PORTLAND, OR 97232 REQUIRED INSPECTIONS Mechanical Insp Phone: 233 -6911 Duct Inspection Reg #: LIC 38868 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 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 -0080. You m • • opies ofi -se rules or direct questions to OUNC by c ing (503)246 -9189. Issue ._ , - C.-C Ak _,, Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for inspections needed t e next b siness day Mechanical Permit Application 4,, Date received: ,5 //& /p/ Permit no.: /~ffCv',40/'04,/6,„R 'Y:� City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt Phone: (503) 639 -4171 Fax: (503) 598 -1960 711 , Case file no.: Payment type: Land use approval: 1 Building permit no.: TYPE OF IrERAIIT 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family Afenant improvement CI New construction XAddition/alteration/replacement ❑ Other: JOB SITE INFORMATION COi\9AIERCIAL VALUATION SCHEDULE Job address: / Q90 51,t./ �^i° A UG Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: ,j �p7- Suite no.: value of all mechanical materials, equipment., labor, overhead, Tax map /tax lot/account no.: profit. Value $ • Lot: 'Block: I Subdivision: *See checklist for important application information and Project name,,, p7i= rU,2 -1 /77 OE jurisdiction's fee schedule for residential permit fee. City/county:77 >7 ZIP: 1 & 2 FAMILY DWELLING PERMIT FIX SCHEDULE Description and I6cation of work on premises: AND COAIAIERIC.kL /INDUSTR EQUIPMENTSCUEDULE ,( ) ?A./ Z7 /S %921 $t�TIO.J 0 0 er Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air handling unit CFM Is existing space heated or conditioned? es CI No Air conditioning (site plan required) Is existing space insulated? e s CI No Alteration of existing HVAC system f 1\l CIIANICAL CONTRACTOR Boiler /compressors : State boiler permit no.: Business name �,Q�JI 91..ip /l & 0 HP Tons BTU/H Address: •p7 „c-, -- "tty," Fire/smoke dampers/duct smoke detectors City: P-7- LID I State I ZIP: g7.7 3 a Heat pump (site plan required) Phone:a ..e_ I Fax93 i f ...p/ I E-mail: InstaWreplacefurnace/butner BTU/H Including ductwork/vent liner ❑ Yes O No - CCB no.:3g Install/replace/relocate heaters -suspended, City/metro lic. no.: , ./.5" -- 67,- wall, or floor mounted Name (please print): J 6m L Vent for a ]lance other than furnace e on: Absorption units BTU/H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER Hoods, Type U II/res. kitchen/hazmat hood fire suppression system Name: Rs4C % - US j Exhaust fan with single duct (bath fans) Mailin g address: D S Sc+ n - F e 00 Exhaust system a art from heating or AC S tate . ZIP: ue p p g an on up to out ets City: 7 Type: LPG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace • City: I State: I ZIP: Insert - type , Phone: ax: 1 E -mail: Woodstovelpelletstove Other: Applicant's signatur I Date: S� s /p/ — Tib er: — Name (print): J - ✓ /1, -A; t - Not all jurisdictions accept credit cards, please call jurisdiction for more informat Permit fee $ CI Visa ❑MasterCard Notice: This permit application Minimum fee $ Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $ Expires within 180 days after it has been State surcharge (8%) .... $ Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ Cardholder signature Amount ■ 440-4617 (6R10/COM) MECHANICAL PERMIT FEES T • .. COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total $1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional $100.00 or induding 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 Fumace $1.54 for each additional $100.00 or including vent 14.00 fraction thereof, to and including 4) Suspended heater, wall 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 induding 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 Cond fraction thereof. footnotes below. Comp* ** 7) <3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00 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 induding 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 induded 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 >50 hp; absorb. unit, 5,725 18) Domestic incinerators 17.40 >1.75 mil. BTU 19) Commercial or industrial type incinerator Air handling unit to 10,000 dm 656 69.95 Air handling unit >10,000 cfrrt 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 induded 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 (minimum charge-one -half hour) $72.50 per hour * State Contractor Boiler CertlflcaUon required for units >200k BTU. ** Residential A/C requires site plan showing placement of unit. i:\dsts\forms\rnech- fees.doc 10/11/00 . ii . CITY OF TIGARD BUILDING INSPECTION DIVISION er 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 , --� _ y f --- j Date Requested (0// AM PM BLD Location *it) i - 724D iiSit 'Z.^ - E 420 SIN ^ & Contact Person , Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: i-7� Slab �� SIT Post & Beam — � e ms - f �� Ext Sheath /Shear J Int Sheath /Shear Framing Insulation Drywall Nailing 11/y_c") ,Q 1.) Firewall ,, -Q- Fire Sprinkler 4- �--L /v ‘` w \ 1 o Fire Alarm i l Susp'd.Ceiling 0/1-- L " - ''v' 12--). `-' � 2 'S Roof . Misc: Final ` ��� p / P ASS PART FAIL -� 1 PLUMBING ' � L , Post & Beam Under Slab Top Out • Water Service Sanitary Sewer -j' ti Rain Drains , i Final • 1, PASS FAIL • Post & Beam Rough In L .' Gas D � Smoke e Dampers ASS' PART FAIL • lir iv V TRICAL � �, Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS 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 Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA //�� Otheoach /Sidewalk Date "vl t O 1 1 Inspector 9 /( � ( 9 Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.