Permit R a CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00233
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/8/2008
PARCEL: 2 S 113AA -00300
SITE ADDRESS: 16330 SW 72ND AVE B3 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: OOA JURISDICTION: TIG
PROJECT: A CUT ABOVE
Project Description: Installing mechanical ventillation for office to outside air using exhaust fan.
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: 1
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:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 5/8/2008 $72.50
[TAX] 12% State Surch 5/8/2008 $8.70
Phone:
Total $81.20
Contractor:
A CUT ABOVE EXTERIORS INC
12985 NW CORNELL RD
PORTLAND, OR 97229 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 639 -7172
FAX 503- 639 -9755
Reg #: LIC 153847
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 ermittee Signature: �l� (--
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.
Mechanical Permit Application FOR OFFICE USE ONLY
. City of Tigard 10 D at e ived ermit No.:
`• 13125 SW Hall Blvd., Tigard, OR 97223 C y S • �: n� GWP --{J
C „�
Plan Review � y r U V i r
�
Phone: 503.639.4171 Fax: 503.598.1960 O16 Date/By: Other Permit: 6lifr �/(/V
r 1 G A K l� Inspection Line: 503.639 0 %� Date ReadyBy: Juris: ® See Page 2 for
Internet: www.tigard- or.gov MP o Notified/Method: Supplemental Information
TYPE OF WORK C,..1, N� lr1AS1,
COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ,Addition/alteration/ cement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CA GORY OF CONSTRUCTION Value: $ ZOO _
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
El ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 330 r . //�� Air conditioning or heat pum
33 V 2 ICI" (requires site plan showing placement) 14.00
City /State /ZIP: -Ti f _o ` ` o 91-22."( 91-22."( Furnace 100,000 BTU (ducts/vents) 14.00
�/ Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: J Project name: l2
IICYU.r..t b IZ-o Ft Nic,L Gas heat pump 14.00
Cross street/directions to job site: 7-L Qctt Tv 1 $t. S 5 Akt,tss L \ Duct work 10.00
/� 4,f-t- �� Hydronic hot water system 14.00
f� Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
A /� (�
Gas fireplace 10.00
M a`G i u Q U P4A -11 (r'-h» A ' o cc. a 4c-0 O ok c4 ,z ¢ [.► i r Flue vent for water heater or gas
fireplace 10.00
1) 5 e )(A/L(4A J51- Cwti . Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER TENANT Other:
Chimney/liner/flue/vent 10.00
Other: 10.00
Name: /' (V.+ 1pptta C
r {k % s Environmental exhaust and 'ventilation 1 _ A1 � �n► //�� Range hood/other kitchen
Address:
1 Z-�� S 1)W C 4 .-c- N.0.19 F.. • equipment 10.00
City /State /ZIP: _ii ‘ c9_e_ 01 - 7 -22_9 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
(
Phone: (5 ) G 3et . 7 (1 'Z Fax: (R C341 _9755" toilet compartments, utility rooms) 6.80
❑ APPLICANT 03 CONTACT PERSON Attic /crawlspace fans 10.00
P her: 10.00 _
Business name: • Co C. f_ A rs ce E x M Fuel piping
Contact name: try 5e 55.40 for first four; $1.00 for each additional
Address: \ 221<3 N W c J a t Furnace, etc.
S Gas heat pump
City /State /ZIP: Qbt4,_ ` f Q c \--9 . _ C-11 22 Wall/suspended/unit heater
■ Fax: : ( ) Water heater
Phone: (
5-59 63 c _ 7 ( 7? 1 S .3 ( 9.7 S .S Fireplace
E -mail: Mr.. ,. (Z Gt_LV� C-31 r Nve P k Ran
` ��t�S COYVI Range
g
CONTRACTOR Barbecue
A- Clothes dryer (gas)
Business name:
�T C- U+ Ab c ' -cjc-ti. - tr 1'7f$ Other:
Address: ( z "18' s N W C n 9 t t. MECHANICAL PERMIT FEES*
City /State/ZIP: P�,kI�M� 0 or 2 c1 Subtotal
1 _ Minimum permit fee ($72.50) 7? ...set; (� ) 6 3t7 7 ( _ 7 - Fax: (s-03 ) 6 c _ 9'75 5 Plan review (25% of permit fee)
CCB lic.: i 9- 3 R. L4 `) State surcharge (12% of permit fee) F-,. 7 0
TOTAL PERMIT FEE R-/ r
Authorized signature: ��� C---- 'Ibis permit application expires if a permit is not obtained within 180
� // days after it has been accepted as complete.
Print name: /1(0.4.(t_ / V l D� Date: 0 5"-/07 A fl • Fee methodology set by Tri-County Building Industry Service Board
1:1 BuildinglPennits \MEC- PermitApp.doc 01/19/07 440- 4617T(11 /02/COM/WEB)
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
$1.80 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.
1:1Building\Permits\MEC- PermitApp.doc 01/19/07 2
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MEC200f3.00233
13125 SW Hall Blvd., Tigard, OR 97223 A._ DATE ISSUED: 5/8/2008
Phone: (503) 639- 4171�tf�hl ►
Inspection Requests (24 Hrs.): (503) 639 -4175 ^!J..
INSPECTION WORKSHEET FOR DATE: 6/20/2008 TIME: 7:02AM PAGE: 35
SITE ADDRESS: 16330 SW 72ND AVE B3 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 00A TYPE OF USE:
PROJECT NAME: A CUT ABOVE
DESCRIPTION: Installing mechanical ventillation for office to outside air using exhaust fan.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: A CUT ABOVE EXTERIORS INC PHONE #: 503 - 6337172
Inspection Request Scheduled For: Date: 6/20/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mochanical final 071629-01 503810.5657 N
Corrections /Comments /Instructions:
1 ,( .....10 ( .--.)
Ivy
.1./1/." .
-
j -pAss---- ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: VI Date: Lei(0 b Phone #: (503) 718 -