Permit CITY T MECHANICAL PERMIT
�i 4c DEVELOPMENT SERVICES PERMIT #: MEC2004 -00706
"f II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/24/2004
PARCEL: 2S1 13AA -00200
SITE ADDRESS: 16398 SW 72ND AVE B -08
SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2
OCCUPANCY GRP: B VENTS W/O APPL: 1 VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: 90,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 2 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: (2) roof top A/C package units, gas piping, vent for water heater & bath exhaust fans.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 11/24/20( $238.25
PORTLAND, OR 97224 [MECPLN] Plan Rev 11/24/20( $59.56
[TAX] 8% State Surchar€ 11/24/20( $19.06
Phone: 503 624 - 6300 Total $316.87
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: 233 - 6911 Gas Line Insp
Heating Unt Insp
Reg #: LIC 38868 Duct Inspection
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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)24.- .;
Issue. By: / Permittee Signature: )
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
16376' 5i) .Z "
M Permit Application /, J / � FO / R � OOFFICE USE ONLY y�� /f �
13125
i ` , Blvd., EI V ED Date/By l cam. ®7 f�` -" �L.Jt i zz 7V O
CI of Tigard � Permit No.: G
SW Hall lvd., Tigard, OR
Phone: 503.639.4171 Fax: 503.9 0 it„ ,W, Plan R eview n J Other Permit:
(� � 1/ -Z3 -D9 !�
2004 l�r "; ''� Date/By:
Inspection Line: 503.639.4175 (( ,p a er� Date Ready/By: 1u(is ® See Page 2 for
Internet: www.ci.tigard.or.us ®C ! 2, --
g Notified/Method: 1 ( Supplemental Information
G►TY OF TIGA�®
�� 1 COMMERCIAL FEE* SCHEDULE =USE CHECKLIST
❑ New construction a 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, labor, overhead, and profit.
• • CATEGORY OF CONSTRUCTION Value: $ /051)0, On
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling pr Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. I Ea. , Total
. JOB SITE INFORMATION AND LOCATION • . Heatinp,/cooling
Job site address: / / 3 9 S 72 Air conditioning
fires plan or heat placement) pump f0 t /v ()
(requires site l showing 14.00
City/State/ZIP: �.� A,t,V Furnace 100,000 BTU (ducts/vents) 14.00
no.:- Project nav -c C Furnace 100,000+ BTU (ducts/ vents) 17.90
Suite/bldg./apt.
(51/ j " ` , , , 4 t 1290,17", kc4.41 /1Lp .'J3as heat pump 14.00
Cross street/directions to job site: Duct work 14.00
U,c //✓e.SS PA�ft
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
,� y , • Gas fireplace 10.00
J G✓O Rod / AV& Poe, f- I/A/ / l S/ ( S ri%oc j i /e t ,- - r - Flue vent for water heater or gas
fireplace 10.00
c /! ,l 41•1 l teA- /�Cip -1;/•- / A/42_ 44 74A o K, FXX - 0 a.fr " --,51- ia f Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER pl TENANT Other: 10.00
,! Other: 10.00
Name: sUA-/41.4._ / c/AJ 1 / e' c 1. A e t Of ' ,5 Environmental exhaust and ventilation
Address: S/ / Range hood/other kitchen
4/,,p /Ix AQ0,, equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT Aid' CONTACT PERSON , Attic /crawlspace fans 10.00
Other: 10.00
Business name:
pRn�e titer 4SS /l9 % f 1/t/G , Fuel piping
Contact name: 6A2tJ4L Q VTN .eti-- $5.40 for first four; $1.00 for each additional
Furnace, Address: , 2 8- g' S� r / 7 /ti A t/� Gas he etc.
p pump
City/ State/ZIP: / D _.7-1 4 t'JA A-- e--. 9 '22_2_ Wall/suspended/unit heater
Phone: (S ki )„.551 5 -‘/ 5 5 Fax:: (S)3) Li (5,_ 9 7 4, 7
Fireplace
ter heater
E -mail: Range
- CONTRACTOR Barbecue
Clothes dryer (gas)
Business name:
S/4 rk 77 X , & -e-- Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 23 9 . ZS
(S Q3) G / 5' 7 Fax: G p2) 23 r-_,)‘ 7 Minimum permit fee ($72.50)
Phone:
S _ Plan review (25% of permit fee) 69.36
CCB lic.: 3 8'3T' ? State surcharge (8% of permit fee) . OS
TOTAL PERMIT FEE 3 ' I 6 .57
signature: �'' This permit application expires if a permit is not obtained within 18
Authorized Si
ye, days after it has been accepted as complete.
Print name: 6 R VLF iV / �,..; Date /Q Z % -,Jy • Fee methodology set by Tri-County Building Industry Service Board
i:\ Building \Permits\MEC- PermitApp.doc 12/03 440-4617T (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule: -
T�r''x� t � - -.� ..✓ is hFr.� �,r rS: .r ,.y � �[.2� -' r' 4 - a
otal valu`a kin Brij mit Fee ig'" ' 1 _ yt
$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.
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i:\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION . Line: (503) 639 -4171 MST
/ BUP
Received _ G� / Date Requested � � /02 -- -(° AM PM BUP
4
Location / c ' 3 ! l5 7� �r�Y Suite MEC Q °s° t 7
Contact Person Ph ( )579 — (. 0 1 g9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof ,
Other: !�
Final
PASS PART FAIL ^/
PLUMBING / y '
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
� � PART FAIL
• ' RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl Reinspectio fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E Please ca for reinsp: tion RE: Unable to inspect — no access
Fire Supply Line
ADA J 0 Approach/Sidewalk Date Inspector Ext
Other:
Final DO N ' REMOVE this Inspection record from the Job site.
PASS PART FAIL