Permit •
CITY T MECHANICAL PERMIT
6 DEVELOPMENT SERVICES PERMIT #: MEC2003 -00122
II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/18/03
PARCEL: 2S 113AA -01000
SITE ADDRESS: 16550 SW 72ND AVE B -09
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT: OOC 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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 50,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: 0 <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Add (1) roof top unit and (1) exhaust fan.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 3/18/03 $72.50
[MECPLN] Plan Rev 3/18/03 $18.13
[TAX] 8% StateTax 3/18/03 $5.80
Phone: Total $96.43
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: 233 -6911 Gas Line Insp
Mechanical Insp
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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699. /1,_
Issued By: / L f � Permittee Signature: ./ ���,�/ /
Call (503) 639 -4175 by 7:00 P.M. for inspections needed t e Heft business day
i anical Permit Application FOR OFFICE USE ONLY
Received ? Mechanical
Date/By:.) — /I6 -v 3 Permit No.: ML-2....2600 2 ) -JO /c -
Planning Approval Building p�
City of Tigard Date/By: Permit No.: O I -000 /
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
a��t I to
Contact Case No.:
Internet: www.ci.tigard.or.us ■ e .' I ( Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 '" Name/Method: Supplemental Information.
• TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST. --- .
2 1 / New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
• ❑ 1 & 2- Family dwelling ❑ Commercial/Industrial Value: Accessory $ e See Page 2 for Fee Schedule
❑ Multi-Family RESIDE EQUIPMENT /SYSTEMS FEE* SCHEDULE
❑ ry Buildin g am Description 1 Qty 1 Fee(ea.) 1 Total
❑ Master Builder ❑ Other: Heating/Cooling
. - . JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: /1,.,6 6/...• 72 A Gas heat pump 14.00
Suite #: 1 Bldg. /Apt. #: Duct work 14.00
�� D � r Hydronic hot water system 14.00
Project Name: Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Lot # Repair units 12.15
Subdivision: Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
/ 0 PTIJ etler � pip Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
9* 2010 F Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
PROPERTY OWNER I ❑ TENANT Other: 10.00
� �� T,� L Environmental Exhaust & Ventilation'
Name: l R ange hood/ other kitchen equipment 10.00
Address: t irm s av /OI4 pkwy Clothes dryer exhaust 10.00
City/State /Zip: J 7 n/o Single duct exhaust
Phone: C. c.3 00e5 Fax: (bathrooms, toilet compartments, •
❑ APPLICANT ❑ CONTACT PERSON utility rooms) 6.80
Name: Attic/crawl space fans 10.00
Other: 10.00
Address: Fuel Piping
City/State /Zip: * *($5.40 for first 4, $1.00 each additional)
Phone: I Fax: Furnace, etc. **
Gas heat pump **
E -mail: - Wall/suspended/unit heater **
CONTRACTOR Water heater ••
Business Name: ,cpT1 Fireplace **
Address: 9T�8' Ss.� 7-",,h/‘ BBQe **
City/State /Zip: 2 _ 2�i #.' 0 tr 9 7=2 Clothes dryer (gas) **
Phone: g 2s3 -c.,i / I Fax air .9,6, 7 . Other: ••
Total:
CCB Lic. #: 3 $gb g Mechanical Permit Fees*
Authorized n Signature: Date: Subtotal: $
Signature: 3 / 3 Minimum Permit Fee $72.50 $
�. �l
-- Plan Review Fee (25% of Pemtit Fee) $
� "( uN 1 State Surcharge (8% of Permit Fee) $
/ (Please print name) TOTAL PERMIT FEE $
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry Service Board.
180 days after It has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Pcrmit Forms\MecPermutApp.doc 01/03
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BU }
Received Date Requested 3 _ 8 AM PM BUP
Location I L 7.'ik P --e-- Suite MEC 3 eo
Contact Person Person Ph ( ) 7 e ‘o r 9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC '
Footing
Foundation ELC
Access:
Ftg Drain 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
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
FAIL
CHANICAL
POSt am
as Li
Smoke. Dampers
1. PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA n� Q
Approach/Sidewalk Date / 7 lnspector_ '
Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION,DIVJSION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested " —I "7 AM PM BUP
Location 6 Ij 55 t 724{- - Suite 3 66
Contact Person Ph ( ) 6 c l (a 1 q? PLM
Contractor Ph ( ) SWR
- BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain 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
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS . • RT FAIL
•L •
• • : Beam
Rough -In
Gas Line
Smoke Dampers
i
• ASS PART FAIL
TRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA —.5 Approach/Sidewalk Date Zp` `/ ) /6 Inspecto Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL