Permit CITY OF TIGARD
MECHANICAL PERMIT
wl& DEVELOPMENT SERVICES PERMIT #: MEC1999 -00454
`- ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/25/1999
PARCEL: 2S 113AD -01900
SITE ADDRESS: 16640 SW 72ND AVE B -10
SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING: I -L
BLOCK: LOT: 009 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: 1 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: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Adding (1) one mechanical unit and duct work.
Owner: FEES
PACTRUST Type By Date Amount Receipt
15350 SW SEQUOIA PKWY PRMT KJP 10/25/19E $50.00 99- 319300
#300 PLCK KJP 10/25/19E $12.50 99- 319300
PORTLAND, OR 97224 5PCT KJP 10/25/19E $4.00 99- 319300
Phone: Total $66.50
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 233 -6911 Mechanical Insp
Reg #: LIC 00038868 Duct Inspection
ELE 201JHA Final Inspection
ORIGINAL
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 may obtain copies of these rules or direct questions to OUNC by
calling (503)246-9189.
Issue By: Permittee Signature: X �dQ
Call (503) 639 -4175 by 7:00 P.M. for inspections neede the next bGsiness day
I
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125'SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 jgg9_o�vSS � � Date to DST •o /as�g9Q�
Print or Type B P Permit #MEG /f '� OOy5S
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
, 2 5 J ZL - 'rG�7)4/4:<.7 Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 16.00
2, I O 1) Fumace to 100,000 BTU
Address /rte 4 Q S � V ° including ducts & vents see footnote 1,2 9.65
Bldg# City /State Zip 2) Fumace 100,000 BTU+
l 0 2vz OA including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Fumace
Owner �C�/ including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
,s O sL✓ SEf?Glen LdY 3oC 5) Vent not included in appliance permit 4.75
City/State Zip Phone Check all that apply: 'Boiler Heat Air
Par72,44,' a. 97aa9 ay.. c For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to pr
/� EC�5/ rm./ .. .�� Cef7AWI- -"e i 100K BTU 9.65 b 4 (
Occupant Mailing Address 7) 3-15 HP;absorb unit
/ , v 5 W 7a Ain 100k to 500k BTU "' 17.65
City /State Zip Phone 8) 15-30 HP; absorb
unit .5-1 mil BTU 24.15
07 W
r7G�t) 10.C' _ 9) 30-50 HP; absorb
Contractor N/arp/ unit 1 -1.75 mil BTU 36.00
1.4", �55tx -LZ. 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy c 07' ti. COt -/4 11 Air handling unit to 10,000 CFM
of all licenses 911state • Zip Phone 7.00 .
are required if r/i,TG,aitit7 Ci. 97a3c7 a33 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Ex Date 11.85
database 38 S� g 3 [ g 1 8 441 13) Non - portable evaporate cooler •
Architect Na ° 7.00
14) Vent fan connected to a single duct
4.75
or Mailing Address
15) Ventilation system not included in
• appliance permit 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
12.00 _
New Repair 0 Replace with like kind: Yes O No O 18) Commercial or industrial type incinerator
R sal 0 Commercial 48.25
19) Repair units
Additional information or description of work' 8.40
20) Wood stove /gas FP /other units /clothe dryer/etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets .
structural gas calcs. See footnote 1 3.75 '�✓�
Type of fuel: oil 0 natural gas"' LPG 0 electric O 22) More than 4 -per outlet (each) .75 _
Minimum Permit Fee $50.00 SUBTOTAL P
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE 4/
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL i O
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
TOTAL
Signature of Owner /Agent Date
/ Other Inspections and Fees:
Vo--,.....•.2 / 0/2.S 1. Inspections outside of normal business hours (mininum charge -two
ame !!! Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
`1Z. / -Atir 3?-G..97 i charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. *State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:\mechpern.doc rev 7/19/99 _
� 6o5<ss
OVER- THE - COUNTER (OTC) PERMIT
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: (24-Di/J6- (I 1 o,,le M hcac. L1L -r + ctW a1 1
Class of Work: -'r Floor Furnace: Evap Coolers:
Type of Use: Unit Heaters: Vent Fans:
Occupancy Grp: Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. 1 Repair Units:
/ / / / 3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: _< 10000 cfm: Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets: /
No. Of Units:
Furn < 100k Btu: /
Furn >_ 100k Btu:
NOTES:
COMMERCIAL INSPECTION ACTIONS FEE MENU
$ S? Permit Fee
apical Inspection Z 5.1" Plan Review
Cooling Unit Inspection $ 4 8% State Surcharge
Shaft Inspection $ Additional Permit Fee
Hood Inspection $ Additional Plan Review Fee
Fire Suppr Inspection $ Inspection Fee
• u Inspectio • $ Miscellaneous Fee
Fire Alarm Inspection
REMARKS:
Fire Damper Inspection
Miscellaneous Inspection
Fire Alarm Ins •ection
inal Inspection
FOR OFFICE USE ONLY:
TYPE OF USE OPTIONS (COM = commercial; CMS = commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW = new ADD = addition; ALT = alteration; ACS = accessory;
FND = foundation; OTH = other, DEM = demolition; REP = repair, FPS = fire protection system. NOTE =USE OTH FOR FENCES, RETAINING
WALL, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
I: /dst/forms /otcmech.doc 9/99
is \dsts \forms \otc- mech.doc9 /99 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639-4171
BUP
Date Requested /(13(9 5 AM PM BLD
Location ! (P' `FQ 5a) - Suite —/ C MEC f `/44 -acay
Contact Person /P/25-e/nte tSSOa • Ph .?.3 /0 9 (/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner Pt-ea sd-6u- J e.AmAn / ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PAR FAIL
CHANI
Post & •h Beam
n �(-
Gas Line
Smoke Dampers
/�W PART FAIL
RICAL
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 /1 Approach /Sidewalk Date // / 3/ 9 Inspector Ext
Other /
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.