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Permit CIT OF TIGARD MECHANICAL PERMIT �r� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00310 ' - - ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/25/2004 PARCEL: 2S 113AD -01800 SITE ADDRESS: 16650 SW 72ND AVE B -12 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L BLOCK: LOT: 011 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: FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Relocate ducts & grilles, relocate thermostats for TI Project Value: $4,600 Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 5/25/200 $132.30 PORTLAND, OR 97224 [TAX] 8% State Surchar€ 5/25/200 $10.58 Total $142.88 Phone: Contractor: BELL HEATING 15550 SE PIAZZA AVE CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Phone: 503 - 656 -1184 Mechanical Insp Final Inspection Reg #: LIC 447 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 • ! , : •rough OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (5' )246 -6699. Is ued B : / ' Permittee Signature: s Y ii4. _� Call (503) 639 -4175 by 7:00 P.M. for inspections needed the -xt business day Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Date/By: ,� y ay Penult No.: NO/Il ,' 3/ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 / /ii ,. ;j '\ D B y Other Permit: v Inspection Line: 503.639.4175 ■ I Date Read /B Juris. ® See Page 2 for g Notified/Method: Supplemental www.ci.tigard.or.us " " " — Ready /By: g ntal Information • TYPE OF WORK .. ' .COMMERCIAL . FEE *. SCHEDULE -- USE CHECKLIST ❑ New construction ' dition/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: $ y .3o 6 ❑ 1 -and 2- family dwelling O g RESIDENTIAL EQUIPMENT / SYSTEMS, FEES* Commercial/industrial ❑ Accessory building special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling -� .JU Air conditioning or heat pump Job site address: �� f; yo ,5 / 7i 4 o f (requires site plan showing placement) 14.00 City/ State/ZIP: 1 01 3 6 f j 4 Q 2 � -/ 7 2 Z y Furnace 100,000 BTU ( ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: 84 4 4 4 u /A, / Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 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 Gas fireplace 10.00 / �c / aLr4Gj 4 ./..)u L/ Gt.r0 /e/L 0A/ (. 2 -) 7 Flue vent for water heater or gas 1/ti t .-C fireplace 10.00 Log lighter (gas) 10.00 2 i; L 0 C /►'7 '� C.€ 44 O ST 4 -7--..c- Wood/pellet stove 10.00 �, Wood fireplace /insert 10.00 LT gtOPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: /2k CTR-4/ S / Environmental exhaust and ventilation Address: Range hood/other kitchen equipment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 62x4_6 v Fax: ( ) Single-duct exhaust (bathrooms, Phone: ( ) toilet t compartments, mennts, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue R,E Q y/= 477,v Clothes dryer (gas) Business name: G ` Other: Address: /3 O S /- / 2,Z4 /4-v E.- . MECHANICAL PERMIT FEES*- City/State/ZIP: C G e 4 Subtotal • [7 / Minimum permit fee ($72.50) 5a Phone: (S03 ) G SG - // P I/ Fax: ( � ) a f"G A/G U Plan review (25% of permit fee) CCB lic.: yy 7 State surcharge (8% of permit fee) / v '5 TOTAL PERMIT FEE , • , , ;, Authorized si attire: This permit application expires if a permit is not obtai , ed within 180 > l days after it has been accepted as complete. - Print name: , ,.. 9Q T Date: /L 5 - 4 ii • Fee methodology set by Tri- County Building Industry Service Board i:\Building \Permits \MEC- PermitApp.doc 12/03 440-017T (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. i:\Building\Perrnits\MEC-PermitApp.doc 12/03 2 �ITY 24 -Hour B Inspection Line: (503) 639 -4175 INSPECFI VISION Business Line: (503) 639 -4171 MST BUP Received Date Requested '7 '3 AM PM BUP Location l ( P 57) Suite L — / ? MEC r W ( v 3/0 Contact Person Ph ( ) 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ��.! �� = �L� 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: c/ 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 PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line S mpers 41 r , ,a1 A 'ART FAIL CAL Rough -In �� 1111ffirA�i�I/— Low Voltage Marari��. /- 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: 0 Unable to inspect — no access Fire Supply Line ADA • Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL _ 1,-0" :_ � SCALE 1/8" — I - r 1 �/�/ 1 y' ALI I pl` � {. te r,. is uuuw ►uul��I 1 tvE in 6' -4 /� 1 d1EM`' 1 (2) 6' X 4' feLITES I WITH 36' SILLS I fill , ; - % ?1, -xfPZ _ s _ • -• ; � . OP }OFFICE = I 0 / D = � O :: w I -- 0 LP hc) — -- 0 0004000 f7 C' -4 ' 1 — -- - -. 100000 © 0�v . < ........ --T— -- Ills • 6. ® o ; t:•: •_:- — - L - — — 1 \p• III' U --• • Ri ih �. 046 C1 I , 1-1,;■11. t •/ q co ' " - a W AREHOUSE I '. 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