Permit CITY TIGARD MECHANICAL PERMIT
Ij DEVELOPMENT SERVICES PERMIT #: MEC2000 -00246
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/19/2000
PARCEL: 2S110CD -00105
SITE ADDRESS: 15900 SW 116TH AVE
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install a vent fan connected to a single duct.
Owner: FEES
UNITED STATES NATIONAL BANK Type By Date Amount Receipt .
REAL ESTATE MGMT DIV -T3 PRMT GEO 06/19/20C $50.00 0003101
PO BOX 8837 5PCT GEO 06/19/20( $4.00 0003101
PORTLAND, OR 97208
Total $54.00
Phone:
Contractor:
QUADRUS INC
4647 SW HUBER ST
PORTLAND, OR 97219 REQUIRED INSPECTIONS
Misc. Inspection
Phone: 503 - 293 -8931 Final Inspection
Reg #: LIC 88404
OR\G
L
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 obtai op'- o these rul -_ a direct questions to OUNC by calling (503)246 -9189.
Issue By: /0 Permittee Signature: _
Call (503) • 41 75 by 7:00 •. • . -r inspections needed the next business day
Plan
CITY OF TIGARD Mechanical Permit Application Recd Byck#
13125 SW HALL BLVD. Commercial and Residential Date Recd 6, / 6 - cNe
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type
Permit # /XE� ° 7oo 0 06'd
Incomplete or illegible applications will not be accepted Called
Name of Development/Project . Description
1, 1 5 QAtoUG kirt/G- l
Table 1A Mechanical Code Qty Price Amt
Gr�,
Job Street Address Suite# A) Permit Fee 16.00
Address (5`700 5 (i) ! i to Ati 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 9.65 -1
Bldg# City /State Zip 2) Furnace 100,000 BTU+
K 1s)& Clry 9722_3 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner t LS 8094)K. . 4 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
It /,3ex 8g 37 0R -5-4/30 '/- 5) Vent not included in appliance permit 4.75 +y, 7.5
City/State Zip Phone . Check all that apply: *Boiler Heat Air
P e 9 7268 2. 73" '/2Sgg, 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
L-5 go rvl< 100K BTU 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
f .5 5 w 1 (6.-t-14.-- 100k to 500k BTU - 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
Kitties- L-/ rti 9 / 7 223
unit 3 30-50 HP; absorb
.5-1 mil BTU 24.15
N ame 1 9) 30 -5
Contractor unit 1 -1.75 mil BTU 36.00
U Pt D AO S 1 I-- N (:.- , 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy 94' L( 7 S u) H u C3 f= 2 l' 11 Air handling unit to 10,000 CFM
of all licenses City/State Zip Phone 7.00
are required if p' i rL.a 41 d 60.4. 97 x"03 .2 c/.3 S-1.3i 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Da ^ f 11.85
database 88 4 D y r v 13) Non - portable evaporate cooler
Architect Name 7.00
/ /4 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 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
Residential 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 0 LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL n _
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE �„ b''
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
TOTAL
Signatu of Owner /A ent 2 Date
Other Inspections and Fees:
.'./ j o) p 1. Inspections outside of normal business hours (mininum charge -two
A
Contact er Name Phone hours) $50.00 per hour
n 2. Inspections for which no fee is specifically indicated (minimum
P/4 e.2/.... /iEND E,� _5 x _ 2 3 - g'73 / 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
*State Contractor Boiler Certification required
units.
**Residential A/C requires site plan showing placement of unit
I:\rnechperm.doc rev 7/19/99
.. .
4i KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
limmi■ Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Workin In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: C e . n �,. , A A pt/'_
located at: 4 5, /,S L,
111; ,L. ___. L i .`J
King City Representative (Q ._ ico
I DSTS KCINST DOC
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested Z3 AM PM BLD
Location taw //6 �i� Suite MEC,,20i-ro - bo
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ( l + S 6 ELC
Retaining Wall ELR
Footing AEe'ess:
Foundation FPS
Ftg Drain
��/ Y/ `"�` Crawl Drain Inspection Notes:
SGN
Slab SIT
Post & Beam i
Ext Sheath /Shear ` CC) 1/j1
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler / .
Fire Alarm /� J 4
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P S PART FAIL
E CHANICAL .
Post & Beam
Rough In
Gas Line
Smo Dampers
• I
P S PART FAIL
ELECTRICAL
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 /./ /(
Approach /Sidewalk Date 23 Inspector ) , Ext % G
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location ) S C� / /Zo Suite MEC 04U U Vi
Contact Person Ph PLM
Contractor Ph 3 8 "5 3/ SWR
BUILDING Tenant/Owner / c A27et ) ELC . Q 2) oc' 3</r
Retaining Wall ELR
Footing
Foundation � ACCeSS� 1 1 FPS
Ftg Drain !� f/ � SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam i ,��l� d / [ �/` Z) `/
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler "41174---
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final ,/4� 1 (( at
L G
PASS PART FAIL -C.._
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Sery ice
Rough In
UG /Slab
Low Voltage
Fire Alarm
F'
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 [ I Please call for reinspection RE: [ Unable to inspect - no access
A � ADA
3v Approach /Sidewalk
Other Date 13 Inspector - C� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.