Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00821
c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/21/2004
PARCEL: 1S135AB-00900
SITE ADDRESS: 10200 SW GREENBURG RD 110
SUBDIVISION: FIVE LINCOLN ZONING: C -P
BLOCK: LOT: 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FN > =100K BTU: <= 10000 cfm: OTHER UNITS:
UR
> 10000 cfm: GAS OUTLETS:
Remarks: Relocate (5) t stats, relocate - add (6) diffusers, add (8) sound boots.
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA ST #300 [MECH] Permit Fee 12/21/20( $134.60
PORTLAND, OR 97258 [TAX] 8% State Surchar€ 12/21/20( $10.77
Phone: Total $145.37
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Final Inspection
Reg #: LIC 40981
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 i AR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these . -s or • irect q uesti • • to O` calling
(503)246 -6699.
Issued By: Permittee Signature
Call (503) 639 -4175 by 7:00 P.M. for inspections nee. - • the next bjillIWIFF
1
Mecha i Per ? ( 3 % ii FOR OFFICE.USE ONLY
City -E ' .._ ' VED !/ /
y of " DateB y /a24 _ (1),.....4, . Permit No.: -E 4 //) 7 ? 1
13125 SW Hall Blvd., Tigard, OR 97223 P lan Review _ _ w v —
Phone: 503.639.4171 Fax: 503.590 ' 1 1 / I ,\ DateBy: Other Permit:
le Inspection Line: 503.639.4175 �' . G . 2007 11 Date Ready/By: JunS 133 See Page 2 for
Internet: www.ci.tigard.or.us .. - . _Notified/Method: '( Supplemental Information
CITY OF TIGARD
NUILDINGDDINVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: $ 7 7cC
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling DKJ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling . .
p Air conditioning or heat pump
Job site address: j Zoo SL. G"� p
Qe s£P gd. (requires site plan showing placement) 14.00
City/State /ZIP: TOa.Z 6.O 0 e_ c 7 Z Z� Furnace 100,000 BTU (ducts /vents) 14.00
� r Furnace 100,000+ BTU (ducts /vents) 17.90
610P• Idg. /apt. no.: , ` p 4. c�aS Project name: F I DEt a r N Imo` 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
4Ec,CC A.,Te s T SCATS CQt.0 M wit L \ Flue vent for water heater or gas
n " -r ` �� A �� i rC0S fireplace 10.00
� T Log lighter (gas) 10.00
�� ( 8 ) 5c%veyci- .`t-S Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER Chimney /liner /flue /vent 10.00
❑ TENANT Other: 10.00
Name: Environmental exhaust and ventilation •
Address: Range hood/other kitchen
.. . .._._ .._, - °-.. _. . .... equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) • toilet compartments, utility rooms) 6.80
❑ APPLICANT ,CONTACT PERSON Attic /crawlspace fans 10.00
-AA- L Other: 10.00
Business name: / ° ct i _a .. Co . Fuel piping
,,�
Contact name: p, c� \ p , $5.40 for first four; $1.00 for each additional
o Furnace, etc.
Address: Jt6c N L L (V so 6s A. D la) Gas heat pump
City/State /ZIP: Po p,� Q 7 l 8 Wall/suspended/unit heater
( ) -�S 1 _ 2.4 QT ( ) Water heater
Phone: l v Fax:
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: elALkt...3S• eht Other:
Address: GYI 0b Ne Co Iu• -►LiA 61 vb. MECHANICAL PERMIT FEES*
City/State /ZIP: PO QT Lagw cL t CA_ 9 7 Z / 8 Subtotal '�y
Phone: ( ) 3!L _ 02,s4 Fax: ( ) Minimum permit fee ($72.50) f� y • 6
Plan review (25% of permit fee)
CCB lic.: Cho I' e _ _ _ State surcharge (8% of permit fee) ) e l_ 11
� TOTAL PERMIT FEE p w� �'
Authorized signature This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: PAzt. s IA_ Date:/ Z — z 1 - C) cf * Fee methodology set by Tri -County Building Industry Service Board
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 42 -36 AM PM BUP `
Location. 0 r • _..40.1a �f_ 4 _ Am_._.. ,� Suite 1/ v MEC � , 7 —) S 0- l
Contact Person f2.t c._ Ph ( ) 3y-g- 0 ,s- - 63 PLM
Contractor Pa_ Ph ( ) S 7 -- 9 7S SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: J am ' ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors G
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling � _ Roof Other: ' Final I i t. ` g, I
PASS PART FAIL IIII 1 w
PLUMBING Y ,p , ,
Post & Beam k) '
Under Slab i
Rough -In v
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
SmD pers
�, P PART FAIL
,E RICAL_
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection ee of $ required befor: ne inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - ❑ Please - , f .r reinsp- tion RE: Ail 1 , , 0 Unable to inspect — no access
ADASupply Line - 4 "
NI
Approach /Sidewalk Date '1 Inspector ! ,' r Ext
Other:
Final DO N •'T REMOVE this inspection record from the Job site.
PASS PART FAIL