Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00508
' 'll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/19/03
PARCEL: 1S135AB-01002
SITE ADDRESS: 10220 SW GREENBURG RD 201
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER ZONING: R -12
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Tenant Improvement - Add (1) fan powered VAV box and relkocate T -Stats
Valuation $2500
Owner: FEES
EOP LINCOLN LLC Description Date Amount
10260 SW GREENBURG RD [MECH] Permit Fee 8/19/03 $72.50
SUITE 100
PORTLAND, OR 97223 [TAX] 8% StateTax 8/19/03 $5.80
Phone: Total $78.30
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Phone: 331 -0234 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 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.
Issued By: - 7' Permittee Signature:
Call (50 Z639-417by 7:00 P.M. for inspections needed t e n xt business day
and of Ti echanical Permit Application OFFICE us
Date received: , Q Permit no.(1( . i# . 7# 0�
dil �I'j ±" City
.�l� J g ProjecUappl. no.: . ji : Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: i By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:1 Lm 3 - 0 t> `jq 0 Building permit no.:
TYPE' OF,PERMIT
❑ 1 & 2 family dwelling or accessory I% Commercial /industrial ❑ Multi - family (5 Tenant improvement
❑ New construction ❑ Addition /alteration /replacement ❑ Other:
JOB SITE INFORMATION 'COMMERCIAL VALUATION SCHEDULE
Job address: 1022;0 SW b R CC-N 13C R(, 2D Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: L1N T'1-4-ZEl I Suite no.: 201 value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot /account no.: profit. Value $ 2- .
Lot: IBlock: I Subdivision: *See checklist for important application information and
Project name: SC-1- 1-IE.3E SUITE ZO I jurisdiction's fee schedule for residential permit fee. •
City /county: POeTL ,ID I ZIP: q122_ 3 1 & .2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: A-1).6 (1) .P I3 AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE
2.E LO C kTC cT— ST&rS) Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM
space insulated? ❑Yes ❑ No Air conditioning (site plan required)
Is existing P Alteration of existing HVAC system
- . MECHANICAL CONTRACTOR. Boiler /compressors
Business name: I` \ _LIPOSTIZ`I CO State boile permit no.:
HP Tons BTU /H
Address: 5 A.►E GOU,.." (3LVl) Fire /smoke dampers /duct smoke detectors
City: l>02_11-N-40 b I State: ()el ZIP: 17a/9 Heat pump (site plan required)
Phone: 503. I Fax: 331.te90(oI E -mail: Install /replace fumace /burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: LAC a ( Install /replace /relocate heaters — suspended,
City/metro lic. no.: ( (79 wall, or floor mounted
Name (please print): CUE I-4-A zero . Vent for appliance other than furnace
CONTACT PERSON
Refrigeration:
• Absorption units BTU /H
Name: GLIF 4<A 2..e--#0 Chillers HP
Address: 5400 �E COLUI`'11' I�LV1) Compressors HP
Environmental exhaust and ventilation:
City: POP TL -VOD State:Ol ZIP: 97z/ g Appliance vent
Phone: ` 3(.02.. Fax:33I. (AO , E -mail: Dryer exhaust '
OWNER' Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
Fuel piping and distribution (up to 4 outlets)
City: I State: I ZIP: Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Address: Other listed appliance or equipment:
Decorative fireplace
City: I State: . 1 ZIP: Insert — type
Phone: I Fax: I E -mail: Woodstove /pellet stove
Other:
Applicant's signature 1� Date: 8 -I } O Other. s.ritzro A/A4/ ( rPol
Name (print): ELI F I-4/ 7E
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
Notice: This permit application Minimum fee $
❑ Visa ❑ MasterCard
Credit card number: expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
$
Cardholder signature Amount 440 -4617 (6 /00 /COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639-4141 MST
//- BUP
Received Date Requestt d % �o AM PM BUP
Location /0 22- a Suite a O f MEC . 0 (50
Contact Person 01/1 ,tfr — e Ph ( 5 12 7 PLM
Contractor ��tit o - 641 Ph ( 5 2,2)/ — 0 23 4" SWR
BUILDING Tenant/Owner 444 , e - g-&--7 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
P' - FAIL
CHANICAL
Rough -In
Gas Line
• .e Dampers
S 'ART FAIL
-..,y' ICAL
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 rj Plea se II for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA /
Approach /Sidewalk Dat l Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL