Permit A : CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00460
DATE ISSUED: 7/14/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB -01002
SITE ADDRESS: 10220 SW GREENBURG RD 350
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: 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: ! VAV bism (3) add. return grilles, and relocate (5) supply grilles. Value: $4000
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
10260 SW GREENBURG RD #100 [MECH] Permit Fee 7/14/200 $118.50
TIGARD, OR 97223 [TAX] 8% State Surchart 7/14/200 $9.48
Phone: Total $127.98
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 331 - 0234
Final Inspection
Reg #: LIC 40981
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these r r direc questions to OUNC by calling
(503)246 -6699.
sOldbf
•
Issued By: ' Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application .. OFFICE USE ONLY ;
��
Received Permit No.: • g j_ 2) / , D
City of Tigard Date/By: 7 / b
13125 SW Hall Blvd., j rd, OR 97223 Plan Review
Phone: 503.639.4171 Fa$: 503.598.1960 4~. Date/By: Other Pent
Inspection Line: 503:7 !J ;41 Date Ready/By: tuns: El See Page 2 for
Internet: www.ci.t Notified/Method: / /4 Supplemental Information
T YPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical p ermit fees' are based on the value of'the work
111 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: $ 4000
-
RESIDENTIAL EQUIPMENT 1 SYSTEMS FEES*.
❑ I- and 2- family dwelling ® Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. Total
JOB SITE INFORMATION "AND LOCATION Heating /cooling
Air conditioning or heat pump
lob site address: 10220 Sw Greenberg Road (requires site plan showing placement) 14.00
City /State/ZIP: Portland OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Suite 350 Project name: Soft Source Gas heal" pump 14.00
Cross street/directions to job site: TWO Lincoln Center 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: Lincoln Center Lot no.:
Oth 10.00
Tax map /parcel no.: Other fuel appliances
'DESCRIPTION OF WORK _ ; . - • , Water heater 10.00
' Gas fireplace 10.00 •
Furnish and install (1) VAV Box Flue vent for water heater or gas
Furnish and install (3) additional return grilles fireplace 10.00
Log lighter (gas) 10.00
Add/relocate (5) supply grilles Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
. ' . :0 PROPERTY OWNER' : ' ' TENANT;.° _._",, " =-, .., Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
t: Attic /crawlspace fans 10.00
®APPL `� .': ;; ,. .. r '13-
❑ =CONTACT IPER.SON`5 -; i.; ,
Other: 10.00
Business name: Mckinstry Co. Fael t
Pping
Contact name: Clif Hazen • $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 5400 NE Columbia Blvd
Gas heat pump .
City /State/ZIP: Portland, OR 97218 - Wall/suspended/unit heater
Phone: (503) 331.0234 Fax: : (503.) 331.6906 Water heater
Fireplace
E -mail: Range
. §i,r;' �r,� «< i`rµti:i - ..s�,�_.. �� .,}3;�i�.�;.�..�e �:- 41:�^�.�" Barbecue
Business name: Mcldnstry 'Co. Clothes dryer (gas)
Other:
Address: 5400 NE Columbia Blvd 11MECHANICALlPERMIT=FEES ° ` ; "i .'..'.;
City/State/ZIP: Portland, OR 97218 Subtotal
Minimum permit fee ($72.50)
Phone: (503 - 331.0234) Fax: (503.) 331.6906 Plan review (25% of permit fee)
CCB lie.: 40981 State surcharge (8% of permit fee)
r TOTAL PERMIT FEE
f j 1,41----C-------. - This permit application expires if a permit is not obtained within 180
AUIhOI7Zed signature ` days after it has been accepted as complete.
I Print name: C'.lif flaxen 1 ( / 1 7 Date: 7 - I * Fee methodology set by Tri -County Building Industry Service Board
CITY OF TIGARD 24 -Hour
BI)ILDWG k Inspection Line: (503) 639 -4175 MST
INSPECTION DIVFSION Business Line: (503) 639 -4171
BUP
Received / Date Re uested 22- AM PM BUP
Location
0) Suite 3 MEOt, ^oo Y6 0
Contact Person
/ 1 �� Ph ( ) 5 2- 95 PLM
Contractor t Ph ( ) ? if" Q S 3 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: Q - SIT •
Post & Beam
Shear Anchors ' r p
Ext Sheath /Shear `-�
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm Irk
Susp'd Ceiling
Roof ���_ 11 1
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
PA ,ART FAIL
ar CAL
• -eam
Rough -In
Gas Line •
Smoke Dampers
ma
'PASS PART FAIL
ELECTRICAL 7
Service
Rough In /f / `AI,
UG /Slab ` "Ir t %1w
Low Voltage
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: ❑ 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