Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00557
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/11/03
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 501
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER 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: 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: 2 GAS OUTLETS:
> 10000 cfm:
Remarks: Mechanical tenant improvement, relocated ducts and grilles, add VAV box and exhaust fan. Project value: $6,435
Owner: FEES
EOP LINCOLN, LLC Description Date Amount
10260 SW GREENBURG RD
SUITE 100 [MECH] Permit Fee 9/11/03 $167.33
PORTLAND, OR 97223 [TAX] 8% StateTax 9/11/03 $13.39'
Phone: Total $180.72
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 331
Duct Inspection
Reg #: LIC 40981 Final Inspection
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 -00
' 1
Iss ed By: . , /lz ja, Permittee Signature: P
tom'
03) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application , _ , - ... CE USE . ONLY
Date received: At a 5 Permit no.: the , 5-- 005 57
�Jr' City of Tigard Pro ect/a 1 no.: Expire date:
" - -- J PP � P
...,,,,„ City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9722
Phone: (503) 639 -4171 /) 50.=6,05/9/
Date issued: By: Receipt no.:
Fax: (503) 598 -1960 / //�jl/y� Case file no.: Payment type:
Land use approval: DPw Building permit no.:
. . TYP OF ,PER .
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family XTenant improvement
❑ New construction ❑ Addition /alteration/replacement ❑ Other:
' ' JOB SITE 'INFORMATION ' . " ` COMMERCIAL , V - SCHED,ULI '
Job address: ( 0Z2a l GR j te,Es c Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 1_4 co L4.4 "CEDE I Suite no.: 501 value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot /account no.: profit. Value $ , . Oe...■ .
Lot: IBlock: I Subdivision: *See checklist for important application information and
Project name: *F114, FPvRtJO I lGRT4A(1 . jurisdiction's fee schedule for residential permit fee.
City /county: PQRTL-IlP I ZIP: 1 & .2 FAMILY DWELLING PERMIt FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIP , MENT SCHEDULE
,
Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
. Tenant improvement or change of use: HVAC: to t o d 0
Air handling unit CFM _
Is existing space heated or conditioned? ❑ Yes ❑ No Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
' . , -, . ` MECHANICAL. CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: t i k. Ktt,eS - r t'. HP Tons BTU/H
Address: S 40 0.4E, Ccsit_1 J Iii 6L..'f) Fire /smoke dampers /duct smoke detectors
City: P0(2.71. 0 I State:OR I ZIP: Q-f2(8 Heat pump (site plan required)
Phone:3 i o234 I Fax:52A ( E -mail: Install /replace furnace /burner BTU /H
CCB no.: .4 a 1 Including ductwork/vent liner ❑ Yes ❑ No
Install /replace /relocate heaters - suspended,
City/metro lic. no.: tIll wall, or floor mounted
Name (please print): e.gtaat _ S I...t -g ta,tAC2. Vent for appliance other than furnace
CONTACT PERSON " Refrigeration:
• Absorption units BTU/H
Name: cc..( F ,.. ,,,„4 Chillers HP
Address: s[).oQ lye, CatLu.not l A. G3�� p , Compressors HP
Environmental exhaust and ventilation:
City: Pa _TLArtt7 I State:ag I ZIP: cr12,I6 Appliance vent
Phone:.5N cIt • Fax: 331(,,c106 E -mail: Dryer exhaust
OWNER ' - Hoods, Type I/ 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
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
• ENGINEER r Process piping (schematic required)
Name: Number of outlets
Address: Other listed appliance or equipment:
Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: I Fax: I E -mail: Woodstove /pellet stove
1 �� (� Date: Cl /� Other:
Applicant's signature:
tQn� I - i ii( (03 Other:
Nagle (print): eA42 -4... $41•SsuLCe
Permit fee $ /4 7i 5t
Not all junsdictions accept credit cards, please call junsdiction for more information.
❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ / - tr
Name of cardholder as shown on credit card accepted as complete. TOTAL G ,
/ n° •
s
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 -4171 MST
BUP
Received 9 ( 2 Date Reque ted ;VI PM BUP
Location . /O 22-0 &4) i2 A. Suite / MEC _ ` 00, 3 a7
Contact Person 2� 0 Ph PLM -3
( O
Contractor Ph ) 5�Z �7 ?1WR
BUILDING Tenant/Owner L _� �! _ = A 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 1
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
PAS . FAIL
M - HANICAL
P.. : ;eam
Roug -
Gas Line
Smoke Dampers„],
Lc& PART FAIL
RICAL
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 El Please call for reins.ection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Q Inspector Ext
Other:
Final DO N • T REMOVE this inspection record from the job site.
PASS PART FAIL