Permit 4 , " CITY OF TI CARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00697
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/21/2004
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 500
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Mechanical TI, relocate ducts & grilles.
Project Value: $5,500
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA #300 [MECH] Permit Fee 10/21/20( $150.50
PORTLAND, OR 97258 [TAX] 8% State Surcharl 10/21/20( $12.04
Phone: 503 412 - 4800 Total $162.54
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Duct Inspection
Reg #: LIC 40981 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)24... .
Issue' By:
g '4 Permittee Signature: Y 4.�.L _
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
M-e Permit App `',, ' r:,PiK , v :.'FOR' OFFICE =USE ONLY, ;:: , `.
C��lI1flC�l A �I'll$llf `a�N�lc��� ®) Received � Mechanical [i �j{,
r Date /By: l / � 0 y Permit No.: [ �`r� 7
Cit Ol TIaiII (1 Planning Appro •al Building
Y Tigard Date/By:: No.:
13125 SW Hall Blvd. Plan Review Other
?ard, Oregon 97223 Date /By: Permit No.:
Post - Review Land Use
rhone: 503 -639 -4171 Fax: 503 -598 -1960 ,n -,7,., , „;r� '. Date /By: Case No.:
Internet: www.ci.tigard.or.us � Contact Ju "
www.ci.tigard.or.us .f, ®See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: R47? Supplemental Information.
. . TYPE OF WORK . ... COMMERCIAL FEE *•SCHEDULE USE CHECKLIST •'. . •
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
54 Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION • mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling I Commercial /Industrial Value: $ _ S g. O See Page 2 for Fee Schedule
r7 Accessory Building 1-7 Multi- Family RESIDENTIAL :EQUIPMENT /SYSTEMSFEE* SCHEDULE .
Description Qty Fee(ea.) • Total
❑ Master Builder ❑ Other: Heating/Cooling
' JOB SITE.INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: /0 2140. Sc....) G 1,,, RJ_.. Gas heat pump 14.00
Suite #: SQf> Bldg. /Apt. #: Duct work 14.00
Project Name: L' ,p 120 Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
'DESCRIPTION :OF WORK • •: •. : ".' Gas fireplace 10.00 1
t-xg-W FP & l NtgtJ `j =T ,- oqzi--- Flue vent (water heater /gas fireplace) 10.00
� q � 04. Log lighter (gas) _ 10.00
Erc ST, l �TAYrS . �uG4 ' C1,S • Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
PROPERTY OWNER :` i; ®aT'ENANT; ` :: , :, :_-::':;:'. Other: 10.00
ame: 6--(1) u t B C� I cGr- Ve A., L
Environmental Exhaust &Ventilation
r Range hood other kitchen equipment moo
Address: o ,„,,; ,,, C4',1„.4,4- Ell) 14
a n-44 1 -4_ 6L `azs - 8 Single es dryer exhaust 10.00
City/State/Zip:
Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
0 APP,LICANT'• a >'- ) L " (: /::i " [gCONTACZPERSON. c : 0:; utility rooms) 6.80
Name: p C,tQ„.1...PP?1,- Attic /crawl space fans 10.00
Other: 10.00
Address:
Fuel Piping
City /State /Zip: _ * *(55.40 for first 4, $1.00 each additional)
Phone:sp3 G7z -7975 Fax: Furnace, etc. **
Gas heat pump **
E-mail: Wall /suspended/unit heater **
- - CONTRACTOR' . , '''''' O'
Water heater **
Business Name: ilick,. j, Fireplace **
Address:
_ 1. givc) Range **
54C,�t�C
h' p: pog - r - he•� Ot q 2I CBQ **
C /State /Z 7 a Clot dryer (gas) **
_ Phone: so3 33( -ol3.( Fax: Other: • **
CCB Lic. #: Lip ea ) Total:
Authorized
Signature: • Date: /0 . Mechanical Permit Fees*
1 / q -0q Subtotal: S
Minimum Permit Fee $72.50 S /56 ;
—c- C k PPS- Plan Review Fee (25% of Permit.Fee) $
(Please print name) State Surcharge (8% of Permit Fee) S /, -.Oce
• TOTAL PERMIT FEE $ /tog .,
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
• is \Dsts \Permit Forms\MecPermitApp.doc 01/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
J BUP
Received Date Requested / I / 7 AM PM _ BUP
I
Location G 2 Ze) / ./> Suite , ---C& ) MEC 2-O v 62)6 97
Contact Person Ph ( ) 3 ed - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam ( -a, ,LZA.0;e—
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm Si
Susp'd Ceiling
Roof
Other:
Final
-
PASS PART FAIL
PLUMBING \
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin I Manhole
Storm Drain
Shower Pan
Other:
Final
PASS AIL
CHANICAL
Rough -In
Gas Line
Smoke Dampers
inal
0 0 PART FAIL
TRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please cal for reins ection RE: „o Unable to inspect — no access
ADASupply Line d1
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL