Permit ri
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00425
�•f �l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/29/2004
PARCEL: 1S135AB-04500
SITE ADDRESS: 10250 SW GREENBURG RD 200
SUBDIVISION: LINCOLN BUILDING PP1991 -055 ZONING: C -P
BLOCK: LOT: 001 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
>
GAS OUTLETS:
10000 cfm:
Remarks: Relocate (2) diffusers & (1) pneumatic thermostat.
Project Value: $498
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
10260 SW GREENBURG RD #100 [MECH] Permit Fee 6/29/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 6/29/200 $5.80
Phone: Total $78.30
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 331
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 -0 s : ... • OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503) ' . -6699.
/ l
Is-ued By: / _ 1 P er mittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bul y
Mcllani cal Permit Application r, ,`: FOR,OFFICE USE ONLY • .
or Received , 4 n , I AM
City of Tigard Date /By: (P i _ Permit No.: ,..„1/1 ',
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Penult:
503.639.4171 Fax: 503.598.1960 t dtr Date /By:
Inspection Line: 503.639.4175 :1 i ' Date Ready /By: Jun a See Page 2 for
Internet: www.ci.tigard.or.us Notified /Method: ha,.. Supplemental Information
W \ .r ifiVssi f TYPCOFWORK . - ",.. 4,4 j :'',;I aCOMN1ERCIAL sFEE SCI3EDiIL °E44SECHECKL`I
Mechanical permit fees* are based on the value of the work
El 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.
M
,: is ` „ _t ' 3 " '3;5A Value: $ 498.00
x� �; �� a t t g „ `CATE0 N STRIICTION
. ; i:RESIDTIA - EQUIPMNT,„osySTES FES* ;
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building EN ° ' "
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty.
Ea. Total
F b • °, ;1 . 1 , t�si 3,:,,
n.-�A JOB SITE Il!7FO. , -, ION AND L .. Heating/cooling
Job site address: 10250 SW Greenburg Rd. Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: Portland, Oregon 97232 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: 200 / Lincoln Four Project name: Forest City 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
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' `s3,' a.,,.,,>
"i t .. r7r : DES @RIPTIOS i ;'OF`1VVORK ;'r`r %il.O -; Water heater 10.00
Gas fireplace 10.00
Relocate (2) Diffusers and (1) Pneumatic Thermostat Flue vent for water heater or gas
• fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
•: < ^ Chimney/liner /flue /vent 10.00
®' P PERT OWNER..•; T
� RO,. T a � j� .... r '�.® ,_ENANT. ,;,
�„�� __.. >. , ,:�_<�._ . � .-�� � ... .. ,� =���.' "��,. . �= �. �_ _ ,., .. �, ..�. , Ill Other: 10.00
Name: Forest City Environmental exhaust and ventilation
Address: 10250 SW Greenburg Rd. Range hood/other kitchen
equipment 10.00
City /State /ZIP: Portland, Oregon 97232 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms, •
Phone: ( ) . Fax: ( ) toilet compartments, utility rooms) 6.80
p; ,� ...;. ; ;;, ;',:;' Attic/crawlspace fans 10.00
9 APRLICANT' '` zr �,, „ 1. CONTACT.rPERSON E . , . P
K'''im _,.�, ..��..,.� �,,.,,,....... q�'.... ,.. .. - .__ < ®..�., " "x,.��..,,,•'� - "_� ..._,� � -�.
�� Other: 10.00
Business name: McKinstry Co.
Fuel piping
Contact name: Eatl Salsbury $5.40 for first four; $1.00 for each additional
Address: 5400 NE Columbia Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, Oregon 97218 Wall/suspended/unit heater
Phone: (503) 331 -2465 Fax: : (503) 331 -6906 Water heater
Fireplace
E -mail: earls @mckinstry.com Range
;'� ° , ,, 4<�� CONTRACTOR`::" �s� „„ Barbecue
Business name: McKinstry Co. Clothes dryer (gas)
Other:
Address: 5400 NE Coulmbia Blvd. �pEi2MITFE *' "�`
� ~'1VIECfi4 CAI , ES, r
v ::. >> _ -n� � .max. -.. _, ... �.... u ,..:,;,,: , �Q�._._ . �,�.. � .. � .
City/State /ZIP: Portland, Oregon 97218 Subtotal
Phone: (503) 331 -2465 Fax: (503) 331 -6906 Minimum permit fee ($72.50) 7 .50
Plan review (25% of permit fee)
CCB lie.: 40981 State surcharge (8% of pennit fee) 5. to TOTAL PERMIT FEE `7t, 3 6
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Earl Salsbury Date: 06 -29 -2004 * Fee methodology set by Tri- County Building Industry Service Board
i:\Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (11/02 /COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received /` Date Red ested 7() AM PM BUP
Location / 0 ° 257) f ' Suite 0-0-0 MEC g
Contact Person �il c X—/ 4 Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 7j K"L.6. ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: , SIT
Post & Beam �� L1
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 C
Under Slab
Rough -In •
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS_ PART FAIL
CHANIC
o'& eam
Rough -In
Gas Line
Smoke Dampers
iii PART FAIL
t��CAL
Service
Rough -In . \ _��� 1 �. �_ ��
UG /Slab ` AWRI/ I� ,� /M
Low Voltage —1 _`
Fire Alarm V
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: 111 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