Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00790
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/3/2004
PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 1180
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT: 014 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: Relocate 2 supply grills, relocate 1 pneumatic t- stats, add 2 supply grills.
Valuation: $3500.00
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA ST #300 [MECH] Permit Fee 12/3/200 $72.50
PORTLAND, OR 97258 [TAX] 8% State Surcharl 12/3/200 $5.80
• Phone: 503 412 - 4800 Total $78.30
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
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 ofthes= . :s or direct questions to OUNC by calling
(503)246 -6699.
d B f
Issue t � i 1
y: � ! /�i ;�_ � , Permittee Signatur • / � .,
Call (503) 639 -4175 by 7:00 P.M. for inspections ne- •ed the next bss da
rvs g �
" Mechanical Permit A FOR OFFICE USE ONLY
w`
am Received amity of Tigard Date/By: � Permit No.: fyl ,p le?,
13125 SW Hall Blvd., Tigard, O1 9,7f223 U 3 2004 Plan Review
0 `� 7
Phone: 503.639.4171 Fax: 503 ' 'r \ Date/Sy: Other Permit:
Inspection Line: 503.639.4175 r` n nta® ll Date Ready/By: JunS 0 See Page 2 for
Internet: www.ci.tigard.or.us Q �1�� �G ®0 6 ��°���� ® � Notified/Method: 776 Supplemental Information
BUILDING TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
1:1 New construction [gl 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling K Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Airbonditioning or heat pump
Job site address: ID 2i. c ti2L tZ V ef.... RA, (requires site plan showing placement) 14.00
City/State /ZIP: Ppe 8._ C.2_ y 7 22-3 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no. t -- I I liC, Project name: ilk E e -� 6 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ Gas fireplace 10.00
� v 1 EY "ZTI Z u ()Phi C, 4. LLL_ Flue vent for water heater or gas
^ b-b 7 C_ ` J ,, p p i � t / , fireplace 10.00
/`� Log lighter (gas) 10.00
K.�-LU C.. r c- I Y CSL 1 L NL V l t.(Ari ( 1 -77.6t-1 5 Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
❑ PROPERTY OWNER • ❑ TENANT Other: 10.00
Name: ( ( (7c-ft LL pe.op .'r-1 -. Environmental exhaust and ventilation •
I 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
❑ APPLICANT ,mil CONTACT PERSON Attic /crawlspace fans 10.00
, Other: 10.00
Business name: IMLIL t t .V t /� 4) t Fuel piping
Contact name: P Ce_", f 4_ $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: C /■(y Col 0 6,,,0._- 6l ilD . Gas heat pump .
City/State /ZIP: i>oL` t..i.,.- -.,), p2_ 9 7 J G Wall/suspended /unit heater
Phone: (,.5>) 7 - 2_9 5 Q Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: i/ r ✓ F.,l ti S'r'(LY Co . Clothes dryer (gas)
Other:
Address: 5 1 cJG. r sE Cpi & (d), MECHANICAL PERMIT FEES*
City/State /ZIP: Po 4T L yqc,.. , D c)L- 9 7Z.' 8 Subtotal
Minimum permit fee ($72.50) r�,
Phone: (S6) Z _ z Li I.O Fax: ( ) Plan review (25% of permit fee)
CCB lic.: y 9 (2,1 State surcharge (8% of permit fee) ..--
TOTAL PERMIT FEE 7
This permit application expires ita permit _is not obtained within 1
Authorized signature: )
u days after it has been accepted as complete.
Print name: . S .7 /1/41 - f 4 Date: /Z, - ..- a 7 * Fee methodology set by Tri -County Building Industry Service Board
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
•
INSt ECfiON DIVISION Business Line: (503) 639 -4171 MST
L p' , BUP
a Pd 6 - IV / Date Requested / a 16 AM PM BUP
Location /0 2-Co Suite 1/ PD MEC 4 ( /' - ' 6) d 79
Contact Person Pal- ..L-' Ph ( e— 6' S e 3 PLM
Contractor Ph ( ) - SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: n SIT
Post & Beam
���'�
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof 4'
Final o IUI1l it ri
PASS PART FAIL
PLUMBING
Post & Beam ` 7
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post-& Beam
Rough -In
Gas Line
Smoke ampers
ASS ART FAIL
C CAL
ce
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE • Please call fo reinsp•ction RE: 1 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date ' Inspecto Ext
v.
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL