Permit CITY OF TIGARD
MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00820
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/21/2004
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 375
SUBDIVISION: LINCOLN ONE /RED LOBSTER /CASA L 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Relocate (3) t stats, relocate (5) diffusers, (1) new vav box, (3) sound boots.
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA ST #300 [TAX] 8% State Surcharl 12/21/20( $12.18
PORTLAND, OR 97258
[MECH] Permit Fee 12/21/20( $152.30
Phone: Total $164.48
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Phone: 503 Mechanical lnsp
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. Tho e rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of thes- ules or irect quest • a • ! C b - i
(503)246 -6699. Air4
9 �
Issued By: Permittee Signature' 411.
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bu;711111MIL
- \ NI ED
Mechanical Permit 43 1',0 I.01 >FOR oFFicE usE olv><.Y
City 0.:Tigglard O�\ Date/By: - 7/ -7 Permit No.: . `. -- / t)
'
13125 SW Hall Blvd., Tigard, OR 97223 P lan Review
q
Phone: 503.639.4171 Fax: 503.598.1960 ®EC 2 L / � E � if ' I ; I � Other Permit:
DateBy:
Inspection Line: 503.639.4175 � ,e. ENI
Internet: www.ci.ti ard.or.us y i , i -. Date Ready/By: 0 See Page 2 for
g CITY of ey _ 1 i`S
.. _ Date
Supplemental Information
j�i ��'^ 1 O RK v COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction NI Addition/alterationlreplacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ S-
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: • � _
Air' conditioning or heat pump
/0 J Sc._) C. 1G. &)e.9 RA • (requires s p showing placement) 14.00
City/State /ZIP: •P L c7)4. 7 213 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
%� ldg. /apt. no.: 1 Li�c o�� r N � A L . Project name: r Gas heat pump 14.00
Cross street/directions to job site: .,,&G /kJ E Prrs 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: 1 Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
-/ D Gas fireplace 10.00
l 6 3 [ V!3 fJ /�rt►cTCC. - 1 7 :. S % Ai 5 Flue vent for water heater or gas
f) - : s � T E fireplace 10.00
F-CC 4 Log lighter (gas) 10.00
1 Ne CJ VA V 6x • Wood/pellet stove 10.00
S ezav N 1> p 0cT - Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation •
•
Address: Range hood/other kitchen
_ . .. ,- _ - _ __ _ .. _.. ._ ... • equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Fax: Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 6.80
ZAPPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
.n � /' Other: 10.00
`
Business name: / ck `
t /..zVr _Y -C) Fuel piping
Contact name: ?0,,z- cRie1/4- 55.40 for first four; $1.00 for each additional
Address: S U 5, , V i Silty Furnace, etc.
Gas heat pump
City/State /ZIP: po erta,,,, D o 2. ?'7 Z I S Wall/suspended/unit heater
Water heater
Phone: (5b'% 331 ^ Zy yo Fax: : ( ) .
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
-A �
Business name: Y I , 6 L'
Other:
Address: S Etc) C (C V,,.4,i #4,, , g1 l) MECHANICAL PERMIT FEES*
City/State /ZIP: POG 4-.dtN4 p
�4. f 7Z1 S Subtotal /3 , 6
t Minimum permit fee ($72.50)
Phone: () 3sr . cast,/ Fax: ( ) Plan review (25% of permit fee)
CCB lit.: 4/0 l 8( State surcharge (8% of permit fee) ,,�., / y p �
TOTAL PERMIT FEE ( y6
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: [ )�� P/'� Date: /Z - 2.1 -(2 * Fee methodology set by Tri- County Building Industry Service Board
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:, (503) „639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
,/ BUP
Received �� Date Requ ed l� <�� AM PM BUP
Location � '` 36 � �i j t '„' —Suite �.� E (,Gr Y" . '�
Contact tact Pe
• ( ��) l 7S PLM
Contractor A e . Ph (S ) 34q Z ST 3 SWR
BUILDING Tenant/Owner f r i ELC
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection NOsL, /0-7 SIT
Post Beam i�C%
Shear Anchors
Ext Sheath /Shear GZ -
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof , 111 Other: - -
Final , I 1 .�
PASS PART FAIL
PLUMBING
Post & Beam V
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: • •
Final
PASS PART FAIL
M HANK L
Pos Beam
Rough -In
Gas Line
Smoke Dampers
AS PART FAIL
ECT'• ICAL
Servic:
• -In
UG/Slab
Low Voltage
Fire Alarm •
Final ❑ Reinspection fee of $ required befor- next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE . fl Please call or reinspe' ion RE: ill, A
Unable to inspect - no access
Fire Supply Line 1
ADA d IJf t..
Ext
Approach/Sidewalk Date _I _ Inspect
Other:
Final DO NO REMOVE this inspection record from the Job site.
PASS PART FAIL