Permit CITY TIGARD MECHANICAL PERMIT
. DEVELOPMENT SERVICES PERMIT #: MEC2004 -00698
' ,'J11 DATE ISSUED: 10/21/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S 135AB -01003
SITE ADDRESS: 10300 SW GREENBURG RD 460
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:
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 (3) supply grilles and (1) pneumatic T -stat.
Project Value: 5,730.00
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA ST #300 [MECH] Permit Fee 10/21/20( $72.50
PORTLAND, OR 97258 [TAX] 8% State Surchart 10/21/20( $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 of these rules or direct questions to OUNC by calling
(503)246 -669 .
Issued ,, �X! Permittee Signature: `
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application F : ONLY
Received Mechanical , / QQ'
• Date /By: 10 u ?/ Q'/ Permit No.: IIfeA i / 1
City of Tigard Planning Appr val Building
Tigard Date /By. Permit No.
1 3125 SW Hall Blvd. Plan Review Other
zard, Oregon 97223 , Date /By: Permit No .
t hone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
I Date /By: Case No.:
Internet: www.ci.tigard.or.us . . Contact Jur .. ® See Pape 2 for
24 -hour Inspection Request: 50 3- 639 - 4175 '
p Q Name /Method' (Cj • Supplemental Information.
• .. . TYPE:OF WORK ... • COM ERCIAL FEE* SCHEDULE 1USE.CHECKLIST' -,-,: •'•
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
R 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.
❑ I & 2- Family dwelling Commercial /Industrial Value: $ 72,O.Op See Page 2 for Fee Schedule
El Accessory Building ❑ Multi- Family RESIDENTIAIJ :EQUIPMENT /SY:STEMSFEE* SCHEDULE • .
Description Qty Fee(ea.) Total
❑ Master Builder ❑ Other: Heating/Cooling
• JOB SITE/INFORMATION.:andtOCATION - ' . Furnace - add -on air conditioning ** 14.00
Job site address: /03Cc Si...) C-t,e6 Ig uEct a . Gas heat pump 14.00
Suite #: 99 (00 Bldg. /Apt. #: Duct work 14.00
Project Name:It�aTo12.G,ex D ft1 vtLo . - . TAL l' 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 1
'DESCRIPTION :OF WORK - i' ° • .. . .. - Gas fireplace 10.00
V -$ Tom' S Su P f 1 1 : L (C� Flue vent (water heater /gas fireplace) 10.00
�io e U 1,4 Av — Log lighter (gas) 10.00
t � C ' 4 `� t ' / T - S7 Art Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
%PROPERTY,•; OWNER;;:::''; ®:; TENANT r;,: a ` .,, ' F " Other: 10.00
Name: EQ u cT t O P F t ck
P&0 Cs Q-T t � S Environmental' Exhaust & Ventilation
Q Range hood/other kitchen equipment 10.00
Address:pNer s,, cl „ S , 30 Q Clothes dryer exhaust 10.00
City /State /Zip: R2 D Oa- `77 ZS
Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
~❑ APPLICANT" `r ° _:`'"::' 1 :`_' , iVONTACTPERSONt `:. ;; utility rooms) 6.80
Name: pN—T-- C_g,PPia,_ Attic /crawl space fans 10.00
Address: Sy 00 Na- C-olu.Kb0n.- igh✓> Other: 10.00
Fuel.Piping
City /State /Zip: Q -( ..'4- 9721 F3 * *($5.40 for first 4, $1.00 each additional)
Fumace, etc. **
Phone: 5O3 331 -ovI Fax: Gas heat pump **
E-mail: Wall /suspended /unit heater **
..: •_._ - .. - .CONTRACTOR:; : . ', .: .... •Water heater **
Business Name: r c. ..k. - -sTd egD Fireplace **
Address: Selo . d Coto v ut 6e,q, g 1,,a Range **
City/State /Zip: PoLr - L. at__ 7 7 218 CBQ **
Clothes dryer (gas) **
Phone: 5 c�3 31.1 -e23 t ( Fax: Other: - **
CCB Lic. #: gOQe) Total: ( Mechanical Permit Fees*
Authorized �.� /D,�g�v Subtotal: $
Signature: Date: ( Minimum Permit Fee $72.50 $
'A� � Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE 5
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.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -41 5
INSPECTION DIVISION Business Line: (503) 63 1 MST
BUP
Received k Date Resuested / AM PM BUP
Location D- eV L 1L_ . Suite q MEC ,(-Y ( 7 4— eD (92
Contact Person _ -AO Ph ( ) PLM
Contractor Ph ( � ) SWR
BUILDING Tenant/Owner - - ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspectio n� o nn 5-33 SIT
Post & Beam �i(C K � � P"--0S-6
Shear Anchors
Ext Sheath/Shear `�lQ e
Ina Sheath/Shear /N ) n nd � / 'vJ
Framing / �/ � C
Insulation I
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
PASS PART FAIL
ECHANIC
Pos Beam
Rough -In
Gas Line
Smoke Dampers
inaft
' PART FAIL
TRICAL
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 ° Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
l�
Approach /Sidewalk Date ` 1 , , Inspector `" Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL