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Permit C ITY OF TIGARD MECHANICAL PERMIT 44' PERMIT #: MEC2004 -00657 DEVELOPMENT SERVICES DATE ISSUED: 10/7/2004 � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DC -00500 SITE ADDRESS: 11626 SW PACIFIC HWY • SUBDIVISION: ZONING: C -G 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: 1 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: OTHER UNITS: FURN > =100K BTU: < =10000 cfm: > 10000 cfm: GAS OUTLETS: Remarks: Installation of ductless split system heat pump unit. Project value: $4,800 Owner: FEES REGAL CINEMAS Description Date Amount BY ACT III [MECH] Permit Fee 10/7/200 $136.90 7132 COMMERCIAL PARK DR [MECPLN] Plan Rev 10/7/200 $34.23 KNOXVILLE, TN 37918 [TAX] 8% State Surchart 10/7/200 $10.95 Phone: Total $182.08 Contractor: AMERICAN HEATING INC 1339 SE GIDEON ST, STE. 1 PORTLAND, OR 97202 REQUIRED INSPECTIONS Phone: 503 - 239 -4600 Mechanical Insp Final Inspection Reg #: LIC 33135 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 -6699. / Issued By: ��� Permittee Signature: g M G'n c �'/� -CI Call (503) 6 9-4175 by 7:00 P.M. for inspections needed the next business day — 9 . J ,i Mechanical Per to • ,,,:;! ,,, • ei) n / FOR OFFICE USE ONLY t Received /_ C City of Tigard DaterBy: d �,�' PernuttiO _ajW✓ 7 ii 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.5 2004 Plan Review t mil! w 9 1960 P�sac i,,,,,,+!1 � ; ' Date/By: J _ + t %! .: • they Permit: Inspection Line: 503.639.4175 ‘'''''d Al,.. l Date Rd e � ae ea B1, , luri Internet: www.ci.tigard.or.us © -* y /0 `� /� See Page 2 for CITY OF TIGAR Notified/method: E A ii 44 /} / • ( ta . Supplemental Information L I 0 Li 443 , [3UIL6NP DIVISION - , TYPE OF WORK '- . „ _ . COMMERCIAL FEE* - SCHEDULE = USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction IS Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. s Value: $ ,, CATEG . OF : CONSTRUCTION / t r 00 I- and 2-family dwelling Commercial /industrial :•'RESIDENTIAL EQUIPMENT / SYSTEMS F El y g ❑ Ac cessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total f' ` i_ "JOB SITE INFORMATION AND .LOCATION ; • a -- Heating/cooling Job site address: 1 • 1,(.0 lo // -- CO , \ V�•�S�y 1 � i L �` U . Air conditioning or heat pump { � � �, W b ('�� (requires site plan showing placement) 14.00 City/ State/ZIP: - 30 < O 61 97 a 1 3 Furnace 100,000 BTU (ducts/vents) 14.00 /fi Furnace 100,000+ BTU ( ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: 7 a O 't V1� ��h5 Gas heat pump 14.00 Cross street/directions to job site: Cr to , i � n CA U Duct work 14.00 V 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 an of above 10.00 O Other: 10.00 Q Tax map/parcel no.: Other fuel appliances ■V ` . _ Water heater 10.00 , .,. .. . DESCRII'TION "OF, WORK ` rr - a .. ,. r I ''I (1 Gas fireplace 10.00 t e A `C.L1 0-+kAC k% Selr l — 6j Flue vent for water heater or gas c n� c. Log 10.00 � og lighter (gas) 10.00 c Wood/pellet stove 10.00 1 Wood fireplace/insert 10.00 M T . � Chimney/liner /flue/vent 10.00 . ; P ROPERTY; OWNER ,,: ' ; TENANT' , " Name: Q t Vi n ..Cf - l �n� Other: Environmental exhaust and ventilation 10.00 ` t � J� R ` � / �'P J Ran e hood/other kitchen c� Address: { 11 equipment 10.00 t3 City/ State/ZIP: k n �sV � I � t l, � V Sri Q ( Clothes dryer exhaust 10.00 V l g Single -duct exhaust (bathrooms, i c Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 .`.!,., "'r' :. Attic /crawls ace fans 10.00 ; 0 �APPLICANtI'`: ' . '0 CONTACT P ERSON ' , ' Attic/crawlspace Business name: �(h�rt C c Other: 10.00 r `� I C r Fuel piping W Contact name: 1 .(OJ'\ < S hRkt — $5.40 for first four; $1.00 for each additional Address: 13 jCj 5, et &i d j n 5-.S Furnace, etc. Gas heat pump 4 ' City/State/ZIP: r () `.(J ( 0 p0 C 1 (3-719c)- ^ � J� � • Wall /suspended/unithester (GJ) a J i — 4 Go o �'`�� r>�,) {� d�J(� -T 0 3 b Water heater Phone: -1 Fax: 1 Fireplace E Range `'• ' F,. CONTRACTOR .. Barbecue Business name: rM Clothes dryer (gas) Other: Address: - MECHANICAL PERMIT. FEES *, . t City/State/ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) ' t CCB lic.: 33 I State surcharge (8% of permit fee) t TOTAL PERMIT FEE l'", Authorized signature: 4 This permit application expires If a permit is not obtained within 180 �� days after it has been accepted as complete. P name: . f f S Lo Date: rfv /C/ • • Fee methodology set by Tri -County Building Industry Service Board i:\ Building \Pemuis \MEC- PcnnitApp.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 ' / a" Date Re ueste• / ( �S AM PM BUP 11( Location i Id MEC d-dr5 4, Ph Contact Person � 2� � PLM (sue Contractor Ph ( ) SWR BUILDING Tenant/Owner i(n1 Q�NiI� ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall File Sprinkler Fire Alarm _ �� ' Susp'd Ceiling �' Roof / • 4/4-- — "L Other: • 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 . P S P T FAIL CH Post & Beam Rough - In • ' Gas Line • ke Dampers rli+ • / PART FAIL RICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Halt, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call f• r reinspe on RE: Unable to inspect — no access Fire ADA Supply Line i _�` �r Approach/Sidewalk Date h 0 Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. • PASS PART FAIL