Permit CITY TIGARD MECHANICAL PERMIT
T,(, I DEVELOPMENT SERVICES PERMIT #: MEC2003 -00331
c ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/19/03
PARCEL: 1 S136CD -00100
SITE ADDRESS: 11705 SW PACIFIC HWY E
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: REP FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
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: Replace existing rooftop gas pac with like kind, 345 lbs. Project Value: $5,472
Owner: FEES
PACIFIC CROSSROADS PROPERTIES, I Description Date Amount
BY WYSE INVESTMENT SERVICES CO
200 SW MARKET ST STE 345 [MECH] Permit Fee 6/19/03 $80.10
PORTLAND, OR 97201 [TAX] 8% StateTax 6/19/03 $6.41
Phone: Total $86.51
Contractor:
REITMEIER MECHANICAL INC
7051 SW SANDBURG ST STE 400
TIGARD, OR 97223 -8011 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 603
Final Inspection
Reg #: LIC 63242
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._tofollow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
Mal
Issue By: / ,. / ./ Permittee Signature: / P / -
Call (503)-639 -4175 by 7:00 P.M. for inspections needed the ne t business day
Mechanical Permit Application Received FOR OFFICE h S c l ONLY
Date/By: Permit No.:
Planning Approval Building
City of 'Tigard Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
Aisinll � �f Date/By: Case No.:
h~� iIR' y
Internet: www.ci.tigard.or.us cT I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 "W Name /Method: Supplemental Information.
•
F` :` it ',_ "'.° , _ ` : _; t�'' 0011' mEiteaL°iFE Isom UI£E wsErenECKLIST :.�. "
��; _ � ,� ... ,T�Y,PE�OFWORK r _�s����,� �_, _ ,� �°- _ _ �� "i`�_
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
,e2vAddihon/alteration/re p lacement m ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead and profit.
;uf;SZ CAzTEGORXIOF CONST OQTIO,N w VN..`t .,:`
❑ 1 & 2- Family dwelling ,ommercial /Industrial Value: $ 5472 • V See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family
RESIDENTIAL EQUIPMENT/ SYSTEMS :FEE CHEDt1ilt g
Description ` Qty Fee(ea.) Total
111 Master Builder ❑ Other: _ Y t,;`" :HeatinglCoo(ing., :::,-1: .'A":
a J 3 JOB SITEINFORMATION and-- CATIO3 x : N, Furnace - add - air conditioning ** 14.00
Job site address: //7 €S .(,t) /Reif /Ci srJy Gas heat pump 14.00
Suite #: E Bld; /Apt. #: Duct work 14.00
Project Name: 6A54 ,t) pis/3 �,t. Hydroni hot water system 14.00
Residenti al 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 Applianc es .' _ ,'�)
Tax map /parcel #: Water heater 10.00
r-AgaRMA=> D + E � SCRIPT�IO, // N �� � , O ,, F �� � � a WORK.;= �,K�..,' e ,�, Gas fireplace 10.00
PEPL ACZ 3 ?DJ Am, 7V/ 4-A-6 P14Ce. Flue vent (water heater /gas fireplace) 10.00
!N/Tu 001-.6a/o2 1/t4H EP c /6uc y Log lighter (gas) 10.00
Wood/Pellet stove 10.00
a/t16 r iveio f S 3V 4 85. Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
g El PROPERTY OWI Ei : 1 ® TENANT ; F,w%it 3±!+�' " }31/t T Other 10 00
2 I �,/ i Cgo5 46S r . , `. „ , ` ijpironmeriiilEzliauit °BirVentilition" :.,, .„u 4' .:;, .
Name: /�jKi /� 5 /w✓
Range hood /other kitchen equipment 10.00
Address: /// 5j aT 1 "*S`` sant MR) Clothes dryer exhaust 10.00
City /State /Zip: Prigndebt/4 a_ 97 2.05
Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
1 Ili /APPLICANT . v ,mm , , ti F,CONTACT PERSON° „:.;`r ., utility rooms) 6.80
Name: Attic /crawl space fans 10.00
Other: 10.00
Address: 4 y ; f m, ', T` =r,,_
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Furnace, etc. **
Phone: Fax: **
Gas heat pump
E -mail: Wall /suspended/unit heater **
1., i.=� ,.s_ ,, .° CONTRACTOR, ,;,"ntff _; Water heater **
Business Name: PE' -r /1460 / I) Fireplace **
Address: 7057 6 SANuato Si Lf$D Range **
BBQ * *
City /State /Zip: 7(,4 - O own Clothes dryer (gas) **
Phone:. 403-0Z05' I Fax: ka—ago Other: **
CCB Lic. #: 45”; 77*, Total:
Mec P,ei mit.F.ees, _ , • Authorized � �� � Subtotal: $ Si') / / 0
Signature: _,..iL�/Y_! a Date: &/t 03 Minimum Permit Fee $72.50 $
e..c7 J /14N5OA) Plan Review Fee (25% of Permit Fee) $ '/
(Please print name) State Surcharge (8% of Permit Fee) $ L40 7
TOTAL PERMIT FEE $ 3/ . 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
GL-(1 /
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total:,Valuation ; Permit Fee , $ ;.; . , ; . -
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45, for each additional $100.00 or `
fraction thereof, to and including
$50,000.00. _ " ` •
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof. • AssumedVal uationslPer Ap Iianc ,, ,e `� . ;,a.' - •
1 pP_..
Value Total
Description: Qty (Ea) Amount
Fumace to 100,000 BTU, including 955 •
ducts & vents
Fumace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700 • , '
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310 .
BTU - . . _ . , • ,
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU '
'
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU ' ' '
Air handling unit to 10,000 cfm 656 . • • ,
•
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656 • . • • • . •
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator . 4,590
Other unit, including wood stoves, 656
inserts, etc. -
Gas piping 1 -4 outlets - 360
Each additional outlet 63
TOTAL COMMERCIAL s
VALUATION: $ ,
� k _ ., . . o.
1,
is \Dsts \Permit Forms\MecPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Re sted PM BUP
Location 117 DS - 7 1 /-of Suite 40 " °°331
Contact Person 15g ( ) Cog3 0205 PLM
Contractor Ph ( Ca/ ) 577- g3 DCo SWR
BUILDING Tenant/Owner C,/J /6 — K.0 bbto .S ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: l SIT
Post & Beam I" ee C �j
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
Under Slab �!
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
RT FAIL
MECHANICA
os eam
Rough -In
Gas Line
a. • e Dampers
, ` - PART FAIL
ICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: Ell Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date /2/ 3/0 3 - Ins pector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL