Permit CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2002 -00470
A DEVELOPMENT SERVICES DATE ISSUED: 11/5/02
''� 13125 SW Hall Blvd., Tigard, OR 97223 (50 639 -4171
PARCEL: 1 S135DD -05000
SITE ADDRESS: 11975 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: 2 VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 35,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: L 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: < =10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of heating system and related ventilation & ductwork.
Owner: FEES
DREW HOFFMAN Description Date Amount
1281 NE 25TH #M
HILLSBORO, OR 97124 [MECH] Permit Fee 11/5/02 $0.00
[MECH] Permit Fee 11/5/02 $72.50
[MECPLN] Plan Rev 11/5/02 $0.00
Phone: 503- 296 -9161 [MECPLN] Plan Rev 11/5/02 $18.13
Contractor: [TAX] 8% StateTax 11/5/02 $0.00
[TAX] 8% StateTax 11/5/02 $5.80
COLUMBIA HEATING + COOLING INC Total $96.43
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 624 - 2704 Gas Line Insp
Mechanical Insp
Reg #: 76359 Mechanical Insp
Mechanical Insp
Final Inspection
•
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)246-669k/
Issued By: r �1 ear_ Permittee Signature: �� // ` _ _ C1 _ _•
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day ' \
.
T Permit Application
D ater eceived;/p pa_ Permit no.: }{a_�f�7
r . . i 1, of Tip and
Tigard Project/appl. no.: Ex r ire date: '
City ojTi a nd Address: 13125 SW Hall Blvd, Tigard, OR 97223
OC T gl�ne: (503) 639 -41 pQ Date issued: I Receiptno.:
11.. II Fax: (503) 598 -1960 u � a — ` 0 Case file no.: Payment type:
C;i i Y ur Y•iv
{� ]jt � G Dltra,�I approval: k KD S 1 &2 family: Simple Complex:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family U New construction 0 Demolition
4Addition/alteration/replacement 0 Tenant improvement O Fire sprinkler /alarm • 0 Other:
I R ,
JOB SITE INFORMATION
Job address: / 1 9 7 S • ' _ I A . ,�� T Bldg. no.: Suite no.:
Lot: "� Block: Subdivision: Tax map /tax lot/account no.:
Project name: Ada 'fluted .4c A . i - .r ./ Alv` /MAN A.I /L...0/NZ.
Description and location of work on premises/special conditions: /.a/S h9t.L. 4 cgh.✓y 5y. s err 1
A /9 Seca/ t' e iti fi / 1 du a /a-ZJU
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: gi`// A/p��41,q:/// (Floodplain, septic capacity, solar, etc.)
Mailing address: / /9P/ 5 Lj A te:, / p , I & 2 family dwelling:
City: T OA „/ St a ZIP: f7 Valuation of work $
Phone: 71 — IFax: I E -mail: No. of bedrooms/baths
Owner's representative: DALC u Total number of floors
Phone: - — 6 , ( Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: • E- mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ f50 rJ . 00
Business name: Existing bldg. area (sq. ft.) 9D1f
C /u/-Ihlli 4 - 64/4+ C Nv New bldg. area (sq. ft.)
Address: p 0 6° 1. ,93 0 9 Number of stories /
City: ak I ZIP: 9702,g3 Type of construction 607/r4...4...- sin Phone:
z -- ;
aZ 7Q T i Fax 5 Ud 7 d E -mail: Occupancy group(s): Existing: e-CMA.« -'-
CCB no.: 9 G 3 5 ? New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCI IITECT /DESIGNEIt licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name. Ir i Contact person: ;, , d Fees due upon application $
Address: 7j /e N E f/,¢,v y e,, /J P P S tu& ADD Date received:
City: Vi- , I ZIP: 9 4,6, a Amount received $
Phone:340 ,6c�.q-A34 Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied with, whether specified herein or not. Credit card number: /Expires
Authorized signature 6Ae._7" Date: /4 Name of cardholder as shown on credit card
Print name: (/r'. /¢ . fra /6 y Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (M)0/COM)
i
C o m mercial Plan Submittal
Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
G�' BUP
Received Date Re uested Z- _ / ( AM PM BUP '' t ``
Location 1/ 6 77,C - Suite MEC — CO ` Z
Contact Person (0411- Ph ( ) e 2 t i — a--7 U'1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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
Fire Sprinkler /
Fire Alarm
R Ceiling 6�� �7� �-
Other:
l
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
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smo.: Dampers
is ? PART FAIL
EL CTRICAL
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: 0 Unable to inspect — no access
Fire Supply Line
ADA /4//3 Approach/Sidewalk Date Inspector d Ext
Other: v
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business' Line:' - (503) 639 -4171
MST
Received Date Requested , ` 0- 7 AM PM - OUP —
Suite z !
Location ' _ 2 (90 ` 7f)
Contact Person / Ph ( ) f f 0 ,' 4,40 ® 00 o Z of 96
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain n.Ao, (alt E r�� ell O I /
v n- (�, .0._ , ELR
Crawl Drain "
Slab Inspection Notes: M < <, cc . SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear L
Int Sheath/Shear ' / 57 l A C 0 / / 2 '/ d J
G
Framing
Insulation g2 4 Q FX l $ / /M �c,
/ 0 2
Drywall Nailing
Firewall
--- /
Fire Sprinkler G 1" r-e �� / c c / j � � � TR y ` »'Gt /0 1.4.. g «? &-• �
Fire Alarm v r
Susp'd Ceiling Q D S f '� 6 r ! Ate " 7/71
�� Roof _ \
Other: "'1 T //,-f / JO6 _
_ PASS F AI L /
Post & Beam •" //ff
Under Slab /'7.Od.w 6S S
Rough -In
Water Service
Sanitary Sewer
Rain Drains .L 7
Catch Basin / Manhole �� I `
Storm Drain
Shower Pan -
Other:
AlirAt 4. S PART FAIL
0 rJ' �04 ,i / Q 47: ; — - - D OIL icY/ SJ Al 6.-
ANI
: -: eam 57 /C/ e d n /t-( �— /y'( O C c� c/ - AL Ku d j
Rough-In _
Gas Line /�� �� !�� /�� �'e �� v�1� .
Smoke Dampers %` 411.i
PART FAIL /'
RICAL r C /i 4: / /'3 ,,i CY
Service
Rough -In
UG /Slab
Low Voltage e C 06 62 ,x 4 _/ /4 rJAt (o cr Ke ,b 0 ✓ i'' y
Fire Alarm gO $ e /i/eSS Af0 ti /Z S 1 0 (J -e,2 fi1. T Pc 4rz
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall B I d.
PASS PART FAIL
SITE ❑ Please call •r reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA e‘ 7 /
Approach/Sidewalk Date 0 3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL