Permit - - , CITY OF TIGARD
MECHANICAL PERMIT
A- � DEVELOPMENT SERVICES PERMIT #: MEC2000 -00040
-' Ia 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE I
PAARR E CELL: : 2 25101 BB-
S101 BB -00301
SITE ADDRESS: 11834 SW PACIFIC HWY
SUBDIVISION: TIGARD ROAD GARDENS ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: ALT 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:
ELE 3 - 15 HP: 1 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm: 4
Remarks: Install four (4) units coolers and one (1) condensing unit, for a tenant improvement.
Owner: FEES
EQUIVA SERVICES/TEXACO Type By Date Amount Receipt
3800 ST HELENS RD PRMT GEO 02/07/20( $61.65 00- 321615
PORTLAND, OR 97296 PLCK GEO 02/07/20C $15.41 00- 321615
• 5PCT GEO 02/07/20( $4.93 00- 321615
Phone: 503-225-4223 Total $81.99
Contractor:
CHILLER TECH INC
DBA: JFI
PO BOX 925 REQUIRED INSPECTIONS
CLACKAMAS, OR 97015 Mechanical lnsp
Phone: 503 - 557 -2316 Final Inspection
Reg #: LIC 132428
ORIGINAL
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 -0080.
You may obtaini: of th -- rules or direct questions to OUNC by , ailing (0,- • - : = 89.
Issue B : i Permitte Si nature•
Y � . l 9 �— //, t,�� f /
Call 503) 639 -4175 by 7:00 P.M. for inspections nee • tit next business d . ,,
CITY OF TIGARD Mechanical Permit Application Re d By #
- 13125 SW HALL BLVD. Commercial and Residential Date Reord
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 0� Date to DST -I1 /n AP
Print or Type Permit fate-eoxo
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
---rxm4 co Table 1A Mechanical Code Qt1L Price Amt
Job street Address Suite. A) Permit Foe
/ /334 ` n /; '/ 1) Furnace to 100,000 BTU
Address k' I %QG/ 4 C 4VY Including ducts & vents see footnote 1,2 9.65
Bldge Day/State ,� np 2) Furnace 100,000 BTU.
vvj ( ^ 6/72-14 including ducts & vents see footnote 1,2 12.00
Na a (or name of busines 3) Floor Furnace
i e - owner T e _, 1/A)41) y j r�� including vent see footnote 1,2 , 9.65
Melling dress //� 4) Suspended heater, wall heater
OD "l f or floor mounted heater see footnote 1,2 9.65
5) Vent not Included in appliance ermit 4.75 •
• GgdState zip Phone Check all that apply: *Boller Heat Air
} ( 77a /i For Items 6-10, see or Pump Cond 1 Qty Price Amt
J N me (or name of ass) footnotes 1,2 Comp ..•
ee5 6) <3HP:absorb unit to
100K BTU 9.65
Occupant Maili dross 7) 3-15 HP :absorb unit
100k to 500k BTU / 17.65 /7 unit .
1
Zip ' Phone 8) 16-30 HP; absorb
unit .5-1 mil BTU 24.15
Contractor Name -7 - C �- \ 9) 30-5 HP; absorb
�tii t / I �lr r c_
• Zl V .J Fr 0) >50HP a unit 36.00
Prior to permit mans Address >1.75 mil BTU 60.15 .
Issuance. a copy )�- j•Rpjx 5 Z ( 11 Air handling unit to 10,000 CFM w�
of aft licenses '`- zip I Phone g 4 7.00 O ..*
are required if t(,c,kf lyt S Gr 97p /S I ,S S 7-231(. 12) Air handling unit 10,000 CFM
expired t In COT 2 �La t /' -7' B 11.75
database � 13) Non - portable evaporate tooter
Architect Name 7.00
14) Vent fan connected to a single duct
magic; Address 4.75
or 15) Ventilation system not included In
. appliance permit 7.00
Engineer CayState Zip Phone 18) Hood served by mechanical exhaust
7.00
• Describe work to be done: -h v i a / ( bra i 4i4 e /_ 17) Domestic incinerators
F C") 12.00
New 02 Repair 0 Replace with like kind: Yes 0 No O 18) Commercial or industrial type Incinerator •
Residential 0 Commercial t5) 48.25
19) Repair units
Additional information or description of work: 8.40
20) Wood stovelgas FP /other units/clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 3.75
. Type of fuel: oil 0 natural gas O . LPG 0 electric 0 22) More than 4-per outlet (each) .75
Minimum Permit Fee 650.00 SUBTOTAL !!- , : :'-' `' -` ,-. •
I hereby acknowledge that I have read this application, that the Information F 6,t /e SURCHARGE C, ;__-;:
• given is correct, that rem r
the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL ' ' ` = "' `� • •
the owner, that plans submitted are In compliance with Oregon State laws. Required for ALL commercial permits ony 1
, ,�:r::`c_,: :�':•.. :
TOTAL f9
Owner t Date
o f
Sign re f ! : • . .. ; 8/.
- f Z 3 r� Other Inspections and Fees:
1. Inspections outside of normal business hours (minlnum charge -two
arson Name ne hours) $50.00 per hour
2. Inspections for which no fee Is specifically indicated (minimum
)� l� PR 1 1 3 , CS 7- 23/(e charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge-one-half hour) $50.00 per hour
2. Provide drawings to stale showing existing and proposed mechanical
units. `State Contractor Boiler Certification required
"Residential NC requires site plan showing placement of unit
lAmechpern.doc rev 02/4/99
OVER - THE - COUNTER (OTC) PERMIT
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: r Co eiteAsi . Si ^'�+
1UA d r
Class of Work: Floor Furnace: Evap Coolers:
Type of Use: Unit Heaters: Vent Fans:
Occupancy Grp: PA, Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3 - 15 HP. 4 Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: _< 10000 cfm: 4- • Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn >_ 100k Btu:
NOTES:
•
COMMERCIAL INSPECTION ACTIONS FEE MENU
Gas Line Ins e ction $ e Permit Fee -
echanicat Inspe ictict or $ 1 4 5 4 ' l Plan Review
Cooling Unit Inspection $ % State Surcharge
Shaft Inspection $ Additional Permit Fee
Hood Inspection $ Additional Plan Review Fee
Fire Suppr Inspection $ Inspection Fee
Duct Inspection $ Miscellaneous Fee
Fire Alarm Inspection
REMARKS:
Fire Damper Inspection
Miscellaneous Inspection
Fire Alarm Inspection
inal lnspection
FOR OFFICE USE ONLY:
TYPE OF USE OPTIONS (COM = commercial; CMS = commercial manufactured structure)
MASS OF OPTIONS FOR ALL PERMITS (NEW = new ADD = addition; ALT = alteration; ACS = accessory; '
(ND foundation; OTH = ,other, DEM = demolition; REP = repair, FPS = fire protection system. NOTE =USE OTH FOR FENCES, RETAINING
WNALL;'DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
I: /dst/forms /otcmech.doc 9/99
is \dsts\forms \otc- mech.doc9 /99 1
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• • M CITY � GARD
• • • j Approved j
..
j — j Conditionally Approved I
1 For only the work as described in: i 1• k
-. PERMIT NO .jll -
`� See Letter to Follow
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04/07/2000 • Activities for Case #: MEC2000 -00040
2:53:30 PM
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 02/07/2000 GEO OTC No Hold GEO 02/07/2000
MECC008 Permit created 02/07/2000 GEO DONE No Hold GEO 02/07/2000
.MECC011 Routed to Plans Examiner 02/07/2000 GEO SENT No Hold GEO 02/07/2000
MECC014 Plan checked /Approved by P.E. 02/07/2000 RP DONE No Hold GEO 02/07/2000
MECC015 Reviewed Plans Routed to DSTS 02/07/2000 RP SENT No Hold • GEO 02/07/2000
MECC706 Mechanical lnsp No Hold GEO 02/07/2000
MECC799 Final Inspection 04/06/2000 TLP PASS No Hold AKJ 04/06/2000
MECC090 (F) Issue permit 02/07/2000 GEO DONE No Hold GEO 02/07/2000
MECC750 Misc. Inspection 03/06/2000 TLP PASS No Hold AKJ 03/07/2000 freon test ok
MECC800 Case Finaled 04/06/2000 AKJ DONE No Hold AKJ 04/06/2000
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 9 qg ()°SZG
Date Requested L e AM PM K BLD
Location 1 (MC Suite 1 7 ME �L d0 6' j
Contact Person }Q,('9Z7 Ph 3100 � �y lil IIII 1000'0 00140
Contractor Ph SWR
gi[I 1R3 Tenant/Owner fl - , a GO ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: `C ,�^
Slab t. 1 ?4% 9- 06(� - 2�
Post & Beam SIT
Ext Sheath /Shear
Ina Sheath /Shear . P ✓ •
Framing .I V i(�-r • � a I
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
tat PART FAIL
• BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
flECHANICAC )
Post & Beam
Rough In
Gas Line
Smoke Dampers
_
� PART FAIL
� RICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Otheoach /Sidewalk Date
/ , Inspector 7 Ext
( 7) PART FAIL DO NOT REMOVE this inspection record from the job site.