Permit CITY OF TIGARD
MECHANICAL PERMIT
Vii; DEVELOPMENT SERVICES PERMIT #: MEC1999 -00385
' I - ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/16/99
PARCEL: 1S134BC -00101
SITE ADDRESS: 12144 SW SCHOLLS FERRY RD
SUBDIVISION: Oik\G\ 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: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 4 DOMES. INCIN:
ELE 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: Refrigeration equipment installation.
Owner: FEES
WILLIAM W. SAUNDERS, TRUSTEE Type By Date Amount Receipt
2155 KALAKAUA AVE STE 500 PRMT DEB 9/16/99 $54.60 99- 318378
HONOLULU, HI 96815 PLCK DEB 9/16/99 $13.65 99- 318378
5PCT DEB 9/16/99 $3.82 99- 318378
Phone: Total $72.07
Contractor:
COMMERCIAL REFRIGERATION INC
5920 SE GLISAN STREET
PORTLAND, OR 972133790 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 234 -6445 Fire Alarm Insp
Reg #: LIC 65271 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 -00 10 thro • q OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calli (503)246 -9189.
Iss a By: /, I, i� a , Permittee Signature:
Call (503) •39 -4175 by 7:00 P.M. for inspections Y ections need ten t business day P
09/16/99 THU 11:53 FAX 503 598 1960 CITY OF TIGARD l J002
Plan Ch # -- CITY OF TIGARD Mechanical Permit Application Recd B
13125 SW HALL BLVD. Commercial and Residential Rec Date E
T 03) 63 9 -4171OR 9 x30 4 ,�, p, - QDl(eo Date to DST , W - /` vc ,
(503) 63, x304 !� � � Permit # / ( /
Print Or Typ Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
C An. L i! (.� " Q Table 1A Mechanical Code Qty Price Amt
Q'- Permit Fee
r��'t ' -�� 16.00
St Address Suite/ Job � - � 5 1) Furnace to 100,000 BTU
Address (2 l Li L ( ',-/ including ducts & vents see footnote 1,2 9.65
Bldg# 2) Furnace 100,000 BTU+
bacg / eD Z 970 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
_ including vent see footnote 1,2 9.65
Owner n-�-S �' n-- 4) Suspended heater, wall heater
Mailing Address o r floor mounted heater see footnote '1,2 9.65
2k C.( (_( 5 SCh�LlS L° 'e�y
5) Vent not included in appliance permit 4.75
City/State Zip Phone 1 Check all that apply: `Boiler Heat. Air
` C( D q7 1 For Items 6 -10, see •. Pump Cond Qty Price Amt
T(� (or name of business) ,
111 footnotes 1,2 om•
Name (or siness) 6) <3HP;absorb unit to /
100K BTU 9.65 3g
Occupant Mailing Address 7) 3 -15 HP;absorb unit 17.65
100)£ to 500k BTU
City /State zip 1 Phone 8) 15-30 HP; absorb 24.15
unit .5 -1 mil BTU
9) 30 -50 HP; absorb 36.00
Contractor Name unit 1 -1.75 mil BTU
,r )PliteG � ( AC Re Fo- A �`6U 10) >50HP; absorb unit 60.15
Mailing >1.75 mll BTU W dailing Address
Prior to permit 11 Air handling unit to 10,
issuance, a copy 5' O iJ (Lc /S 1l 10,000 CFM
C (St are required if Vo ate Zip Phone 7.00
of all licenses }V` „ nit_ ? 2_ l 3 `L3z1-6e/�l 12) Air handling unit 10,000 CFM+
� etc 11.85
expired in COT - or n Const Cont. Board Lic.# Exp.
database Crr 52-71 fi 0q 62 O 13) Non - portable evaporate cooler
7.00
Architect Name 14) Vent fan connected to a single duct
4.75
Or Mailing Address 15) Ventilation system not included in
appliance permit 7.00
Engineer City /State Zip I Phone 16) Hood served by mechanical exhaust
7.00
17) Domestic incinerators
12.00
Describe work to be done:
New Repair 0 Replace with like kind: Yes O No O
18) Commercial or industrial type incinerator 48.25
19) Repair Resi ential O Commercial 0 epar units
8,40
Additional information or description of work: 20) Wood stove /gas 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
_ See footnote 1 3.75
structural gas talcs. 22) More than 4 -per outlet (each) 75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 Minimum Permit Fee $50.00 SUBTOTAL - 7 -�O'
PLAN REVIEW 25% 7 %SURCHARGE OF 4L
' °'+
I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of Required for ALL c EW 25% SU its only „ 1' r = 1
the owner, that plans submitted are in compliance with Oregon State laws. TOTAL x 4� 72
`
nature of Owner /Agent / Date
Other Inspections and Fees: 7� •� 7
2 1 t el- ' 4. 5,1 / Phone 1. Inspections outside of normal business hours (mininum charg
Phonne hours) $50.00 per hour
o t Person Name 2. Inspections for which no fee is specifically indicated (minimum
o si tc Copt .t f� 7 [[[ ! _ 2 T ' (-i i11( charge -half hour) $50.00 per hour
( ` 3. Additional plan review required by changes, additions or revisions to
o onote or commercial projects only: plans (minimum charge -one -half hour) $50.00 per hour
1. Provide full schematic of existing and proposed gas line and pressure.
2. Provide drawings to scale showing existing and proposed mechanical
*State Contractor Boiler Certification required
, units. "Residential NC requires site plan showing placement of unit
I:\mechperm.doc rev 7/19/99
L
OVER - THE - COUNTER (OTC) PERMIT
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: ' --C l6se0a.tro/l gv,p, AJ; MiSMee44
Class of Work: at Floor Furnace: Evap Coolers:
Type of Use: Ce Unit Heaters: Vent Fans:
Occupancy Grp: 01 Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: < = 10000 cfm: Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn > =100k Btu:
NOTES:
:: COMMERCIAL' INSPECTION< ;ACTIQNS „ tmt MENU
r $ Permit Fee
Gas Line Inspection $ 134‘ Plan Review
h anical Inspection $ -, 7% State Surcharge
Cooling Unit Inspection $ Additional Permit Fee
Shaft Inspection $ Additional Plan Review Fee
Hood Inspection $ Inspection Fee
Fire Suppr Inspection $ Miscellaneous Fee
Duct Inspection
Fire Alarm Inspection
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
Fire Alarm Inspection
Final Inspection
FOR OFFICE USE ONLY:
TYPE OF USE OPTIONS (COM = commercial; CMS = commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW = new; ADD = addition: ALT = alteration; ACS = accessory;
FND = foundation; OTH = other; DEM = demolition; REP = repair; FPS = fire protection system. NOTE =USE OTH FOR FENCES,
RETAINING WALL, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
is \ovrcntr.doc (dst) 8/97
)
7 'ice
10/08/1999 Activities for Case #: MEC1999 -00385
10:42:07 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 09/16/1999 DEB DONE No Hold DEB 09/16/1999
MECC008 Permit created 09/16/1999 DEB DONE No Hold DEB 09/16/1999
MECC014 Plan checked /Approved by P.E. 09/16/1999 09/16/1999 09/16/1999 RDP DONE No Hold DEB 09/16/1999
MECC016 DST Post - Review Completed 09/16/1999 DEB DONE No Hold DEB 09/16/1999
MECC706 Mechanical lnsp 09/16/1999 09/16/1999 No Hold DEB 09/16/1999
MECC736 Fire Alarm lnsp 09/16/1999 09/16/1999 No Hold DEB 09/16/1999
MECC799 Final Inspection 09/16/1999 09/16/1999 10/04/1999 RB PASS No Hold AKJ 10/05/1999
MECD060 (F) Issue permit 09/16/1999 DEB DONE No Hold DEB 09/16/1999
MECC750 Misc. Inspection 09/22/1999 09/22/1999 09/22/1999 LN PASS No Hold AKJ 09/22/1999 pressure test on freon system
MECC800 Case Finaled 10/05/1999 AKJ DONE No Hold AKJ 10/05/1999
Page 1 of 1
:I'wY OF TIGARD BUILDING INSPECTION DIVISION 1 Ll b f `
24 H our Inspection Line: 639 -4175 Business Line: 639 -4171 MST
Date Requested In - "I 7 q AM PM _ BLD
2,I L I q sti rs /3 'Ff' Suite CP gc.l��_1� -AO
Location ��� — / -- --
Contact Person InA; Ph Mf ∎0 Z7 9EM i ?C/�7 -c03 R s
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
1
Foong r 1
Foundation Access: p(� . 1 b', ‘3 1 tW "- d'
� • �/ '` FPS
Ftg Drain [ "J — 14' ° c) Ot'(
SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear �Y • ^ \ Q S irs V f : 6A-4.------- Framing j \ ' '�1,'
Drywall on
Drywall Nailing
Fire wall ,���� 1 / rr.,---._ r.,---._ Fi Sprinkler Ql V �,
Fire Alarm
� 'F '
Susp'd Ceiling `�- �
Roof p 1 <c -7 ✓ LS �,>
M isc: U - ��-
�
Final
PASS PART FAIL
PLUMBING bq LA, S 4 - \ -- .9_,A- \T-0_, ,A c c
Post & Beam
Under Slab it-1 i� S - L_ _ -c
Top Out
Water Service L/" C -- L.-9 `,^--1 ' - A"
Sanitary Sewer n ^ 1 1 —
Rain Drains 1 /'�'
Final
PASS PART FAIL t n n
Po '.O1 -ANfC LT ' V ( v tS 5(OLe 0 C ""1 )
& Beam
Rough In r 1 V`�' (IAA-0 t t e 4 o)
Gas Line
Smoke Dampers ' 1' -' / A i Z C 'v t (Q o 4 S
final e � /
ASS ART FAIL
RICAL G _ _ _ � ' 6 ' c /1 Service �" LET►' yC-�
Rough In / \ -Q� - Q
UG /Slab V 1 vv J` V 6 A_ Tiv� -t/
Low Voltage 1
Fire Alarm d _ �a _ ‘ �� v
Final ` ^\
PASS PART FAIL . " C.-4-5 ,
SITE
Backfill/Grading
Back
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ 1110 ired 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
Approach /Sidewalk 1 (Y4 / J 1
Other Date Inspector v` Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
A11PEWV111111 1101 S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238 -5700
1. •V P 1W 850 CONGER • EUGENE, OREGON 97402 • (503) 683 -9333
iSAFETYCOMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
CERTIFICATION - INSTALLATION /INSPECTION
Customer Name (.'/ /4-
Address /24 4 /C) i L.A. ! /- G' r,. i•.._. /c: y i 7
SYSTEM
Model(s) and serial numbers
P
i
Number of nozzles and Part No. J ~ ! ` 1 i4Al f 7-
Number of detector(s) and degree rating
Energy shut -off devices — type and size
Other accessory equipment provided (pull station, electric switches, etc.) /V � "''G i !i _ . -0 itr'%,(J
COOKING /VENTILATING EQUIPMENT
Number of duct(s) and size y s
Hood size and plenum size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those
being protected.)
1. / "_ 4.
2. f / €,V IL 5.
3. 6.
TO BE COMPLETED BY INSTALLER
❑ YES ❑ NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard
96 and 17 (current issue), and all applicable state and
local codes. Exceptions to other provisions of NFPA 96 ❑ YES ❑ NO
that were observed are noted below. I understand that it is the recommendation of ANSUL
Exceptions: and of the National Fire Protection Association
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly.
CUSTOMER NAME AND TITLE
❑ YES ❑ NO
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DAT
INSTALLER NAME C i"C;‘,.._ N A,
SIGNATURE 4 / 4_ l J� i
DISTRIBUTOR r"a
A
\L
DDRESS
DATE
A S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238 -5700
IVM I P 1 • 850 CONGER • EUGENE, OREGON 97402 • (503) 683 -9333
IIIMMSAFETYCOMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
CERTIFICATION 'INSTALLATION /INSPECTION
Customer Name ( ` "' /n
Address / �" / ' -� �;� VA /10 �.•
1:)6,
SYSTEM
Model(s) and serial numbers -/ , �'% �- 12
Number of nozzles and Part No. ,.) C 7 – a t' ;; -- ✓44' %`
Number of detector(s) and degree rating / 45V
•
Energy shut -off devices — type and size A1.4.
Other accessory equipment provided (pull station, electric switches, etc.) ` ` ' ,' %/ 0 A'
COOKING /VENTILATING EQUIPMENT
Number of duct(s) and size / 1,• '?
Hood size and plenum size /0 7 . 0 f'• c- i °
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those
being protected.)
1. r'��Lc tom,. 4.
2. ! / C 5.
3. 6.
TO BE COMPLETED BY INSTALLER
D YES D NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard
96 and 17 (current issue), and all applicable state and
local codes. Exceptions to other provisions of NFPA 96 D YES D NO
that were observed are noted below.
I understand that it is the recommendation of ANSUL
Exceptions: and of the National Fire Protection Association
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly.
CUSTOMER NAME AND TITLE
D YES D NO
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DATE
INSTALLER NAME ' I. C► I " •
SIGNATURE 1d/2
DISTRIBUTOR
ADDRESS j /mot
DATE
MEW t w.IAED"^11111 1101 S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238 -5700
IIINErarer•V =« /• 850 CONGER • EUGENE, OREGON 97402 • (503) 683 -9333
MIME SAFETYCOMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
CERTIFICATION - INSTALLATION /INSPECTION
Customer Name r; �. ✓l t::
Address /Ye C,,
r
SYSTEM
Model(s) and serial numbers p �._,["
Number of nozzles and Part No. ./. / -- �) 1 E lr / /`i '
Number of detector(s) and degree rating I r
Energy shut -off devices — type and size 1./Z; L
Other accessory equipment provided (pull station, electric switches, etc.) .1 1 ;14L f? "'I/ Ad
f
COOKING /VENTILATING EQUIPMENT
! .
Number of duct(s) and size ;1'
Hood size and plenum size / QV 6 A ci /244,41,4 - i-
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those
being protected.)
1. w t' r L r°` r ., V- 4.
2. 5.
3. 6.
TO BE COMPLETED BY INSTALLER
❑ YES ❑ NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard
96 and 17 (current issue), and all applicable state and
local codes. Exceptions to other provisions of NFPA 96 i,YYES ❑ NO
that were observed are noted below.
I understand that it is the recommendation of ANSUL
Exceptions: and of the National Fire Protection Association
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly.
CUSTOMER NAME AND TITLE
❑ YES ❑ NO
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DATE
INSTALLER NAME 4", 74/1: S yg
SIGNATURE
DISTRIBUTOR. - ,,,..••.�
ADDRESS '� )j
DATE