Permit CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2001 -00378
u^�I�� DEVE H Hall SERVICES 97223 C 39 -4171 DATE ISSUED: 12/6/01
PARCEL: 1 S134BC -00300
SITE ADDRESS: 12220 SW SCHOLLS FERRY RD
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: M 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: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 4
Remarks: Relocate gas piping main and water heater supply.
Owner: FEES
BPP RETAIL LLC Type By Date Amount Receipt
BY BURNHAM PACIFIC PROPERTIES PRMT CTR 12/6/01 $72.50 2720010000
ATTN: JOHN WATERS PLCK CTR 12/6/01 $18.13 2720010000
SAN DIEGO, CA 92101 5PCT CTR 12/6/01 $5.80 2720010000
Phone: Total $96.43
Contractor:
GRIDLINE PLUMBING & HEATING
4343 SE 37TH
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 503 - 771 -8790 Mechanical Insp
Reg #: LIC 74105 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 -0080. you may obtain ,opies of these rules or direct que tion t• 0 NC by calling
(fl \94R -QI s-
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Issue By: Permittee Si natur �'t!
Y: L C/ � 9
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
r— t t- Z- 0 (CGi ' )u (
A) Mechanical Permit Applicat
\ Date received: il5r1 p 1 Permit no.:IworA9 /-093 7/3
,�
i. '.1i 1 City Tigard Tigard
.. Project/appl. no.: Expire date:
City of Tigard Address 13125 SW Hall Blvd, Tigard OR 972 Date issued: By:J I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
❑ I & 2 family dwelling or accessory Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
• JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: , a22,0 SW S (', -14 5 Of i � ' Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 1 ► Cira .
Lot: (Block: ISubdivision: *See checklist for important application information and
Project name: k ,) 0 ,13 --1- 14 kcir T Iv Ay S TD p2e jurisdiction's fee schedule for residential permit fee.
City /county: 'r/ �} ZIP: I.S 2FAMILY DWELLING PERMIT FEE SCHEDULE
escliption and & ation of work on remises: J?1Bu'�t"� ..111$ AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE
i pt if vh,4iAi l►J►t- /4/44-P1 s; y , Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air handling unit CFM
Is existing space heated or con Oned? Yes CI No
space insulated? re Yes ❑ No Air conditioning (site plan required)
Is existing P Alteration of existing HVAC system
Boiler /compressors
Business name: Q , 1./ 7 j z ' forr �/ State boiler permit no.:
GT r/ HP Tons BTU /H
Address: ¢.A . ? , S 3 rbi Fire/smoke dampers/duct smoke detectors
City: ? c l fQ r I State p; I ZIP: 9 7 .2e Z-- Heat pump (site plan required)
Phone: ! 7'/ 4 7 yWI Fax: if Of I E - mail: Install/replacefurnace / burner BTU /H
_CCB no.:/QS Including ductwork/vent liner ❑Yes CI No
Install/replace/relocate heaters — suspended,
City /metro lic. no.: / 707.6 wall, or floor mounted
Name (please print): JefiAJ D V/ ■■,1t:44 a Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: J e4./ N b ✓ivt,'4" Chillers HP
Address: <g lyt, Compressors H
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent _
Phone: IF —6 . Fax: — ! 'i E -mail: Dryer exhaust
OWNER Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
_
City: I State: I ZIP: Fuel piping and distribufttn (up to 4 outlets)
Type: LPG •V/ NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert — type
Phone: F : 1 E -mail: Woodstove/pellet stove
Other:
Applicant's signature I Date je — ...-0/ Ot
Name (print): D,j'ell P(MICO fti
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
❑ Visa CI MasterCard Notice: This permit application Minimum fee $
Credit card number. / / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount 440-4617 (6/00 /COM)
e /
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: - Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code QtY (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond
fraction thereof. footnotes below. Comp
Minimum Permit Fee $72.50 SUBTOTAL: 7) <3HP; absorb unit
$Z to 100K BTU 14.00
8% State Surcharge $ p 8) 3 -15 HP; absorb 25.60
S • D� unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $[ 9) 15-30 HP; absorb 35.00
Required for ALL commercial permits only ! D' unit .5-1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb
14.4. unit 1 -1.75 mil BTU 52.20
11) >50HP; absorb
unit >1.75 mil BTU 87.20 •
ASSUMED VALUATIONS PER APPLIANCE: 12) Air handling unit to 10,000 CFM
10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) Amount 17.20
Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct
ducts & vents 6.80
Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater 17) Hood served by mechanical exhaust
Vent not included in applicance 445 10.00
permit_ 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955
to 100k BTU 19) Commercial or industrial type incinerator
69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101k to 500k BTU 10.00
15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
mil. BTU 5.40
30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each)
1 -1.75 mil. BTU 1.00
>50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656 8% State Surcharge $
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not included in 656
appliance permit
Hood served by mechanical exhaust 656 Other Inspections and Fees:
Domestic incinerator 1 170 1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
Other unit, including wood stoves, 656 $72.50 per hour
inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum
Gas piping 1 - 4 outlets 360 charge -one -half hour) $72.50 per hour
Each additional outlet 63
State Contractor Boiler Certification required for units >200k BTU.
TOTAL COMMERCIAL $ "Residential A/C requires site plan showing placement of unit.
VALUATION: All New Commercial Buildings require 2 sets of plans.
i:\dsts \fomts\mech- fees.doc 08/29/01
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14'- 1� ' } `r A roved CITY OF TIGARD
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9,L , c p - � L � Conditionally Approved. t)e):
a For only the work as described in: )'
•
.„.- , rto7, & y PERMIT NO.__.n6e ,d_ it e2e31
See Letter to: Follow ( ):
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CITY OF TIGARD 24 -Hour
•"I UILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/� BUP
Received Date `�/ � AM PM BUP
Location �d--c7 S� � d i/1 uite EC) v0 /— 003 7e
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: `fie C S i'rtax..,4 SIT
Post & Beam
Shear Anchors qt' m./ S - /fin
Ext Sheath/Shear _ 11
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
V‘ 7 , ,„7
Roof
Other:
Final
P ASS 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 PAT' FAIL
�CH L
Post & Beam
Rough -In
Gas Line
Sm. e Dampers
�
4
S - PART FAIL
- - ' ICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE LI Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA �j n —
Approach/Sidewalk Date 4 ` ( V �� Inspector v' V Ext
I Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
i—VDILDING Inspection Line: (503) 639 -4175 '-`�'
INSPE TION DIVISION Business Line: (503) 639 -4171 MST
BUI? I %
eived ."3 G Date Requested 3/a >/d AM PM BUP
Location / 0. d / ma y ?� .Sc�i.,d //I Suite ,,,e)0,1- 2 0037 8
Contact Person c2 , lj' 1' Ph ( ) 3 d 2— e /3 S' PLM
Contractor ✓ Ph ) SWR
BUILDING Tenant/Owner —ti s ELC
Footing
Foundation - ELC
Ftg Drain Access: /1 i `„^ L,p d / ._ d 4-P<-(.. ELR
Crawl Drain / U
Slab Inspection Notes: 44„,... p. 7 , . • SIT
Post & Beam
Shear Anchors ! //lick....
Ext Sheath/Shear ! e '
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal l sr? J 19- f U�� /-- P / r ec / /.1. w ) 3 y
Fire Sprinkler
Fire Alarm D X v e/(7-7( . 5.g, C v -4., ?
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 '•. ( c 7
Storm Drain _
Shower Pan j `
Other:
Final .
PASS FAIL
�IL CHA�
Post & Beam
Rough -In
Gas Line
Smo Dampers
PASS PART FA J
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage • `
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line w L Ve L._
/
s
ADA ( /
Approach/Sidewalk Date Inspector , Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
l.t
tITv OF TIGARD BUILDING INSPECTION DIVISION
- 24 -Hour Inspection Line: 639-4175 Business Line: 639 - 4171(
1 BUP
Date Requested AM PM BL
Location / ZZ - F�.i1/
gL� Suite de-et - MEC' ?d4 e 378
Contact Person Oa Ph PLM
Contractor Ph % / g 790 SWR
f „
BUILDING Tenant/Owner � ` — _ ELC _
Retaining Wall ELR
Foundation
Footing dation Access: . � (- (f ( / ' = 1' ` i , FPS
Ftg Drain �� � - s � �• SGN
Crawl Drain Inspection Notes: 1 VVV
Slab /� !r? SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear
Framing / l D /// /y
/ �F /
Drywall on ) _
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
12 rov4
o e Dampers
Fin
ASS PART FAIL
TRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
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
Approach /Sidewalk 1 r k / other Date Q Inspector ` (�v Ext
Final
PASS PART FAIL DO NOT REMOVE this 'inspection record from the job site.
CI aY OF TIGARD BUILDING INSPECTION DIVISION MST
24 - Hour Inspection Line: 639 75 Business Line: 639-41
BUP
Date Requested )62// F/ AM PM BLD
Location l�ca� J�� -Y� Suite ME �) / —C/ .� . ;,
Contact Person - Ph 7 7/ k75?) 5O PLM
Contractor Ph SWR
BUILDING Tenant/Owner Zer--)-‘4 6rA. ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN •
Crawl Drain Inspection N. -s:.,
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing i i X • X
Insulation
Drywall Nailing
Firewall P
Fire Sprinkler a ,. Ar" / SS �
Fire Alarm
Susp'd Ceiling / -
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
T FAIL
(MECHANI L
Post & Beam
Roush In
.7 7 4_
Smoke Dampers ig
Final
PASS PART •
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
BackfilUGrading
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
Approach /Sidewalk
Other Date ,"7d f Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.