Permit CITY TIGARD MECHANICAL PERMIT
"°'IA DEVELOPMENT SERVICES PERMIT #: MEC2003 -00725
..I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/6/04
PARCEL: 1 S 134BC -00300
SITE ADDRESS: 12282 SW SCHOLLS FERRY RD
SUBDIVISION: GREENWAY TOWN CENTER ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 3
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS: 3
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: kitchen equip.$7,000.00 valuation.
Owner: FEES
BPP RETAIL LLC Description Date Amount
BY BURNHAM PACIFIC PROPERTIES
ATTN: JOHN WATERS [MECH] Permit Fee 1/6/04 $177.50
SAN DIEGO, CA 92101 [MECPLN] Plan Rev 1/6/04 $44.38
[TAX] 8% State Surchart 1/6/04 $14.20
Phone: Total $236.08
Contractor:
G.M. ENTERPRISES .
12501 NW MOORES VALLEY RD.
YAMHILL, OR 97148 REQUIRED INSPECTIONS
Phone: 503 - 537 - 8991 Cooling Unt Insp
Hood Inspection
Reg #: LIC 137237 Hood Inspection
Hood Inspection
Duct Inspection
Duct Inspection
Duct Inspection
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 -00
Issued By:
,1(:a{g,z.... Permittee Signatu
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
I 2.28Z .5 W ScefO/ P -
Mcchtnical Permit Application FOR OFFICE USE ONLY
Received SGM / zz ., � 3 t °'® FOR
Mechanical
Date/By: id. A∎5/b.3 , Permit No.:01 GC -00 7? 6
Cit of Ti and - Planning Approval Building -0033
y g s , , F ,.,: ' Date/Ely: Permit No.: I JP )Q
13125 SW Hall Blvd. 4, 4 C1 . Plan Review J Other
Tigard, Or 97223 � �� Date/By: / -6 , Z Permit No.:
Phone: 503- 639 -4171 Fax: 5 SS 8r19o,( ,rJ Post - Review Land Use
CIU� � ,� - +' I '� Date/By: Case No.:
Internet: www.ci.ti us ard.or. , 1 ,S!O I
g Qi t p �l? D'V - ■ �� I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 5b -6 9 -4175 Name/Method: -roc Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST •
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
[ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling X Commercial/Industrial Value: $ 7 )) 0O4 See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty 1 Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: /105f I Sa ALS l Ab Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name: t .Z7 Hydronic ot water system 14.00
Cross street/Directions to job site: (orid radiator boiler
� (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 Appliances
Tax map/parcel
Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
3 - 17/D0D5 3 XNmU1"l FAA/ / /90 Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
0 PROPERTY OWNER 1 ❑ TENANT Other: 10.00
Name: Environmental Exhaust & Ventilation
Range hood/o er kitchen equipment 1 10.00
Address:
City /State /Zip: s dryer exhaust 10.00
Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
IZI APPLICANT ❑ CONTACT PERSON utility rooms) 6.80
Name: / „y7 S <94fcc, .14/094/r Rzo,4 61/14 Attic /crawl space fans 10.00
Address: $03 3 51,0 c1,Q,Qt, f S %tee.. Other 10.00
Fuel Piping
City /State /Zip: j ,*d-re"/ ZP2 _9 70Z * *($5.40 for first 4, $1.00 each additional)
Phone: s -4 9'/-36c I Fax: Spa ?Pt o I Furnace, etc. *•
Gas heat pump •*
E -mail: ' /- -�✓ /9 Wall/suspended/unit heater *•
CONTRACTOR Water heater •*
Business Name: 6 . / yf, F,,,iwroQ/S S Fireplace ••
Address: /a ‘ pt) /49ie45 .✓dic /6 • Range •*
City/State/Zip: Clothes Cit
Y P� / �Vl'1 /y�it! L O IQ , 97 !f� Clothes dryer (gas) •*
co, 7 Ste/
Phone: � Fax: O ther: *•
CCB Lic. #: • 3 -7 slo/ 7/B S Total:
Authorized Mechanical Permit Fees*
Signature: Date: / 2/1 -3/�� Subtotal: $ ?- ..�0
', Minimum Permit Fee $72.50 $
,� ��J/� j/ /9rAE-S Plan Review Fee (25% of Permit Fee) $ L/ 4/. 38
(Please print name) State Surcharge (8% of Permit Fee) $ / q . 2 0
TOTAL PERMIT FEE $ 2 36 . 08
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.
is \Dsts\Permit Forn s\MecPermitApp.doc 01 /03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
TOTAL VALUATION: PERMIT FEE:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each
additional $100.00 or fraction thereof, to and
including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for
each additional $100.00 or fraction thereof, to
and including $10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for
each additional $1'00.00 or fraction thereof, to
and including $50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for
each additional $100.00 or fraction thereof, to
and including $100,000.00.
$100,001.00 and up $1,396.50 for the first $100,000.000 and
$1.10 for each additional $100.00 or fraction
thereof.
All New Commercial Buildings require 2 sets of plans.
is \Building \Permit Forms \MecPermitAppPg2 09- 01- 03.doc
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (603) 639 -4175
C6---
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested — 7 AM PM BUP
2 7
Location 12 1v C ,/ / ` � y 4( Suite MEC a ---119-75---
Contact Person &Ai/ki /Pa-S ff...e+ • Ph ( z) &/ u/b, PLM
Contractor n Ph ( ) SWR
BUILDING Tenant/Owner !'(? ) .4 5 t t i ? ELC
Footing O ELC
Foundation Access: ^w
Ftg Drain 'V V`L L ELR
Crawl Drain
Slab Inspection Notes:•3_ ,! SIT
Post & Beam f / 419-04-5
Shear Anchors � GGG
Ext Sheath/Shear
Sheath/Shear
Fr
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
411 -15-1
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS . PART FAIL
- os :eam
as me
e Dampers
PA PART FAIL
ECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line \�c
ADA ' D
L ie
Ext
Approach/Sidewalk Date Inspector
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL