Permit C ITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2003 -00120
� DEVELOPMENT H BMENg Tigard, ) 639 -4171 DATE ISSUED: 3/18/03
PARCEL: 2S112AD-01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 110.
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2
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: 50,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> GAS OUTLETS:
10000 cfm:
Remarks: Add (1) rooftop unit, relocate grilles and (2) exhaust fans.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300=WM1
PORTLAND, OR 97224 [MECH] Permit Fee 3/18/03 $72.50
[MECPLN] Plan Rev 3/18/03 $18.13
[TAX] 8% StateTax 3/18/03 $5.80
Phone: Total $96.43
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: 233 -6911 Gas Line lnsp
Mechanical Insp
Reg #: LIC 38868 S.D. Shut -down 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 • to fol o les adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -00
O thLo Iss . • d B : t ' l i L �� i ! / - ermittee Signature:
Call (503) . • • -4175 by 7:00 P.M. for inspections neede the Itext business day
Mechanical Permit Applieatioli Received a FOR OFF1 Mechanical ON�'LY
Date/By: I r 05 PermitNo.: /lgP „.5 //90
Planning Approval Building
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Post-Review Land Use
Phone: 503 -639 -4171 Fax: 503 - 598 -1960 / �, ,s I ,,� Post R Post - Ry: Case No.:
Internet: www.ci.tigard.or.us ■ �¢ e I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 - ^ "" Name/Method: Supplemental Information.
�;*YT'1'YPE :OE: WORK . : -i; ri COMMERCIALFEE*eSCHEDUISEr=;USE CAECKLISV; ::. t
New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition /alteration/replacement 1 ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
.: s :: ,,`' )".r,' [CATEGORY OF CONSTRUCTION; <` s ::, _- :-.`',:
mechanical materials, equipment, labor, overhead and profit.
+ -
Value: $ S 50 a See Page 2 for Fee Schedule
111 1 & 2- Family dwelling [11 Commercial/Industrial l ��
RESIDENTIAL.EQUIYMENT/ SYSTEMS 'FEE *:SCHED.DLE -
❑ Accessory Building 111 Multi- Family Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: • Heating/Cooling •
r : : ;'_'.': ;':'JOB °SITE,INFORMATION and LOCATION -'•: . Furnace - add -on air conditioning ** 14.00
Job site address: pi at,✓ 6evuO/a t � K . Gas heat pump 14.00
Suite #: ,/ 0 I Bldg. /Apt. #: Duct work 14.00
Hydronic hot water system 14.00
Project Name: �4C, oFF i C 6 213 Residential boiler
Cross street/Directions to job site: (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 •
Repair units 12.15
Subdivision: I Lot #: - Other, Fuel Appliances : ,,' ../.. .
Tax map /parcel #: Water heater 10.00
;tg , q;:- '•:,1 : • ;-? := `i'D'ESCRIPTION OF WORK' , ' - ' ::r'.`-'_".•'" ' Gas fireplace 10.00
/. PT Z, wlDuG a•2.o . rb � itt s Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
2. �iQ� Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00.
� � , . - ' 10.00
• O ERTY40:1VNEl :; '1= El TENANT,`• '_:; f'• Other:
- Environmental Eahaust-&'Ventilation` '' • Y ; >'• •.-.. .
Name: ii+(C,Tx Range hood/other kitchen equipment 10.00 •
Address: , S - O sw Si era, 4 Pit ^'y Clothes dryer exhaust 10.00
City /State /Zip: i!'. Ti..6 nip OK. Single duct exhaust
Phone: 1q 43 0 C Fax: (bathrooms, toilet compartments,
- ": `•''' []'CONTACT�PERSON l''''' utility rooms) 6.80 •
�[°j�PPLIC•ANTt``" ,"'•'1.;,
' Name: Attic/crawl space fans 10.00
Other: 10.00
Address: :: / "!.; Fuel Piping, . ,.1 ,,' s'> : ,
City /State /Zip: "•($5.40 for first 4, $1.00 each additional)
Furnace, etc. "
Phone: Fax: Gas heat pump **
E -mail: Wall/suspended/unit heater **
; ty,' -: . - �j '• ,, "' _. •. .`''CONTRACTOR • _ . -. _ Water heater **
Business Name: R, 23 F ireplace •*
tP **
Address: 97g 5c� / 7'4/ Range **
City /State /Zip: A7, A, ra Cie 9 .7.7.,22 Clothes dryer (gas) **
Phone: -C ji/ I Fax aav .(7,6, 7 . Other: **
Total:
CCB Lic. #: 3 g$eS g Mechanical Permit Fees" .
Authorized / Subtot $
Signature: Date: 3// $/03 Minimum Permit Fee $72.50 $ '7a' 50
/l Plan Review Fee (25% of Permit Fee) $ /15 s /5
� °uN 1 State Surcharge (8% of Permit Fee) $ ,' ∎ ,t`O
(Please print name) TOTAL PERMIT FEE $ 9'(Q. ill
Notice: This permit application expires If • permit is not obtained within "Site methodology ied for Tn -C exterior A/C B musing Industry Service Board.
180 days after It has been accepted as complete.
i :\Dsts\Permit Forms\MecPernitApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639-4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested S L_ � A M PM BUP
Location / i / p ii S I Suite AO MEC 3 - co / 2-0
Contact Person 7/17.0/An Ph ( ) o / �'1 �� /' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: 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
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
Storm Drain
Shower Pan
Other:
Final
PASS • - T FAIL
Rougn -in
Gas Line
S • e Dampers
all
PART FAIL
RICAL
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: El Unable to inspect — no access
Fire Supply Line
ADA Date 5 7 1 2.--2/ / d I nspector � Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL