Permit ..-ii. .
CITY TIGARD MECHANICAL PERMIT
A k DEVELOPMENT SERVICES PERMIT #: MEC2004 -00823
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/21/2004
PARCEL: 2S112AD -01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 150
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:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace existing ceiling register, relocate duct to opposite wall. Value: $3000.00
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 12/21/20( $95.50
PORTLAND, OR 97224 [TAX] 8% State Surcharl 12/21/20( $7.64
Phone: Total $103.14
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 233
Final Inspection
Reg #: LIC 38868
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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By:
a-cluzi-- p:Ce-'t.--(-
/ ,Cf Permittee Signature
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechpitia.1 Permit Apt_.1._t' +1 ® FOR OFFICE USE ONLY .
City of Tigard ,
Date/By: / i - 1 1. . 0 Permit No �/s ° '] ` � x7_CO j/� 4, _ 3
13125 SW Hall Blvd., Tigar Plan Review `�
Phone: 503.639.4171 Fax: 03.598.1960 � ^o oi` o.�IWI Date/By:
t Other Permit:
LL
inspection Line: 503.639.4175 C_ Date R eady /By: El See Page 2 for
Internet: www.ci.tigard.or.us \l�" ' "' Notified/Method: Supplemental Information
G' •
�'�I yP ¢� S COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ition/alteration /replacement Mechanical permit fees* are based on the value of the work
B performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ L { QO f, a
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling ,ommercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. Ea. I Total
. JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: L R j',..., _ Q Air conditioning or heat pump
! L\ lJ 01 of / kW �1 (requires site plan showing placement) 14.00 -
City/State/ZIP: h 8 /
- � Furnace 100,000 BTU (ducts/vents) 14.00
- - Furnace 100,000+ BTU (ducts/vents) 17.90
t
Suite/bldg. /apt. no.: 6 f G Project name
, Gas heat pump 14.00 ,
Cross street/directions to job site: ' J h .Lr (I _ „- i &X N LO / Duct work 14.00
l !' Hydronic hot water system 14.00
Residential boiler (radiator or
. hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' DESCRIPTION OF WORK , Water heater 10.00
/�
Gas fireplace 10.00
Rem �� des. ,r�� Ca L ,✓ Rif t'i iL:�, Flue vent for water heater or gas
��e,1�L e.-r- fireplace 10.00
r Q 'J -71,_ d 7Z*s � Log lighter (gas) 10.00
O r CF /” i c.` 4.)/4 G L Wood /pellet stove 10.00
Wood fireplace/insert 10.00
Chimney /liner /flue /vent 10.00
' PROPERTY OWNER ❑; TENANT . • -
-. Other: 10.00
Name
r vi PA C � � Environmental exhaust and ventilation
Address: / ( , `, Range hood /other kitchen
equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6.80
' 'APPLICANT JONTACT. PERSON ' . Attic /crawlspace fans 10.00
Business name: / QO ���� � SfO G 4, �( Fuel piping
r in 10.00
P�P� R
Contact name: 8 J A L Qd 1 $5.40 for first four; $1.00 for each additional
Address: 5'? re Se _ , / ?, L Avg
Furnace, etc.
l Gas heat pump
City/State/ZIP: /p ,s77.4,....i.k Ott_ T72_zL Wall/suspended/unit heater
Phone: 642 ) S %F-Cj ? 7 Fax:: (03) J3 S.- p) t. 7 Water heater
E -mail: Fireplace
Range
'CONTRACTOR - ' Barbecue
Business name: �� 4,1"
Clothes dryer (gas)
��i Other:
Address: : MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal q/ t , t.�
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.:.3 mg g State surcharge (8% of permit fee) 7. (p q
TOTAL PERMIT FEE /03 /
�
Authorized signature This permit application expires if a permit is not obtained within 18
days after it has been accepted as complete.
Print name:A /l J e r' a „!,' e,A__ Date: / 2....-2- ( -O y' I • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440.4617T (I 1 /02/COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 6 75
INSPECTION DIVISION Business Line: (503) 71 MST
BUP
Received Date Requested / /3 AM PM BU
� q 9S DO z(- .06e.
Location .��_.� -�-�c� Suite /Sd • °7
Contact Person Ph ( ) / -' / 9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: l/�J �e C SIT
Post & Beam -✓
Shear Anchors 0 fS /( -' St 4 / !/o I
Ext Sheath/Shear � '�/ 'r` �
Int Sheath/Shear a
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam 1
Under Slab •
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS T
CHAN� FAIL
/ 4;
Post & Beam
Rough -In
Gas Line
Smoke Dampers
4
i e PART FAIL
TRICAL
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: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL