Permit 1 CITY OF TIGARD MECHANICAL PERMIT
r DEVELOPMENT SERVICES PERMIT #: MEC2001 -00001
s ' � ' DATE ISSUED: 1/8/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 100
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 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:
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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Mechanical TI - Installing new duct work to existing Heat Pump Systems
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 1/8/01 $72.50 2720010000
PORTLAND, OR 97224 PLCK CTR 1/8/01 $18.13 2720010000
5PCT CTR 1/8/01 $5.80 2720010000
Phone: Total $96.43
Contractor:
BEWLEY MECHANICAL
5591 SW ARCTIC DR
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Duct Inspection
Phone: 626 -8986 S.D. Shut -down inspection
Reg #: LIC 63582 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- 09_Q_through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling 3)246 -9189.
Issue y: ` f ,i , !u ,,j I,� Permittee Signature: /(,-- o��� 4111C
Call (503) •39 -4175 by 7:00 P.M. for inspections needed the next business day
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Date received: / -A. / Permit no.: rig e 1- j .
a ' Y�1�1''� City ° tJ - -o — - Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory Al Commercial/industrial 0 Multi- family /Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION • COMMERCIAL VALUATION SCHEDULE
- lob address: is 350 su.\ t P..e t.....)..1 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Titt eD / value of all mechanical materials, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ q, B'c)•, •
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: Sig jurisdiction's fee schedule for residential permit fee.
City /county: •-_i►‘_ , ZIP: - Z% 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE'
Description , n t � d location of Nark �n premise • r'_v AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE
ytP� et .t l' kV •Qno t►.+c) tw s �PQ �-M t�
t s Fee(ea.) Total
Est. date of completion /inspection: N / Description Qty. Res.only Res.only
Tenant improvement or change of use: HVAC:
Air handling unit CFM •
Is existing space heated or conditioned ?$.Yes 0 No Air conditioning (site plan required)
Is existing space insulated ?, Yes 0 No Alteration cf existing HVAC system /
/ ' Boiler/compressors
ressors
MECHANICAL CONTRACTOR • T. :L P
Business name: C .e. - ' I — State boiler permit no.:
HP Tons BTU/H
Address: �j'Sen SG.S I 1.7 'C b. r. Fire /smokedampers/duct smoke detectors
City: I State: aKI ZIP: a Z Heat pump (site plan required)
Phone:�'J t � bA� Faxtpq{- G, I E - mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: Cpeg.66 Z Install /replace/relocateheaters - suspended,
City /metro lie. no.: (q Li wall, or floor mounted
Name (please print): tee.., IC, , , Vent for ap p fiance other than furnace
CONTACT PERSON , •
Refrigeration: _
Absorption units BTU/14
Name: j-Li-dli-c_fic_ Chillers HP
*
Compressors HP
Address: 1 q / p� 4`,
Environmental exhaust and ventilation:
City: Rj.o. .+ I State: •CI ZIP: 92E3 6 Appliance vent
Phone:60 , -pi800 Fax: (04 / -(, , E-mail: leen.60.1• 4 4 Dryer exhaust
OWNER Hoods, Type 1/ H/res. kitchen/hazmat
hood fire suppression system
Name: 1) t c jc. L.-0.et tA4 etc (1-e ( Exhaust fan with single duct (bath fans)
Mailing address: (t 350 Sc...) .
, Exhaust system part from heating or AC
City: y o „� j tate:e I ZIP: - 7213 Fuel piping ant iistribution (up to 4 outlets)
Type: LPG NG Oil
Phone: - , Z.- (03 60 Fax: N " E - mail: V 09 Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: ( e4 9 F vt I" Number of outlets
rs Other listed appliance or equipment:
Address: 2q p 2 S, 1 1 1 „ e� t �b C Decorative fireplace
City: rat_ , r.vt_ - Stater.. A- ZIP: (f •. Insert - type
Phone' 3 a- Fax: A.) .1 E - mail: et: Woodstove/pelletstove
Applicant's signature: 1 I'�� MAIM f ®� Other:
Name (print): vt A.c �,;
Not all jurisdictions accept credit cards, please call jurisdiction for more information.
fee $
O Visa ❑ MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at %) $ /2% ) t
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)
MECHANICAL PERMIT FEES at -
• , 1
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: 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 includin • 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* '"
7) <3HP;absorb unit .
ASSUMED VALUATIONS PER APPLIANCE: to look BTU 14.00
8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9) 15.30 HP; absorb
Furnace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00
ducts & vents - 10) 30 -50 HP; absorb
Furnace > 100,000 BTU including 2 1,170 unit 1 -1.75 mil BTU 52.20 ,
ducts & vents - 11) >501IP: absorb
Floor furnace including vent 955 - unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not included in applicance 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct '
3-15 hp; absorb. unit, 1,700 6.80
101k to 500k BTU 16) Ventilation system not included in
15-35-3 0 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30-50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU 18) Domestic incinerators
>50 hp; absorb. unit, 5,725 17.40
>1.75 mil. BTU 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 69.95 _ -
Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves
Non - portable evaporate cooler 656 10
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656 8% State Surcharge $
inserts, etc.
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimum
charge-one-half hour) $72.50 per hour
`State Contractor Boiler Certification required for units >200k BTU.
** Residential A/C requires site plan showing placement of unit
hdsts\forms\mech- fees.doc 10/11/00
CITY O,f TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP i,S _
Date Requested I- Z Z AM PM BL I a
Location 3 5 5 " SI f 1 40L' Suite C % — vv °
Contact Person Ph i Z G i 5' ' PLM
Contractor . Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
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
NCI _ N
Post & Beam
o ygh.l►�
Gas Line
Smoke Dampers
F'•
t PART FAIL
CTRICAL
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 Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
ti CITY OF TIGARD BUILDING INSPECTION DIVISION r MST
2i -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP a ';d o U
Date Requested 0 AM PM BLD L �
Location /53 5 l e / Suite / t) MEC /•'� 0 G 6
Contact Person 1 //'�
v C'�C c s - Ph 3o-77z-/ PLM
Contractor Ph 7> _G 7,rJ - 7 z/ i SWR
UILDIN Tenant/Owner mid- day ELC
Retaining Wall ELR
Footing Access: FPS
Foundation
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath/Shear,
Int Sheath/Shea
Framing
Insulation C (''-(
Drywall Nailing
Firewall
Fire Sprinkler
Fire Al- us
Mi • •
agf: PART FAIL
• : BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
Post & Beam
+: ouq r
Smoke Dampers
F'
RT FAIL
ELECTRICAL
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 to ins ect - no access
Fire Supply Line [ ] Please call for reinspection RE: [ ] P
ADA / 6 / Approach/Sidewalk a //6
Other Date Inspector 7 4 Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST . -
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP v�Lb
Date` Requested :'( ,2 .-` I AM PM BLD
Location ): , - - L -'�P' Suite / 0® Tr„...MEC g / e9 1 & /
Contact Person Ph p l - 3H/IO PLM 7
Contractor ' ' ' ' ?. /U Ph SWR
CB11J PJ Tenant/Owner
ner 4 4 t S ELC
Retaining Wall - ELR
Footing r i i!�f � .. ��
Foundation . � - l a c : r l2 , y �' r • FPS
Ftg Drain I f iy s E M E:: �*i� :'� a ' i � ',°, "' �':" � �'i: 4 SGN
Crawl Drain Inspectipn t��l /o
Slab 11 w��l T7� eV e
Post & Beam 000 ��
Ext Sheath /Shear r? U - 0!/
int Sheath /Shear
Framing
Insulation _
Drywall Nailing
Firewall
i ire'Sprinkle
Fire Alarm
Susp'd Ceiling e 4110'
L
Roof
Misc:
PAS PART FAIL
(WLUMBING'
Post & Beam • . _
Under Slab
Top Out
Water Service
Sanitary Sewer
Ra rains
Fina
AS PART FAIL
dgigCA NICAD
Post & Beam
Rough In
Gas Line
Smoke mpers
SS PART FAIL
'E 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 D 3/1
Inspector i s ector Ext
Other / � p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.