Permit A r CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2002 -00483
ANL � DEVELOPMENT SERVICES DATE ISSUED: 11/19/02
13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DA -00700
SITE ADDRESS: 15353 SW SEQUOIA PKWY
SUBDIVISION: PACIFIC CORPORATE 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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 150,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of a roof top unit
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 11/19/02 $0.00
[MECH] Permit Fee 11/19/02 $72.50
[MECPLN] Plan Rev 11/19/02 $0.00
Phone: [MECPLN] Plan Rev 11/19/02 $18.13
Contractor: [TAX] 8% StateTax 11/19/02 $0.00
[TAX] 8% StateTax 11/19/02 $5.80
AMERICAN HEATING INC Total $96.43
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202
Phone: 239 - 4600 Gas Line Insp
Mechanical lnsp
Reg #: 33135 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
require you 0 of I low- les adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -00
Issu By: ( 4 r g,, /_vi • ermittee Signatur =: ; i •a /L ' •
Call (503) 6 • -4175 by 7:00 P.M. for inspections needed e next business day
t
�l OZ, ,
r M echanical ermij�tcat
' "• MOM MN= il v/ .L ; : date received: 10 A - Permit no.:04 (. /'
=,u ' . U City of Tigard r Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard (R 1T 97229 1;1. / Date issued: By: I Receipt no.:
Phone: (503) 639 -4171 ;d1 y iii _
Fax: (503) 598 -1960 tr 'rfi Ir *"- ,,,� �_ "4 ..::_... ' Case file no.: Payment type:
Land use approval:
TBuilding permit no.: tO
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory a Commercial/industrial 0 Multi- family ❑ Tenant improvement
❑ New construction VAddition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: i s-3 b 3 St.) S 0 %+ I) i f i v gs - Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 1 Suite no.: value of all mechanical materials, eguipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ _ la, 3 g 6. .
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: a of ( ZIP: 4. 1 & 2 FAMILY DWELLING PERMIT' FEE SCIEDULE
Description and loSation of work on premises: Ti i- r ha_1✓ • I COMMERICAIJINDUSTRIAL EQUIPMENTSCHEDULE
C u n n t r a r P , S 14 V.t IJA I V r., ST J .1.. Oric tru K Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res.only
Tenant improvement or change of use: / HVAC:
Is existing space heated or con itioned? l9'Yes 0 No Air handling unit CFM .500
Air conditioning (site plan required)
Is existing space insulated? Yes ❑ No Alteration of existing HVAC system
' MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name:
_ Arvu -Qtc.iwR nor:AT ti HP Tons BTU/H
Address: 1,3301 Ter G,daO„J St •! Fire/smoke dampers/duct smoke detectors
City: Pool Tt,an, 0 ,1 I State: 04 ( ZIP: 497 ao2 Heat pump (site plan required)
Phone: Sol 2334 4.440611 Fax:23 940311E-mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner O Yes 0 No
CCB no.: 33135 Install/replace/relocate heaters-suspended,
City /metro lic. no.: )//7 77 wall, or floor mounted
Name (please print): I 0 . aL M rr - 14 Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: Chillers HP
Address: Compressors HP '
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
. MINER Hoods, Type 11 I l/res. kitchen/hazmat
hood fire suppression system
Name: eitiri C R/+.& 1-1" ' ...4 as 1.A 'As Exhaust fan with single duct (bath fans)
Mailing address: ',, 4.'Z ,"0 S'ar u , 0 j„ Zll^ ' 3� Exhaust system apart from heating o AC
City: Pp- ,v e l ' State�e 11y , Fuel piping and distribution (up to 4 outlets)
�[ 9 Type: LPG NG V Oil 1
Phone: ' Fax: E -mail: Fuel iping each additional over 4 outlets
Process p p ng (schematic required)
Number of outlets
Name: - Other listed appliance or equipment:
Address: Decorative fireplace •
City: I State: I ZIP: Insert -type
Phone: F : ,/ Etta / ail: Woodstove/pelletstove
Other:
Applicant's signature: jf!illi Date: o L - r 2 Other.
Name (print): nrt3wnv v . Tia rr 1.l .
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
❑visa ❑MasterCard Notice: This permit application Minimum fee $ 7Z • -
Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $ /f8' /_ 3
Expires within 180 days after it has been State surcharge (8 %) $ .S gU
Name of cardholder as shown on credit card accepted as complete. $ TOTAI. $
_
Cardholder signature Amount 440-4617 (6/00ICOM)
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 r Pump Cond
C
fraction thereof. footnotes below. m Comp ••
Minimum Permit Fee $72.50 SUBTOTAL: 7) <3HP; absorb unit
$ to 100K BTU 14.00
8% State Surcharge $ 8) 3-15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb 35.00
Required for ALL commercial permits only unit . -1 mil BTU •
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU
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 appliance 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
101 k 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
>1.75 mil. BTU Minimum Permit Fee $72.50 SUBTOTAL: $
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)
$62.50 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 $62.50 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) $62.50 per hour •
Each additional outlet 63 *State Contractor Boller 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.
is \dsts \forms\mech- fees.doc 02/11/02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
z - BUP
Received r .� Date Requested t? J 1' AM PM BUP - l '`
Location l S 3 S,3 ( . 1 -s 0 (--- Suite MEC 2 2 — Or) "Mi.,
Contact Person Ph ( 0 0 PLM
Contractor Ph ( - - ) 5 3 — & -5 7 SWR
BUILDING Tenant/Owner 6-zg-46p ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ' SIT
Post & Beam
Shear Anchors
vin.ae,4
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm - - OO Ta (P / ( S ✓ Q /7E
Susp'd Ceiling
Roof
Other: A-70 � e 7) / C C7 L { 6'4 - /) !
PASS PART FAIL
PLUMBING
Post & Beam
"7-D �' / Ci
Under Slab / �w� d J 3 /
Rough -In
Water Service �.
Sanitary Sewer � o /Cf Cow 7' ,z.� C r dde 37) 1 3
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan �� . / e 7 f/3 , � // » v e
Other:
Final �7�—
AS P CHANIC FAIL / -/ i ��_ / 6 / l
Rou -In
Gas Line /'v,�, Aid d
Smoke Dampers F Q'� r / ,V [.
�''ART FAIL c.4./)9 � ' _ '_ u C �J vim► ' L
EL CTRICAL
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
v « "V
Approach/Sidewalk ' 61--
Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL