Permit 1►
CITY OF TIGARD
MECHANICAL PERMIT
A *-�Ar DEVELOPMENT SERVICES PERMIT #: MEC2004 -00617
,.� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/15/2004
PARCEL: 2S112DD -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 140
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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Relocate ductwork. Value: $900.00
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 9/15/200z $72.50
PORTLAND, OR 97224 [TAX] 8% State Surcharl 9/15/200 $5.80
Phone: Total $78.30
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: 233 -6911 Duct Inspection
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: / � / Permiftee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mech jiical Permit Applic - FOR OFFICE USE ONLY
Tigard G Received q // 7
City of I $'rd Date/By: ive ° '7 D � Permit No.: ��/o 6 .j �6/
13125 S IW Hall Blvd., Tigard, OR 9 2 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 rD 200k /�� s �'ll
,\ Date/By: Other Permit:
Inspection Line: 503.639.4175 Stf 1 5 _ �iY
■ f'�W Date Ready/By: lurit: ® See Page 2 for
Internet: www.ci.tigard.or.us � Notified/Method: / {t Supplemental Information
CITY OF TIGAR'
51°M -
' �VF KK COMMERCIAL FEE* SCHEDULE•- USE CHECIUJST
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION - . . Value: $ c(e2
i' E •
; = RSIDENTIAI: EQUIPMENT. /SYSTEMS FEES* i
❑ 1- and 2- family dwelling Mt ommercialindustrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION . Heating/cooling
Job site address: /5 S Gt/ Air g conditioning o heat pump
� t1 �� P/C Gv c9-� (requires site plan showing placement) 14.00
City/State /ZIP: + // - ta 0A'& . Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: /Y 0 Project name: S J 0 Gas heat pump 14.00
Cross street/directions to job site: L'OA-hifs, 2s. Duct work 14.00
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
/ / ' opt t./ a Gas fireplace 10.00
370 v-C.. 1 J Ii e t kin /-k , ? Al f�/�!/. rie.cerrticogiuue vent for water heater or gas
fireplace 10.00
_
�� -1 Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
PROPERTY OWNER ❑ TENANT Other:
Chimney/liner/flue/vent 10.00
Other: _ 10.00
Name: PA3-i riL1lfr-- Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
JEKUPLICANT ❑ CONTACT PERSON - ' Attic /crawlspace fans 10.00
Other: 10.00
Business name: P 0 /r, 4.S a- ,.;:, - Fuel piping
Contact name: a/Zt/Gt_ Q u j-ye.", $5.40 for first four; $1.00 for each additional
Address:
9 75.17 S e 1 r Furnace, etc.
Gas heat pump
City/ State/ZIP: 445.7044A9 eil... , Wall/suspended/unit heater
Phone: crto ? _c / Fax: : (S-02) Water heater
Fireplace
E -mail: Range
CONTRACTOR ' Barbecue
Business name: tr R 6-7--,1, Clothes dryer (gas)
Other:
Address: ,_S-4-- MECHANICAL PERMIT FEES* s r `" -
City/State/ZIP: Subtotal
Phone: G' 2_33...-C C 9 // Fax: (.7 2,2 sr-9 7 C. Minimum permit fee ($72.50) �p� • ��
Plan review (25% of permit feee )
CCB lie.: J 8'S ' ee r State surcharge (8% of permit fee) X0
TOTAL PERMIT FEE 1 -
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: ° f /d * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \PmnitsWEC- PennitApp.doc 12/03 440.46I7T(11/02/COM/WEB)
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 $100.00 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.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\ Building \Pennits\MEC- PermitApp.doc 12/03 2
CITY QF TIGARD 24 -Hour /” 4‘1/4
BOLDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /d - 14 AM / PM BUP
Location / �7 S i 1 A--�- ) Suite ( v MEC ct%D (/-DcD i 7
Contact Person Ph ( ) / - fit' 99 PLM
Contractor Ph (\ ) SWR
BUILDING Tenant/Owner - U ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing f
Firewall _, �711 ��: M� � •
�r! �L��•i ��'._:/��=
Fire Sprinkler
Fire Alarm � �
4IS 4 A �
Susp'd Ceiling tr�
—
Roof
Other:
Final
PASS PART FAIL ��/ / [WM
PLUMBING
Post & Beam
Under Slab ►�J'
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
/ Dampers
PASS PART "FAIL/
ELECTRICAL J
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call • r rei pection RE: • Unable to inspe – no access
Fire Supply Line 1116-
ADA D D A . Ins e cto 40 l r Ext
Approach/Sidewalk P —
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL