Permit M '
CITY OF TIGARD
MECHANICAL PERMIT
I 6 " DEVELOPMENT SERVICES PERMIT #: MEC2004 -00695
..� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/20/2004
PARCEL: 2S112DD -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 150
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Re- arrange duct work, add all new diffuser's on (3) units & relocate (3) thermostats.
Valuation: $8100.00.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 10/20/20( $164.90
PORTLAND, OR 97224 [TAX] 8% State Surcharl 10/20/20( $13.20
Phone: Total $178.10
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: Permittee Signature: e. ,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permi • • • li _. FOR OFFICE USE ONLY
Cit ' of Tigard ;l Received
loa -eV l d / , permit No.\ C(' �/g9 J
13125 SW Hall Blvd., Tigatd, O _ R 97 223 J L� �I p' Plan Review
Phone: 503.639.4171 Fax: 503.598.1960., , lgOk /i � .d�, h ,.•.,� \ Date/By: Other Permit:
Inspection Line: 503.639.4175 ' , `' • ! J'. ill Juris: ard.or.us F .. Date ReReady/By: X `/ ® See Page 2 for
Internet: www.ci.tigard.or.us
,, n . ' - i�/ . ,� Notified/Method: l /V Supplemental Information
• �`I"�'P OF WORK COMMERCIAL TTEE* `SCHEDULE = USE CHECKLIST
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION- ..y Value: $ gioo 0 0
- R ESIDENTIAL EQUIPMENT / SYSTEMS FEES* • ❑ 1- and 2- family dwelling ,Commercial/industrial ❑ Accessory building - ,
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. Total
JOB SITE INFORMATION :AND LOCATION '-* ',. Heating/cooling
+ Air conditioning or heat pump
Job site address: 5 6(4J, 0/7 �'�
/ (requires site plan showing placement) 14.00
City/State/ZIP: 77� ,L,„, �s�r, � G Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name: y Furnace 100,000+ BTU (ducts/vents) 17.90
�sr -e S Q � , ,C/ 4 LC I�.�Lf9� Gas heat pump 14.00
Cross street/directions to job site: 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
nas fireplace 10.00
/i2BV , e -cf ;✓2s A tx Re - /94/4.4"s►S-e - me vent for water heater or gas
r I fireplace 10.00
�l7 i.-t /I V P ; � t i� ALL. / l / 'e l�l Log lighter (gas) 10.00
c' /v - ,l/l -ee. �,Pa i r S • 4//C2 Re.Lt cif 3 1 heAm a 5 da,- -r S Wood/pellet stove 10.00
Wood fireplace /insert 10.00
'PROPERTY OWNER; ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 1 0.00
Name: ' L� )J€ 0
� 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
AT APPLICANT ' X CONTACT PERSON ' • Attic /crawlspace fans 10.00
Other: 10.00
Business name: PR 0 lemD° Ass .5" ,1�, 4r j Fuel t to
P g
Contact name: 6R V L 4, 4 I/ r,.'1/e ..., $5.40 for first four; $1.00 for each additional
Address: 97W g _'e, /7 TA 4s/ Furnace, etc.
•
Gas heat pump
City/State/ZIP: POR j ,jo C 972-2. Z Wall/suspended/unit heater
Phone: (5 Sj S _ 6 "? t Fax: : (543) , j 2 6 Water heater
Fireplace
E -mail:
Range
. CONTRACTOR -. Barbecue
Business name: 3' M e _ As p4a 0i ,,�_ Other: dryer (gas)
Other:
Address: _ MECHANICAL PERIYIIT FEES* "
City/State/ZIP: Subtotal 7 y.9 6
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 3 8'gc 'r State surcharge (8% of permit fee) 11.2 Q
TOTAL PERMIT FEE ( x � / 6
Authorized signature:�� This permit application expires if a permit is not obtained' 180
days after it has been accepted as complete.
Print name: 8R v ( /e ✓ j ")e_2 Date`)-7 S - 07 • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Pem \ n
tits MEC- PenitApp.doc 12/03 440- 4617T(II /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. �1
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and �J
$1.80 for each additional $100.00 or 1 1 I
fraction thereof, to and including 1 1
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
y
$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 \Pemrits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING • Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Request / ( — >' AM PM BUP
Location l S S 7 '' �! -- Suite l MEC dI P o 1 1 —oa ( ,9 5
Contact Person ) -2-- Ph ( ) 519 I Gf PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain 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 i . j ��
PLUMBING k '%A=
Post & Beam
Under Slab
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
Smoke Dampers
P ART FAIL
RI CAL
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 LI Please ca for rein ction RE: ❑ Unable to inspect — no access
Fire Supply Line ► 1 ��
ADA PP Y
Approach/Sidewalk Date `' Inspector dr `. Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL