Permit CITY OF T I GA RD MECHANICAL PERMIT
I� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00423
..� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/6/2004
PARCEL: 2S112DD -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 160
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: 1 BO ILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 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: 1 AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: (1) new rooftop unit, distribution ducts, gas piping & smoke dampers.
Value: 9,500
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 6/29/200 $222.50
PORTLAND, OR 97224 [MECPLN] Plan Rev 6/29/200 $55.63
[TAX] 8% State Surchart 6/29/200 $17.80
Phone: • Total $295.93
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: 233 -6911 Gas Line Insp
Mechanical Insp
Reg #: LIC 38868 Duct Inspection
Fire Damper Insp
Misc. Inspection
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 fort in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct question to OUNC by calling
(503)246 -6699.
Issued By: Permittee Signature: _ Agrais jllYWA
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the n It business day
/5 Sw s'5Qvo/A
i Itcianical Permit_ APp1 catigl FOR OFFICE USE ONLY
City of Tigard e nom; `J �� dt Da , F TM Permit No.: / „/ +�C1a5
13125 SW Hall Blvd., Tigard, OR 97223 � eview
Phone: 503.639.4171 Fax: 503.598.1960 ', `�Q,0 Um ; , „ ,� Plan Plan Review - -Off Other Permit: /A �� Date
��
Inspection Line: 503.639.4175 , ,.
1 ��
Internet: www.ci.ti ard.or.us Date Ready/By: RI See Page 2 for
g C� � OF T GARD Notified/Method: Supplemental Information
`•TYPE OF WORK COMMERCIAL 'FEE* SCHEDULE' L. USE■CHECKLIST
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 .' , , ; „. ` 7, '' '' .... - : . Value: $ 9
.. ' RESIDENTIAII EQUIPMENT /SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION ,' v.j;, Heating/cooling
Air conditioning or heat pump
Job site address:
ss 7s S lAd ?t O/,4 px (requires site plan showing placement) 14.00
City/ State/ZIP: / rr�.c.a, Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
nt7Idg. /apt. no.: /,� Project name:,„rprA,E15 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 _
/�/ l7 1.... 1 g 1 V 3/rf Ov , Gas fireplace 10.00
/s / J Flue vent for water heater or gas
/ 17---s-0 , s 111 fireplace 10.00
9 .4 5 P/,'/Ai? / Log lighter (gas) 10.00
!!! Wood/pellet stove 10.00
Wood fireplace /insert 10.00
,/ PROPERTY OWNER ❑ TENANT_' Chimney/liner/flue/vent 10.00
Other: 10.00
Name: /'.A3c• v51" 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: ( s" o %)C - Cv3ce Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ,CONTACT PERSON • Attic /crawlspace fans 10.00
Business name: Fuel Other:
piping 10.00
/1
Contact name: ,y / [�/ 4/ � '(
�/ $5.40 for first four; $1.00 for each additional
Address: -' t Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: �3) J tg _ �9 / i Fax: ( ) Water heater
�
Fireplace
E- mail: .),4/,)7 -69Pp7 4 #1 P CeP/14 Range
CONTRACTOR • ' Barbecue
•
s t� Clothes dryer (gas)
Business name: ,42'er Other:
Address: 12ge Se -. / 70\ /4.4e-- ' MECHANICAL PERMIT FEES':': -. •
City/State/ZIP: � ,t/i>J Subtotal t o1 60
,
Minimum permit fee ($72.50)
Phone: ( )a ,g3 C_?1 I Fax. ( 't-a ) eZ gr. 97r-,� Plan review (25% of permit fee) 56 • 3
CCB lic.: ..... .52g.. - e .-- - ... 4 p. State surcharge (8% of permit fee) /7. Sew
e
TOTAL PERMIT FEE �'195i`i3
Authorized signature: Thi per mit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: je jif 1,/ /74,7 Date,/29/ • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits\MEC- PenrmApp.doc 12/03 440 4617T(I /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 \Permits\MEC- PermitApp.dot 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUPZIONN54Ngggl
Received Date Requested — Z AM 1 PM BUP
•
Location / 5 S 7 5 4 .t Suite 160 MEC 2-(254
Contact Person R «yY ✓✓ Ph ( ) (D 7 9 v 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 I L & i���
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
• ) er:
•A PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough-In Service Water Service so. IIIP
Sanitary Sewer � �- r . "— <�1` — WI LC„ ' I4 A -/
Rain Drains �
Catch Basin / Manhole
• Drain
Drain
Shower Pan (t -15-1519 ( (— J t PU*----
Other:
Final
PASS PART FAIL
MECHANICAL
•
Post & Beam
Rough -In
Gas Line
- • • ' ampers
Fin -
PART FAIL
RICAL
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 Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL