Permit A-- CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC1999 -00515
1J- � DEVELOPMENT SERVICES DATE ISSUED: 11/29/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DD -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 180
SUBDIVISION: 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:
ELE 3 - 15 HP: 1 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: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install one air conditioning unit and adjust grilles throughout space.
Owner: FEES
PACIFIC REALTY ASSOC Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 PRMT DST 11/29/19. $50.00 99- 320035
TIGARD, OR 97223 PLCK DST 11/29/19. $12.50 99- 320035
5PCT DST 11/29/19E $4.00 99- 320035
Phone: 503-624-6300 Total $66.50
Contractor:
OREGON AIRE INC
7921 SW NIMBUS AVENUE
BEAVERTON, OR 97008 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 626 -2000 Final Inspection
Reg #: LIC 000642
CRISWAL
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 -0080. You may obtain copies of es or direct questions to OUN by
calling (503)2e 189.
Issue By: .. 1L . ,V' / / Permittee Signature. _
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Che ._# /-
CITY OF TIGARD Mechanical Permit Application Recd By
13126 SW HALL BLVD. Commercial and Residential Date Recd I "
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 fp -c- Date to DST it i; 4 15 OW
Print or Type
Permit # Nrc � - -
V ( P, - aL Incomplete or illegible applications will not be accepted Called
N
c ,
e of Development/Project J� '� Description
kl1�V\ V . "1 � UN Table 1A Mechanical Code Qty Price Amt
Street Address suite# A) Permit Fee • 16.00
Job A � Sw Q ki 0 / f c!I 1) Ft; .:e to 100,000 BTU
Address J� Gv including ducts & vents 9.65
Bldg# City /State Zip
2) Furnace 100,000 BTU+
including ducts & vents 12.00
Name (or name of business) 3) Floor Furnace
Owner Pt exf0i 1 • including vent 9.65
Mailing Address 4) Suspended heater, wall , heater
/�� or floor mounted heater 9.65
� • � �� 5) Vent not included in appliance permit 4.75
City /State p P o ne Check all that apply: 'Boiler Heat Air
9 ', ,.,� ei 7 U ( 4 ?/"6 For items 6 -10, see or Pump Cond Qty Price Amt
Naryb ( or name of business) footnotes 1,2 Comp
6) Repair units
Airy) E'/1 C �� 8.40
Occupant Mailing Address 7) <3HP;absorb unit to (
f 66,5 5 &Olt®A elec 100K BTU 9.65
Cate Zip Phone 8) 3 -15 HP;absorb unit
1 ) /9/2,0 100k to 500k BTU 17.65
_
Contractor N ame 9) 15 -30 HP; absorb
O 4 �� - ,n " unit .5 -1 mil BTU 24.15
�•-f //2 L° 10) 30 -50 HP; absorb
Prior to permit Mailing Address -,/2 unit 1 -1.75 mil BTU 36.00
/
issuance, a copy 7/5 / ' - 33/ p .VA 11) >50HP; absorb unit >1.75 mil BTU
of all licenses C jt State Zip Phone 60.15
are required if f"C o /1- Al in 9 ?a // 336=2,,,_2 12) Air handling unit to 10,000 CFM
expired in COT / /Oregon Const. Cont. Board (ic.# Exp. ate -7 �I 7.00
database Le
( 7 1 .
database 13) Air handling unit 10,000 CFM+
Architect Name r 11.85
14) Non - portable evaporate cooler
or Mailing Address 7.00
15) Vent fan connected to a single duct
• 4.75
Engineer city/state Zip Phone 16) Ventilation system not included in
appliance permit 7.00
Describe work to be done: 17) Hood served by mechanical exhaust
7.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Domestic incinerators
Residential 0 Commercial 0 Modification 0 12.00
19) Commercial or industrial type incinerator
Additional information or description of work: 48.25
20) Other units, including wood stoves 0) V
7.00
NOTE: For Commercial projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets
roof, require structural calcs. prepared by licensed engineer. 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 22) More than 4 -per outlet (each) .75
• Minimum Permit Fee 550.00 SUBTOTAL 5
I hereby adcno . ledge that I have read this application, that the information , -✓
:iv: , is Corr- , that I : e owner or . . ' ed agent of 8 /o SURCHARGE y
PLAN REVIEW 25% OF SUBTOTAL S
the o ner, th :t pla sub : i .. • li -nce with regon tate�la s. Required for ALL commercial permits only 1Z /
- r. , t . I % TOTAL �//
Si a na ure of Owner/Agent Date 1 k L
- 1 ) c J,p LL 3 3 NT 9-°-- - Other Inspections and Fees:
Contact Person Name Phone
1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
Foonotes for commercial projects only:
$5o
3. Additional o onaal l plan review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge one - half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
units. "Residential A/C requires site plan showing placement of unit
I:Mechperm.doc rev 11/1/99
OVER - THE - COUNTER (OTC) PERMIT
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: Tit I f - L 0) 4 I Yz A..
0-/1i I les -- 1"AYv J ;foe -r
•
Class of Work: /4-L Floor Furnace: Evap Coolers:
Type of Use: 7 (? Unit Heaters: Vent Fans:
Occupancy Grp: , Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. l Repair Units:
3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: <_ 10000 cfm: Oth Units: Gee, ) 1,
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn >_ 100k Btu:
NOTES:
COMMERCIAL INSPECTION ACTIONS FEE MENU
Gas Line Inspection $ �U / Permit Fee
Mechanical Inspection $ Plan Review
Cooling Unit Inspection $ `i " 8% State Surcharge
Shaft Inspection $ Additional Permit Fee
Hood Inspection $ Additional Plan Review Fee
Fire Suppr Inspection $ Inspection Fee
Duct Inspection $ Miscellaneous Fee
Fire Alarm Inspection
Fire Damper Inspection & G REMARKS:
Miscellaneous Inspection
Fire Alarm Inspection
✓ Final Inspection
FOR OFFICE USE ONLY:
TYPE OF USE OPTIONS (COM = commercial; CMS = commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW = new; ADD = addition; ALT = alteration; ACS = accessory;
FND = foundation; OTH = other, DEM = demolition; REP = repair, FPS = fire protection system. NOTE =USE OTH FOR FENCES, RETAINING
WALL, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
I: /dst/forms /otcmech.doc 9/99
is \dsts \forms \otc- mech.doc9 /99 1
02/17/2000 Activities for Case #: MEC1999 -00515
3:37:34 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 11/29/1999 BON DONE No Hold BON 11/29/1999
MECC008 Permit created 11/29/1999 BON DONE No Hold BON 11/29/1999
MECC011 Routed to Plans Examiner 11/29/1999 BON DONE No Hold BON 11/29/1999
MECC015 Reviewed Plans Routed to DSTS JHF No Hold BON 11/29/1999
MECC706 Mechanical lnsp 11/29/1999 11/29/1999 11/30/1999 TLP PASS No Hold TLP 12/01/1999
MECC799 Final Inspection 11/29/1999 11/29/1999 02/01/2000 TLP PASS No Hold AKJ 02/01/2000
MECC090 (F) Issue permit 11/29/1999 DST DONE No Hold DST 11/29/1999
MECC800 Case Finated 02/01/2000 AKJ DONE No Hold AKJ 02/01/2000
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BU* l 1g9�� VS
Date Requested
:/i AM PM BU I 1 �j f °— • 36
Location I c S S S l uite 1 b / —C $/
Contact Person Ia/l) Ph 52?) PLM
Contractor Ph SWR
, Q ' a R
11DING Tenant/Owner wneer $IV!Y" _ � '(, � "'PL
Retaining Wall AVT C� trl r D ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: /� D <, v., _ /� /�
Post & Beam
3 `1 � % ` � � U L SIT p C -fir L �}
Ext Sheath/Shear /
th /Shear lI�'v`-t' f � 641 q ! / "0U 3 d
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall •
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
1r ASS, PART FAIL
• LUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
?ASS-20T FAIL
ECHANIC)L
Post & Beam
Rough In
Gas Line
Smoke Dampers
i PART FAIL
` RICAL
•
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: [ I Unable to inspect - no access
ADA " ApproachlSidewalk Date ( 0 c } Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.