Permit CITY T I G A R D MECHANICAL PERMIT
51 � DEVELOPMENT SERVICES PERMIT #: MEC2002 -00397
'� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/16/02
PARCEL: 2S112DD -00701
SITE ADDRESS: 15800 SW UPPER BOONES FERRYRD A -120
SUBDIVISION: OREGON BUS. PARK II 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: 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: 120,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP:
WOODSTOVES:
GAS PRESSURE: L 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Extend Gas line to serve existing units
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 9/16/02 $72.50 2720020000
PORTLAND, OR 97224 PLCK CTR 9/16/02 $18.13 2720020000
5PCT CTR 9/16/02 $5.80 2720020000
Phone: Total $96.43
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Final Inspection
Phone: 453 -4822
Reg #: LIC 62196
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 952-001-0011 r• h OAR 952 - 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by ca i 4'43)246 -9189.
Issue By: j d i t ieu i) Hi Permittee Signatur
Call (503) 639 -4175 by 7:00 P.M. for inspections n ` . -d - e ext business day
.,,
Mechanical Permit Application OFFICE USE ONLY
Date received: - - Q . Permit no4)6, • ■ 2
AU ' � City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ;'Tenant improvement
0 New construction 0 Addition/alteration /replacement ❑ Other:
.10R SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 1 sitv !D✓ u�� RoomaS AO iett Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: I value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ ZAoO • 60 .
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: #2, /7 ep/ jurisdiction's fee schedule for residential permit fee.
City /county: �( Q /C4ns/.�! I ZIP: 9729 I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: ArX/AvAJD 6424 AND COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE
G4aV46 7b ArX& 77'NI 66-4 Pi9e.Kc Fee (ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air handling unit CFM
Is existing space heated or conditioned? Yes ❑ No Air conditioning (site plan required)
Is existing space insulated? Yes 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: CGAOt 9ya QN77eOL HP Tons BTU /H
Address: /65 S ) 7z ,s4,67 Fire/smoke dampers/duct smoke detectors
City: /-W2,72 I State:, I ZIP: 97209 Heat pump (site plan required)
Phone$63•tj/53- I Fax: f` - 722/( E -mail: Install/replace fumace/bumer BTU /H
CCB no.: b (Q�y Including ductwork/vent liner O Yes ID No
Install/replace/relocate heaters - suspended,
City /metro lic. no.: / 4 1/9 wall, or floor mounted
Name (please print): �0 _ Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
G_ Absorption units BTU /H
, n
Name: /g/vlC- /CAL Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: ,)4/ -- 842. Fax: E -mail: Dryer exhaust
OWNER Hoods, Type 1/ 11 /res. kitchen/hazmat
hood fire suppression system
Name: Pi9C '4 57 Exhaust fan with single duct (bath fans)
Mailing address: 75350 5 ( . 4- 30 Exhaust system apart from heating or AC
7Z. ,48 � 9 71Z722e/ Fuel piping and di b lion (up to 4 outlets)
Cit y: t' ,€. State: ZIP:
Type: LPG NG Oil
Phone.
(, Z'/ -.. , Fax E - mail: Fuel piping each addit onal over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: Fax: E -, . il: Woodstove /pellet stove
/ Date: Other:
Applicant's signature
f� //ll.. �GZ Other:
Name (print): • - ?
SD Not all jurisdictions accept credit cards. please call jurisdiction for more information. Permit fee $ /i•
❑ Visa ❑ MasterCard Notice: This permit ap Minimum fee $
Credit card number:
/ expires if a permit is not obtained Plan review (at _ %) $ /8.13
Expires within 180 days after it has been
State surcharge (8 %) .... $ 5.
Name of cardholder as shown on credit card accepted as complete. TOTAL $ - - -�Z
Cardholder signature Amount
440-4617 (6/00 /COM)
MECHANICAL PERMIT FEES I
,.. .
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
;F TOTAL'VALUATION:.' 'PERMIT'FEE: . <:.< ` ', ,Description,',,,':, . ° - :,z, % ,', •-- s,;; Price Total
$1.00 to $5,000.00 Minimum fee $72.50 .Table'A Mectienical- Code ^•, -.Z,,',•>;.� `, •,. `DiyY- ;.,`(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 , ' ' - ', 7 - - . -
$1.20 for each additional $100.00 or For item's 7 -11, see ` or . = ,Pump • p`_ Co nd ;
fraction thereof. footnote's below. Com
Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit
to 100K BTU• 14.00
8% State Surcharge $ 8) 3 -15 HP; absorb
unit 100k to 500k BTU 25.60 ,
25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb
Required for ALL commercial permits only unit .5 -1 mil BTU 35.00
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP, absorb
unit 1 -1.75 mil BTU 52.20
11) >50HP; absorb
unit >1 75 mil BTU 87.20
12 Ai h unit to 10,000 CFM
',ASSUMED VALUATIONS PER APPLIANCE: = ._; :: s 10 00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955 17 20
ducts & vents 14) Non - portable evaporate cooler
10.00
Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct •
ducts & vents
•
Floor furnace including vent 955 6 80
Suspended heater, wall heater or 955 16) Ventilation system not included in
floor mounted heater appliance permit 10 00
Vent not included in applicance 445 17) Hood served by mechanical exhaust
10 00
permit 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU
3 -15 hp; absorb. unit, 1,700 69.95
101k to 500k BTU 20) Other units, including wood stoves
15-30 hp; absorb. unit, 501k to 1 2,310 10.00
mil. BTU 21) Gas piping one to four outlets
5 40
30 -50 hp; absorb. unit, 3,400
22
1 -1.75 mil. BTU
22) More than 4 -per outlet (each)
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 •
Air handling unit >10,000 cfm 1,170 8 /o State Surcharge $
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446 TOTAL RESIDENTIAL PERMIT FEE: a .
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 Boiler 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 \dots \forms \meth - fees.doc 02/05/02
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11/16/2004
Case Activity Listing 11:37:22AM
TIDEMARK Case #: MEC2002 -00397
COMPUTER SYSTEMS. INC
- " • y - Assigned- Done Updated"
ri Date 1 Date 2,.- Date:`3 °u`- - Hold Dis - T • B B t 1Votes .5,f." ,r < °t
.Activity Descri,ptio Date]. _ ,., , -� _
MECA007 Application received 9/9/2002 None DONE JMT 9/9/2002
RCP
MECA008 Create Permit 9/9/2002 None DONE JMT 9/9/2002
RCP
MECA011 Routed to Plans 9/9/2002 None DONE JMT 9/9/2002
Examiner RCP
MECC799 Final Inspection 9/20/2002 None PASS GWL 4/29/2003
RB
MECC014 Plan 9/12/2002 9/12/2002 9/12/2002 None DONE DWJ 9/12/2002
checked /Approved by DWJ
P.E.
MECC015 Reviewed Plans 9/12/2002 None DONE DWJ 9/12/2002
Routed to PT DWJ
MECCO28 Post - review 9/16/2002 9/16/2002 9/16/2002 None DONE BB 9/16/2002
completed BB
MECCO50 (F) Ready to issue 9/16/2002 None DONE BB 9/16/2002
BB
MECC090 (F) Issue permit 9/16/2002 None DONE BB 9/16/2002
BB
MECC705 Gas Line Insp 9/20/2002 None PASS GWL 9/20/2002 17# for 15 min. Tag #429616
GWL
MECC800 Case Finaled 4/29/2003 None DONE RB 4/29/2003
RB
Page 1 of 1 CaseActivity..rpt
CITY OF VIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received Date Requested " 7b AM PM BUP
Location / 5 go 0 • Suite r MEC 0 — 3 7
Contact Person Ph ( ) PLM
Contractor Ph ( ✓1� ) 4 /S - - 3 J Lte ZZ SWR
BUILDING Tenant/Owner /7 F 1 �l 1�� C-G 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 Tq ' 12 9 Drywall Nailing 77 Fi rewall
Fire Sprinkler rr
Fire Alarm / 7 ` O / L'1 / u
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
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
grerstirel
Smoke Dampers
Fin
PART FAIL
ELECTRICAL
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 call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date 20 �G� Inspector G�`7 P- Ext
Other:
Final d t! � DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL ��