Permit ,r s CITY OF TiG' RD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00101
c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/5/04
PARCEL: 2S1 12 D D -00700
SITE ADDRESS: 15780 SW UPPER BOONES FERRY RD BLDG
SUBDIVISION: D ZONING: IP
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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Add (1) supply grille. Project value: $250.00
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 3/5/04 $72.50
PORTLAND, OR 97224 [TAX] 8% State Surchar€ 3/5/04 $5.80
Total $78.30
Phone:
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 233-6911
Final Inspection
Reg #: LIC 38868
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 -00 -! ::. ou may obt -'n copies of these rules or direct questions to OUNC by calling
(503) 46 -6699. Issue By: , - Permittee Signature: 41
Call (503) •39 -4175 by 7:00 P.M. for inspections needed th next a siness day
. . ,
Mechanical Permit Application . FOR OFFICE USE ONLY
..,, .,„
City'of Tigard , - Received ffilyM111
Permit No .,
Date/By , A G, i
13125 SW Hall Blvd , Tigard, OR 97223
Plan Review
Phone: 503 639 4171 Fax: 503 598 1960 Attztip Date/By Other Permit.
Inspection Line 503 639 4175 .- r.'11..1 Date Ready/By PM 21 See Page 2 for
Internet www ci.tigard.onus Notified/Method. Supplemental Information
t ':"'' ''' ; -
firiii 4614c P'1;' ' ..:.! cokqiiierkr,'`FEE
si,-.::::::..4Y-t- - ': 4, 'Itct't fl- Nz.!;' ?i ,', ,,L ..,;.. = '__,, _ ._:''"`:`;',:.: 't''-.... ,-=-"' =-..- ! ■ ,...-, -, , , .- - , Q
New construction 0 Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
0
performed Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical matenals, equipment, labor, overhead, and profit
:'';,- ''.=•'-,-- 1 , ''=.- .1:--l- '‘`+ -: '."'
CATEGORY OF i&tIV$TkUtTiot■FT. 41''71:7 Value $
:,f.)::: ;, -. ' ' . ,^.:Y eL:: : i , u tt..,, , t :,• - ,,, • ',,,,,d, _ 1,—, . l' _ -, - ,, ,A1 - ` ,P,- % 7- : , ):,:-.Iv. ':::r. r4 ,,, / , . --- ---, -1-,:. -- -
/ ttiE
::,IP:' ,4SIDTENTaLEQUif;NjENr #SYSTEMS FEES*
0 1 - and 2-family dwelling La
Commercial/industrial 0 Accessory building
For special information use checklist
0 Multi 0 Master builder 0 Other:
Descnption Qty Ea Total
* : Heating/cooling
Air conditioning or heat pump
Job site address: / .5 7'e 0 C, p?ex 3,,,,,,, Fkgey Re./. (requires site plan showing placement) 14 00
City/State/Z1P 7 - )G.Ave_ jo • 2,L., Furnace 100,000 BTU (ducts/vents) 14 00
/ Furnace 100,000+ BTU (duets/vents) 17 90
Suite/bldg./apt. no : D Project name 2 .-.-
4vi €:: 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
Flue/vent for any of above 10 00
Subdivision: Lot no :
Other 10 00
Tax map/parcel no.: Other fuel appliances
(- ',. ! -, ' 1-5 ' - -C4 .- - -; ','IbES'dRIP' . floN-?elF*ORk ‘-; :7:1- ,i.. At:-.' ,.ilr-' Water heater 10 00
//
Gas fireplace 10.00
, 400 l -5 PG, (
./..e.. Flue vent for water heater or gas
fireplace 10 00
Log lighter (gas) 10 00
Wood/pellet stove 10.00
Wood fireplace/insert 10 00
-
-, - - , - . .,- i,- rA._5: --,-,., - -- -- ,-..- . — -, - . : - -
-,-- ... , ,,,,-..-.... , ,-,„; .. Chimney/liner/flue/vent 10 00
;"1;til,-,12trilitOPEliTY':ONVI!TE , R ;,-'i ,, - •i
4'''i." '. El -1TENANT ! . Other k:":'!:' q 44 '
10.00
Name: /: i Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10 00
City/State/ZIP: Clothes dryer exhaust 10 00
Single-duct exhaust (bathrooms,
Phone: ( a • c v v Fax ( ) toilet compartments, utility rooms) 6.80
APPLICANT "4''' 4-' ':i.1 Attic/crawlspace fans 10.00
..
' -7,"' '"re.;? - ■7i ,... .. , . , --.4 4 6.7 - - . . 42',:x;'_ .-_-;', 1.2,2; 4 4..,- , a '4:,-- ..-...:.- - -.' .:....''W■a':',:',7'
Other. 10 00
Business name:
Fuel piping
Contact name. $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail: Range
--- cl‘ , ■; 64 ' 6. "'n• 4 EPri* - : , ' ', '''' ' :' :‘-t-'1C."7 Barbecue
;1''t '. ; .. ' -4 '4%4' -- 4 - :'4'"'2' '
Clothes dryer (gas)
Business name: iqci57 0 Other:
Address: .9,. a. ,5 4:- ) -, -^ 4 e,e ,'`aZ,---:. .MECHANICAVPERMIT,YEES
City/State/ZIP: i'ey-z.."77 o t/D Oh. 9 7 (t.2 2 Subtotal
Minimum permit fee ($72 50) 7.•
.50
Phone: (sTs ) )•=2.3 - C79 // Fax ( ,; 3 s _ _ ? 7
Plan review (25% of permit fee)
CCB lie.: -.,- '-,, .cg- State surcharge (8% of permit fee) 5 . KO
TOTAL PERMIT FEE 7. --)
A
A.77.. 1r ,.
This permit application expires if a permit is not obtained within 180
uthorized signature: -
days after it has been accepted as complete
•
Print name: Date: Fee methodology set by Tr-County Building Industry Service Board
),<.-- /7/.. ) VI/rdy
1 \ButldingTermits \MEC-PerrrutApp dot 12/03 440-46I7T (I I/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
T6tal \aluation 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 •
$50,0
$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:\BuildingWermits\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
� ness � � ODD6Z.
Received L3 7: Date Requested 5/ iC V AM PM BUP
Location • . : lid_ - i 1 / uite
ADD /t 1
Contact Person ' - ' a teGrtit,c - Ph ( . 20 "6 D / PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC •
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: / � ? y� _ SIT
Post & Beam e -C Q u-O --( - SD /)14.-lA.i�
Shear Anchors ,, -�(-
Ext Sheath/Shear J � "' ` d
Int Sheath/Shear
Framing ,�^ /
Insulation � I _ 4 � 1-6fi - 6L , 0 -� ,E / r � o t s 4 .ej A Drywall Nailing Jul ���Ylg
Firewall
Fire Sprinkler ��
Roof r.'r �✓ • v ' / / ) /0 // I/ d 8-g
•._.
CrIP III / M
PASS PART dir
PLUMBING ��✓✓
Post & Beam 3 e g/015 r1,b (r f a 0 0 0 - ! � , 1/ ^ _ / Lu� _ J Under Slab V 11 "� ta v Rough -In lA , l 1 L „ 1 n J
Water Service
Sanitary Sewer VA/t/V""C-
1'l/� M /tf'(/(K -�
V
Rain Drains a \ �_ Lg i2 0 O - loo O lg L 0w I
Catch Basin / Manhole /) `/
Storm Drain
Shower Pan
pt,,,„„24 do4- b 114 A i4
Other:
Final
PASS PART
MECHANICAL FAIL �,• ,1. it G ` - 1 �' e '1 UA Y 1 a i a eC (A)cy 4ei-
Post & Beam r
Rough -In
Gas Line
I ampers
_ ___ _ 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 ( � I
Approach/Sidewalk Date — ” Inspector �`�� I ' Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL