Permit CITY OF T MECHANICAL
PERMIT
^ 44, DEVELOPMEN SERVI P ERM I ISSUED: �D8 /1M -0289
PARCEL: 251O2CP -02300
SITE ADDRESS...: 13200 SW PACIFIC HWY
SUBDIVISION ° FREWINGS ORCHARD TRACTS ZONING: C —G
BLOCK LOT °008 JURISDICTION: TIG
CLASS OF WORK.. :ALT FLOOR FURN 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES 2 BOILERS /COMPRESSORS HOODS : 0
FUEL TYPES 0 -3 HP • 5 DOMES. INCIN: 0
:GAS 3 -15 HP 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP : 0 REPAIR UNITS: 0
FIRE DAMPERS?..: Y 30 -50 HP : 0 WOODSTOVES..: 0
GAS PRESSURE...: M 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.:17
FURN < 1O0K BTU: 7 <= 10000 cfm: 7 GAS OUTLETS.:11
FURN ) =1O0K BTU: 0 ) 10000 cfm: 0
Remarks : Commercial tenant improvement.
Owner: FEES
MILLIKAN MEDICAL CENTER type amount by date recpt
13200 SW PACIFIC HWY PRMT $ 195.50 DEB 08/12/98 98- 308205
TIGARD OR 97223 PLCK $ 48.88 DEB 08/12/98 98- 308205
SPCT $ 9.83 DEB 08/12/98 98- 308205
Phone #:
Contract or:
J & J MECHANICAL CONTRACTORS
14755 SE 82ND DR
$ 254.21 TOTAL
CLACKAMAS OR 97015
Phone #: 655 -2696
Reg #..: 001079
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Heating Lint Insp
approved plans. This permit will expire if work is not started Cooling Unt Insp
within 180 days of issuance, or if work is suspended for more Duct Inspection
than 180 days. ATTENTION: Oregon law requires you to follow rules S.D. Shut—down
adopted by the Oregon Utility Notification Center. Those rules are Misc. Inspection
set forth in OAR 952- 001 -0010 through OAR 952-001 -0080. You may Final Inspection
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue Permittee Si g nature:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
(�- Plan Check C
CITY OF TIGARD Mechanical Permit Application PQ Rec'd By
13125 SW HALL BLVD. CCOmmerci )d Residential Date Rec'd 7 I -
TIGARD, OR 97223 1� (0 Date to P.E. 7 c2 // cp.- Tfre
(503) 639 -4171, x304
Date to DST 1//7 /�y 7- r
Print or Type P q 037 Permit #, Ec �� -p078 ?
Called . ' - 8 OP . /
Incomplete or illegible applications will not be accepted gpe4,2,e, i' • , k_____.
N m�e De Description
IAA 1 v' I1t /J UAe/AI t Aii-- Table 1A Mechanical Code QTY PRICE AMT
Job Street Address . Suite# A) Permit Fee -0- -0- 10.00
Address tl'Z� '''',, II Pu-c U ` r6t is'1(l�i' i i
Bldg# Cty/State zip B) Supplemental Permit 3.00
- etatt-o v2 e t ' /223
Name (or n of business) 1) Furnace to 100,000 BTU
Owner IN LII{ A (2(1\1ak5 incl. ducts 8 vents -
00 ,4 'v
Mailing Address 2.) Furnace 100,000 BTU + 1 0
7.50
incl. ducts 8 vents
city/State Zip Phone 3.) Floor Furnace 6.00
incl. vent
Name (or name of business) 4.) Suspended heater, wall heater 6.00
or floor mounted heater
Occupant Mailing Address 5.) Vent not incl. in 3.00
appliance permit
City /state Zip Phone 6.) Boiler or comp, heat pump, air con / • 4 7 6.00 „ „
to 3 HP; absorp unit to 100K BTU 9 ■ • , ',a'J
174 ).... / 7.) Boiler or comp, heat pump, air con 11.00
; �C,}��fJl�f�t. �L7UtT_ lN/c. 3-15 HP; absorp unit to 500K BTU t
Contractor Mailing Address �p 8.) Boiler or comp, heat pump, air cond. 15.00
1 6 ✓G i Oa. 15-30 HP; absorp unit .5-1 and BTU
• Attach copy of City/State Zip Phone 9.) Boiler or comp, heat pump, air cond: 22.50
Current Licenses C'/Q ( ILe: WIG ,, S . /0(5 £ ?CA � 30-50 HP; absorp unit 1 -1.75 mil BTU
Oregon Connst. Cont. Board Licit Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
G / 1 Q'? - 1 1l 07 - fl > 50 HP; absorp unit 1.75 mil BTU
S COT Business Tax or Metro # ( Exp. Date 11.) Air handling unit to 4.50 �(�
Z' - -- 91 10.000 CFM 1 v
Architect [ 12.) Air handling unit 7.50
�� I/i ( i V 5vo rwi \j g 10,000 CTM +
or ailing Addre 13.) Non portable 4.50
3( et G t Ale evaporate cooler
Engineer City/State Zip Phone 14.) Vent fan connected 3.00
j P6O - f low( - to a single duct
Describe work New O Addition 0 Alteration 0 Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 Non - residential 0 included in appliance permit
Additional Description of work 16.) Hood served by mechanical exhaust 4.50
17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industnaltype 30.00
building or property incinerator
19.) Repair units • 4.50
Proposed use of 20) Woodstove . 4.50
building or property
21) Clothes dryer, etc. _ 4.50 ^
Type of fuel - oil 0 natural gas 0 LPG 0 electnc 0 22) Other units , f/ I 4.50 / 249
I he by acknowledge that I have read this application, that the 23) Gas piping one to four outlets , 7 S 2.00
info ation given is correct, that I am the owner or authorized agent of -
the ner, That la s bmitted are in compliance s / with Oregon State 24) More than 4 -per outlet (each) w $642 .50 ,S"°
la
Signa re of er /Agent //,�, Date QTY.SUBTOTAL
- Lk 01) ilk iii-IC & c 1/ ' 'SUBTOTA Ili . -,.
Contact Person Name Phone 5% SURCHARGE t n
PLAN REVIEW 25% OF SUBTOTAL 0
TOTAL 1. LI
i:\dst\rnechpmt.doc (rev 7/96) *Minimum permit fee is 525 + 5% surcharge
CITY OF TIGARD BUILDING INSPECTION DIVISION MS -U, 61 7_('.S
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP , S' C) `3,13
Date Requested I 1 D-' \ ° \9 AM PM BLD c v
Location f ,70-.0 C6 4—r Suite MEC / a ° Z c� -
7
tact Person � — Ph 3 D (o PLM
Contractor Ph SWR .
BUILDING Tenant/Owner ELC
Retaining Wall ELR J
Footing Access:,4,e� —,,,
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspectio Note . • Slab p i ! — —, O S" 1 6 SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear 3 7.E n TE --Q Q c?—°° 19
Framing U ,,,QJ _(
Insulation / /
Drywall Nailing 4).-e, ‘..eAsdileede, , ( I / i Q.-6,4.6
Firewall
Fire Sprinkler 444 AeLe `-
Fire Alarm / / r
Susp'd Ceiling _41 4 �! ' ` Jk 2 / - ' �' w
Roof
Misc:
• / ,� � /_ ' 3, / - /
PASS • FAIL — = //�� ��
PLUMB! , L-- U t r. - -°
Post & Beam 4
a"--
• - 1 - 4
Under Slab ot“) a ke.,-,-6L-e-A-p
Top Out ,
Water Service _� Se9-E 1-- _ _ 0 , „ -�
Sanitary Sewer �� 1 ; = // j
Rain Drains �� j . . ,-„, rr� , _
Final
PASS PART FAIL C� l c r 3 �' /
MECHANICAL / /
Post &Beam 4 `' 1;°J_, / � -'
Rough In 9, ` c� °�, „ �i ii • °l J / t 0/Le?
Gas Line -
Smoke Dampers VYLet , Q 2 -
4 , PART FAIL ,,,�
RICAL `� exr-rt) - .
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: [ ] Unable to inspect - no access
ADA
Other oach /Sidewalk Date J ■ ? ? Inspector a,-,..e._._ > Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job.site.