Permit (128) - CITY OF TIGARD MECHANICAL
�aV, , -,: \ DEVELOPMENT SERVICES PERMIT
� I� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # - MEC 97 -0359
DATE ISSUED: 10/29/97
PARCEL: 2S115BA -00101
SITE ADDRESS...: 16200 SW PACIFIC HWY #X
SUBDIVISION ZONING: C -G
BLOCK LOT .............: JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN - 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:M VENTS W/0 APPL: 2 VENT SYSTEMS: 0
STORIES • 1 BOILERS /COMPRESSORS HOODS - 0
FUEL TYPES. 0 -3 HP....: 0 DOMES. INCIN: 0
3 -15 HP : 0 COMML. INCIN: 0
MAX INPUT: 60000 BTU 15 -30 HP : 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP : 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP....: 0 CLO DRYERS.. : 0
NO. OF UNITS -• -- AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN ) =100K BTU: 0 > 10000 cfm: 6
Remarks: Marshalls tenant improvement
Owner: -- --------------- - -- FEES --
CAPITAL /BIT HOLDINGS TWELVE IN type amount by date recpt
C/O FORUM PROPERTIES PRMT $ 61.00 JSD 10/28/97 97- 300455
8705 SW NIMBUS PLCK $ 15.25 JSD 10/28/97 97- 300455
BEAVERTON OR 97005 5PCT $ 3.05 JSD 10/28/97 97- 300455
Phone #_
Contractor: - - -- - --
GENERAL SHEET METAL WORKS INC
11231 SE HWY 212 -- -- -- -- - - --
$ 79.30 TOTAL
CLACKAMAS OR 97015
Phone #:
Reg #..: 000401
•- REQUIRED INSPECTIONS -- - - - - --
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other S. D. Shut-down
applicable laws. All work will be done in accordance with Final I n s p e c t i o n
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 by 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 these rules or direct questions to OUNC by calling - _
(503)246 -9187.
4' - _ ,
-......,,,.....,__.: C/ I
Issue By: - Permittee Signati-t e• _A
+ + + ++ ++ + + ++ +-I ++++++++++++++++++++++ + + + + ++ + ++++ + + + + + + + + + ++ + + ++ + + ++ •+ + + + ++ ++ +++ ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++++ + + + +-I--1 + + + + ++ + + + ++ + + + + + + + + + ++
Plan Check # ■/' C.'
CITY OF TIGARD Mechanical Permit Application Recd By_
13125 SW HALL BLVD. Commercial and Residential Date Recd D - .'--
TIGAcRD, OR 97223 Date to P.E. r7 9z597---
(503) 639 -4171, x304 // Date to DST 1 0 4 2- 4 17
rit - 1 to Print or Type Permit # M CC- q7 -- 0%1
e? Called / �� 1 fro ,� k'
l �° Incomplete or illegible applications will not be accepted �,
Name of Development! Pro Description
///4, /y Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Surma A) Permit Fee -0- -0- ' 10.00
Address /62oz., 5�l/ u// i /
Digit CltylState A Zi 1.) Furnace to 100,000 BTU 6.00
/ A /P. 9772' including ducts & vents
Name (or name of Du ' 2.) Furnace 100,000 BTU+ • 7.50
Owner & _ / a including ducts & vents
Mailing Address / 3.) Floor Furnace 6.00
? 'Y �ti ce al SrL' 21 including vent
9y/State Zip Phone 4.) Suspended heater, wall heater 6.00
. y7 � yi /^C, .a 7 fr / or floor mounted heater
Name (or name of2siness) 5.) Vent not included in appliance permit 3.00
�v
OCCUpant Ad dre l J � 6.) Boiler or comp, heat pump, air cond. 6.00
�a li; c,4 vu to 3 HP: absorb unit to 100K BUT
, � City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
/r., .; t - /77ij Uf 7f)j 3-15 HP; absorb unit to 500K BTU"
Contractor Na , , 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to /g e71,/,..-/4 � 15-30 HP; absorb unit5-1 mil BTU"
issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant /7.3/ ` S` / S/, 2/ 2 30-50 HP; absorb unit 1- 1.75mil BTU
must provide all Ctty/state' Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor Zl 1, 976/ 6 .--eibY > 50 HP; absorb unit 1.75 mil BTU"
license Oregon Const Cont. Board licit Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
information if y
expired in /�/7C2 /� / �
COT COT Business Tax or Metro o Exp. ate 12.) Air handling unit 10,000 CFM 7.50
database).
Architect tgarne / ,/ 13.) Non - portable evaporate cooler 4.50
4'y�i l7G
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer �/S�e _ // y �� Zip _- AAene- 15.) Ventilation system not included in 4.50
C f�f�lf.A hurt, // /6e D /77/ _ appliance permit
Describe work New 0 Adsiitlon 0 Alteration f 11 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non- residential,t
Additional Description of work 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
i9c.L�i `7 i 57ep -i ��.7 ` 4 i Incinerator
Existing use p 19.) Repair units 4.50'
building or property
20.) Wood stove 4.50 "
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas,Q' LPG 0 electric, 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of Owner /Agent Date SUBTOTAL ,
(
4 p /i/ 9 _ G2 -_ ?2 5% SURCHARGE - "Contact Person N - Phone / PLAN REVIEW 25% OF SUBTOTAL 2.
!� i �f, �O 3 / xie9 TOTA 3 Y%tc �a / �� J .yl�a (i_c_e
Odin mechpmtdoc ( - Minimum permit fee is $25 + 5% surcharge
-" ; g 22/‘
"Residential NC requires s' e plan showing placement of unit.
Ch_ .10 "--
6/30/99 Activities for Case #: MEC97 -00359 •
4:44:06 PM
Assigned Hold Updated •
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 9/22/97 JSD PASS JD 9/25/97
MECC008 Permit created 9/25/97 JSD PASS JD 9/25/97
MECC011 Routed to Plans Examiner 9/25/97 JSD PASS JD 9/25/97
MECC015 Reviewed Plans Routed to DSTS 10/22/97 RDP APPR RDP 10/22/97
MECC706 Mechanical lnsp 10/22/97 10/29/97 TLP PASS J *H 10/29/97
MECC745 S.D. Shut -down 10/22/97 11/12/97 TLP PASS J *H 11/12/97 •
MECC799 Final Inspection 10/22/97 - 11/12/97 TLP PASS J *H 11/12/97 This permit for work also in
space X. Check plans, they
• may have included or combined
both spaces.
MECC016 DST Post - Review Completed 10/23/97 JSD PASS JD 10/23/97
MECCO50 (F) Ready to issue 10/23/97 JSD PASS JD 10/23/97
MECC090 (F) Issue permit 10129(97 JSD PASS JD 10/29/97
MECC735 Duct Inspection 10/29/97 TLP PASS J *H 10/29/97
MECC800 Case Finaled 11/12/97 TLP PASS J *H 11/12/97
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