Permit (207) CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2003 -00391
��I� DEVELOPMENT H BMENg Tigard, ) 639 -4171 DATE ISSUED: 2/17/04
PARCEL: 2S 115AB -01900
SITE ADDRESS: 16200 SW PACIFIC HWY A
SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: A3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 2 BOILERS /COMPRESSORS HOODS: 2
FUEL TYPES 0 - 3 HP: 3 DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 1,964,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: 8 GAS OUTLETS: 14
> 10000 cfm:
Remarks: Mechanical work to convert day care facility to buffet restaurant. Value $10,418.00
1/15/04, Revised project value to $22,418, cooking units to include: (1) 8 burner wok, (4) deep fryers, (1) smoker,
(1) oven, (2) rice cookers, (1) grill/BBQ.
Owner: FEES
BIT HOLDINGS LTD PARTNERSHIP Description Date Amount
BY FORUM PROPERTIES INC [MECPLN] Plan Rev 2/17/04 $39.00
FIVE CENTERPOINTE DR STE 290
LAKE OSWEGO, OR 97035 [TAX] 8% StateTax 2/17/04 $12.48
[MECH] Permit Fee 2/17/04 $156.00
Phone: [MECH] Investigation Fe 2/17/04 $156.00
Contractor: [MECH] Permit Fee 2/17/04 $17.55
[TAX] 8% State Surchaq 2/17/04 $1.41
NW EAGLE MANAGEMENT CO INC (additional fees not shown here)
PO BOX 764 Total $401.22
SHERWOOD, OR 97140 REQUIRED INSPECTIONS
Phone: 503 - 516 - 8808 Gas Line Insp
Mechanical Insp
Reg #: LIC 146090 Hood Inspection
Fire Suppr Insp
Duct Inspection
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, St: of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with a • .ved
plans. This permit will expire if work is not started within 180 days . • uance, or if work i.uspended
for more than 180 days. ATTENTION: Oregon law requires yo o folio rules adopted e Oregon
Utility Notification Center. Those rules are set forth in OAR 95 -001-0010 through OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions . OUNC by c -. ng
(503)246 - 669 ,
Issued By: tGZ��= t,G� Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the • usiness day
7/08 3 18:23 FAX 12122748889 X0 7
��LOB PAC ,c //coy \
' . \ 1 \ -(\ \ 0 '
MechanicalPennit ( ,I I( I I ,,I r I.1
Date received 7 e 03 Permit no.:Plkejea--0039/ • ! ji
.4 (.' _ 1 City of Tigard � ED Ptoject/appL no.: (Si date:
CinofTigard Address: 13135 SW Hall Blvd, Tigard. OR � Dale i ssued: Reeerpt t:o.:
Phone: (503) 639 -4171 g 2 {`-
Fax: (503) 598 -1960 Case file no.: Payment type:
CITY OFT ARA Building perm Do.:
Land use approval: I� ljii.pii�i� C1 �IST 4,
I 1 I'I 111 PI IOW
F
0 1 & 2 family dwelling or accessory 3 Commercial/industrial 0 Multi - family A Tenant improvement
0 New construction 3 Addit ion /alteration/replacement 0 Other
lob address: It 20D sw PACT Ftc 1-F W Y lit- Indicate equipment quantities in boxes below. indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead.
Tax map /tax lot/account no.: profit. Value $
Lot: IBlock: I Subdivision: *Sec checklist for important application information and 7
Project name: TIN TIN Big F ET jurisdiction's fee schedule for residential permit fee.
City /county: TI FpA R D ( ZIP: I s 2 F.11111.1 1.)11 ri I\(: x1.12111 I 1 1 1. ' ( 1111)1 1 ,Eo
Description and location of work on premises: 1 \ D ( ()NMI : I t I ( \I .11\1A s I R I 1 I . I . Q1 I P N I I . NI `1( 111 1)1 I .I .
■ A : a .! . ► • : • ■ — I • V E . • : ES ' - . Fee (ea.) 'redid
Est. date of completion/inspection: ysOO Qty. Res. ouly Rat -ody
Tenant improvement or change of use: HVAC:
Air handling unit kQt7 CFM — 1
Is existing space heated or conditioned? 3 Yes 0 No Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
N11.(11 % \I( 1L (O\ I R 1(1 ()It Boiler /compressors
���� State boiler permit no.:
.
Business ' , "e: �i jc� L r(Z- 41 HP Tons BTU/H
• Address: 0 ,,x 114 • Fire/smoke dampers/duct smoke detectors
CITY: /.f•Sil - 1 ) j 5 I State:dlL I ZIP: 97/%2 Heat pump (site plan required)
Phone: 506 - 54-$$C I Fax: I E -mail: install/replace firnace/burner BTU/H
Including ductwork/vent liner Cl Yes 0 No
CCB no.: iii6G90 Install/replacdrelocate heaters - suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent far appliance other than furnace
Refrigerant
(/) \ 11(. I I' 1. H S O \ Absorption units BTU /H ,
Name: RITA LAN Chillers �jy HP
Compressors 19- HP 3
Address:
$1� 'aN FI L ST • E�uonewl cannot and veraiIatiom
City: NEW -fog I State: NY I ZIP: 10002 Appliance vent
jje:jjjj exhaust
Hoods. ype Wtes. tc eo/hazrnat 2
hood fire suppression system
Name: JANES CAM Exhaust fan with single duct (bath fans)
Mailingaddress: ( a JE IA2r�to VE (1E Exhaust from healing or AC r_
?.Z 3 Pe ii and dlahibntio0 outlets)
City: &Re slot( State: OR• IZIP: qqa Type : LPG ✓ NG (up to 4 oil ,
Phone: Fax. E-mail: Fuel pipi4 each additional 4 outlets
Process img (schematic required) .
Number of outlets /O
Name: I(( fills Assoc/ AT es: lA NI R s h CE Pt SC I►E R purer listed millrace or equipment
Address: D4 l NA L ST. Decorative fireplace
City: NE•W Yoe IC I State: 1,3y I ZIP: 10002 Insert - type
Phone: Fax ' Woodstovefpellet stove �—
71.22� �3� :21Z2�F8$i E-mail: 4 Other
Applicant's signature. I Date: r /x /ct3 ocher:
Name (print): RITA LRM
Nal all jurisdictions accept aedir cords, plane an junsaicdm far mart mformanae. Permit fee S
Notice: This pe application Minimum fee $
Viw _ rt expires if a permit is an obtained Plan review (at %) S
cream a tom • _ ' _ _ w ithin 180 days attar it has been o ) .... $
`s A • . ` 0.: ` - xpnrza y State surcharge (8 /o
� / r as ••w,r an _.„ • accepted as complete. TOTAL
f
���� ��- . n- Amount 440-4617 (emtlrc!]M)
CITY OF TIGARD 24 -Hour `
BUILDING Inspectio �. 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 ST
404 // , 3 zP
Received (p 7- Date Requested 4 3 XIAM PM BUP
Location /011) /Jd # s ic Suite E _ A 1 — On
� G/ —
Contact Person Ph (3 �ZD f �d � PLM Cr), � �
Contractor 7 ( ) • SWR
BUILDING Tenant/Owner l in / / fi ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: II � ^^ ,L, . SIT
Post & Beam PU CL.�.f>f' e.1), e%ffll/'C .�?/I
Shear Anchors , / _ ,
Ext Sheath/Shear l`�'T/
Int Sheath/Shear
Framing
Insulation W; Cam �r - - `, -- l `J`-1L
,
Drywall Nailing �C U v�
Firewall r�� (� ` (
Fire Sprinkler C�1 � � � ' �`
Fire Alarm c am. � 8
Susp'd Ceiling ��
Roof is _.,5 •
Other: \
Fina 4i
P` PART FAIL
:J BING
Post & Beam
Under Slab
li C1114 11 111 ; 0• 115 060 / 141 °
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PA AR FAIL
Post & Beam
Rough -In
Gas Line
�S Dampers
PART FAIL
E CTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire ADA Line , L3 /a ! I /e
Approach/Sidewalk Date Inspector -
Other:
Final DO NOT - REMOVE this inspection record from the job site.
PASS PART FAIL
•