Permit (71) A CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2005 -00106
DEVELOPMENT SERVICES DATE ISSUED: 3/14/2005
13125 SW Hall Blvd., Tigard, OR 23 503 - 639 -4171 PARCEL: 2S115BA -02500
SITE ADDRESS: 16200 SW PACIFIC HWY W» ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUAR• LOT: 001 JURISDICTION: TIG
Project Description: Relocate registers and add gas line for new tenant. Project Value: $1,500
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
SN INVESTMENT PROPERTIES Description Date Amount
1 121 SW SALMON STE 400 [MECH] Permit Fee 3/14/200f. $72.50
PORTLAND, OR 97205 [TAX] 8% State Surchar€ 3/14/200f. $5.80
Phone: 503 242 - 2900 Total $78.30
Contractor:
WILLAMETTE HVAC SERVICE
PO BOX 23334 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
Phone: 628 - 6841
Reg #: LIC 56951
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 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by cal hg 503 - 246 -6699
or 1- 800 -33 - -
Issued B : � .4 • Permittee Signature: A
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
+ Received
City of Tigard Date/By: de 1 d i PermitNo.: fir S 75/0,6
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 / /rids - , Date/By:
Inspection Line: 503.639.4175 i lit Date Ready/By: El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
' TYPE OF WORK
• , COMiMERCIA1 FEE *,:SCHEDUL = USE CHEC
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ ,r arj �'
RESIDENTIAL EQUIPMENT / S
FS*
1:: 1 and 2 family dwelling Commercial /industrial ❑ Accessory building '
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
• JOB SITE INFORMATION AND LOCATION - ,. - ' Heating/cooling
Air conditioning or heat pump
Job site address: .0/P-4 / a G' t'Ct G 17 L.t./>. (requires site plan showing placement) 14.00
City/ State/ZIP: / Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: /O Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
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
Subdivision: Lot no.: Flue /vent for any of above 10.00
• Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
e /p C- cZ'Z!'ti 1 C 5,7 %e« s Flue vent for water heater or gas
/ r , C.,-=.• 5 fireplace 10.00
` `�� Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER Chimney/liner/flue/vent 10.00
❑ TENANT
Other: , 10.00
Name: W E W 6 fps -7�s Environmental exhaust and ventilation
Address: a g +� 5,1-1j10 a L i(0 O Range hood /other kitchen
equipment 10.00
City/ State/ZIP: D ca 7ao5 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (5 2- aIQc) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON • Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace _
E -mail: Range
CONTRACTOR _Barbecue _
_A 7/ e../.6.1._ / J/ � Clothes dryer (gas)
�
Business name: a z!/ c� Other:
Address: j""p / 3v A, 3 3 '3 y MECHANICAL PERMIT FEES* .i '_ = -'' •' • .r;
City/ State/ZIP: ,,. Q C.A.∎ 6 1'7 ,2 'a[ Subtotal
Phone: ( ) !J 0. Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 3 G Q s- State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This p ermit a expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ,--Pl�( /..e, s✓ ,{ Date: • Fee methodology set by Tri- County Building Industry Service Board
i:\ BuildingTem ,its\MEC- PermitApp.doc 12/03 440 -46177 (11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard •
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: 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
$50,000.00.
$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:\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY-OF TIGARD
BUILDING DIVISION PERMIT #: MEC200500106
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2005
Phone: (503) 639- 4171 h
Inspection Requests (24 Hrs.): (503) 639 -4175 -' `'I
INSPECTION WORKSHEET FOR DATE: 4/13/2005 TIME: 7:10AM PAGE: 73
SITE ADDRESS: 16200 SW PACIFIC HWY W2 CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: CHRISTIAN BOOK CENTER
DESCRIPTION: Relocate registers and add gas line for new tenant. Project Value: $1,500
OWNER: SN INVESTMENT PROPERTIES, PHONE #: 503- 242 -2900
CONTRACTOR: WILLAMETTE HVAC SERVICE PHONE #: 628 -6841
Inspection Request Scheduled For: Date: 4/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 004389-01 503. 8054408 N
Corrections /Comments /Instructions:
■
I
I
A i (
I ( P a . gm
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO■ AL FE S ASSESSED
Inspector: MEN Date: � _ e5Phone #: (503) 718 -
iW '
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MEC2005"00106
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 3/14 /2005
Phone: (503) 639 -4171 /�i � ro+Q4 �'41h It
Inspection Requests (24 Hrs.): (503) 639 - 4175 ` I
INSPECTION WORKSHEET FOR DATE: 3/22/2005 TIME: 7 :13AM PAGE: 58
SITE ADDRESS: 16200 SW PACIFIC HWY W CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Relocate registers and add gas line for new tenant. Project Value: $1,500
OWNER: SN INVESTMENT PROPERTIES, PHONE #: 503.242-2800
CONTRACTOR: WILLAMETTE HVAC SERVICE PHONE #: 628 -6841
Inspection Request Scheduled For: Date: 3/22/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 002426 -01 503 - 805.4408 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date Phone #: (503) 718-
CITY OF TIGARD - -
BUILDING- DIVISION PERMIT #: 1MEC2005.00106
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/14/2005
Phone: (503) 639 -4171 .�
Inspection Requests (24 Hrs.): (503) 639 -4175 „..I4- 11.
INSPECTION WORKSHEET FOR DATE: 3/17/2005 TIME: 7:13AM PAGE: 5
SITE ADDRESS: 16200 SW PACIFIC HWY W CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Relocate registers and add gas line for new tenant. Project Value: $1,500
OWNER: SN INVESTMENT PROPERTIES, PHONE #: 503 - 242 -2900
CONTRACTOR: WILLAMETTE HVAC SERVICE PHONE #: 628 -6841
Inspection Request Scheduled For: Date: 3/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 002112 -01 503.957 -3348 N
Corrections/Comments/Instructions:
(err 1 ) tI -i3)
� l �
,..ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 414 Date: g Phone #: (503) 718-