Permit ' C1TY OF TIGARD MECHANICAL PERMIT
4 '* 01 DEVELOPMENT SERVICES PERMIT #: MEC2002 -00398
" x " 13125 S W Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/8/02
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 400
SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE
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: 0 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 OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: 8 water heat pumps
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 10/8/02 $112.63
PORTLAND, OR 97224 [MECH] Permit Fee 10/8/02 $0.00
[MECPLN] Plan Rev 10/8/02 $28.16
Phone: [MECPLN] Plan Rev 10/8/02 $0.00
[TAX] 8% StateTax 10/8/02 $9.01
Contractor: [TAX] 8% StateTax 10/8/02 $0.00
PROTEMP ASSOCIATES INC Total $149.80
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 233 - 6911
Mechanical Insp
Reg #: 38868 Mechanical Insp
Final Inspection
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 - 1=0100: - Y9u may obtain copies of these rules or direct questio s to OU , by calling
(503 246 -6 99. • � 9
Issue By: I Q,� �' Permittee Signature: P„
Call ( 6 9-4175 by 7:00 P.M. for inspections needed the.nei�t business day
1\
. RP
' Mechanical Permit Application
.••. Date received: of 0 2- Permit no.4g Ga00;" 00 qi
4 4= '" ti �� ' ► ;,. City of Tigard - ., _.
'� tiw • k.�,, Project/appl.no.: Expire date:
Add 13125 SW Hall Blvd ta k 9 223
City of Tigard _ Date issued: By: ( Receipt no.:
Phone: (503) 639 -4171 O
Fax: (503) 598 -1960 SEP 0 9 2002 Case file no.: Payment type: 1
Land use approval: ��I It ( :� d {�. r r Building permit no.:
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family . Tenant improvement
O New construction 0 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCIIEDULE
Job address: /ag0q s eg, 8 rh pojej .w4fy 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 $ ,Qye04
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name:,, Nt4ut rr ro./ jurisdiction's fee schedule for residential permit fee.
City /county: T A, it. p I ZIP: q7 1 & 2 FAMILY DWELLING PERMIT FEE SCI1EDULE
Description and Ideation of work on premises: a4r6t 7178d.tit LF AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE
#p r & /ptie . r w sit a, Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res.only
Tenant improvement or change of use: HVAC:
Air handling unit CFM
Is existing space heated or conditioned? Yes ❑ No
Air conditioning (site plan required)
Is existing space insulated? • . es 0 o Alteration of existing HVAC system
•,';,. MECIIANICAL CONTRACTOR Boiler /compressors
Business 7 State boiler permit no.:
usiness name:
/ �ror,"a /a save_ HP Tons BTU /H
Address: S er 7 ,c.i caic.ay Fire/smoke dampers/duct smoke detectors
City: . - State: ZIP: 7,2 Heat pump (site plan required)
Phonea534 e.ar i t Fax S — 7,4-t E - mail: Instal replace furnace /burner BTU /H
Including ductwork/vent liner CI Yes O No —
CCB no.: 3 a R ti. a Install /replace/relocateheaters— suspended,
City /metro lic. no.: 41$ i wall, or floor mounted
Name (please print): ea "7 Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
. . Absorption units BTU/H
Name: ✓z •y i,T Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone .4.9 / / Fax: E -mail: Dryer exhaust
OWNER Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: IZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace ,
City: I State: I ZIP: Insert - type
Phone: Fax: 1 E -mail: Woodstove/pelletstove
Other:
Applicant's signatu I Datetj_ Other. .
Name (print): .t,,o 4 ,'r
Permit fee $ //2. 4,3
'Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
0 Visa ❑ MasterCard Minimum fee $
/ expires if a permit is not obtained Plan review (at _ %) $ Z ' /Go
Credit card number: within 180 days after it has been
Expires accepted complete.
State surcharge (8 %) .... $ ' b
a cre as com
Name of cardholder as shown on credit card $ p p TOTAL $
Cardholder signature Amount , 440 -4617 (6✓00/COM)
i
MECHANICAL PERMIT FEES t
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: . PERMIT FEE:. Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code QtY (Ea) Amt .
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1.) Fumace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Fumace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Fumace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 0 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: - Boiler Heat Air
$1.20 for each additional $100.00 or For items 7-11,-see C Pump Cond
fraction thereof. footnotes below. m p
Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit
to 100K BTU 14.00
8% State Surcharge $ 8) 3-15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb 35.00
Required for ALL commercial permits only unit .5 1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU
11) >50HP; absorb
unit >1.75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12) Air handling unit to 10,000 CFM
10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) Amount 17.20
Fumace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Fumace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct
ducts & vents 6.80
Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater 17) Hood served by mechanical exhaust
Vent not included in appliance 445 10.00
permit 18) Domestic incinerators
Repair units _ 805 17.40
< 3 hp; absorb. unit, Q 955 7 � 19) Commercial or industrial type incinerato • to 100k BTU U /� 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101k to 500k BTU 10.00
15 -30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
mil. BTU 5.40
30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each)
1 -1.75 mil. BTU 1.00
>50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $
>1.1. 75 mil. BTU .
Air handling unit to 10,000 cfm 656 8% State Surcharge $
Air handling unit >10,000 cfm 1,170 •
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not included in 656
appliance permit •
Hood served by mechanical exhaust 656 Other Inspections and Fees:
Domestic incinerator 1,170 1. Inspections outside of normal business hours (minimum charge -two hours)
$62.50 per hour.
Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
Other unit, including wood stoves, 656 $62.50 pet hour
inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum
Gas piping 1 - 4 outlets 360 charge -one -half hour) $62.50 per hour
Each additional outlet 63 *State Contractor Boiler Certification required for units >200k BTU.
TOTAL COMMERCIAL - **Residential NC requires site plan showing placement of unit.
VALUATION: ni, All New Commercial Buildings require 2 sets of plans.
i:\dsts\forms\rnech- fees.doc 02/11/02
I
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
_ ; BUP
Received --- :: = Date Requested i /D- AM PM BUP
Location i c- C l 0 9 C et, f kyr Suite ' MEC 2 " d v-3
Contact Person Ph ( ) , 7- 4, /''' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC Vtif)
Ftg Drain
Crawl Drain
Slab Inspection Notes F SIT
Post & Beam , �.d . -- �1 .., _ :- .�.
Shear Anchors ����itt,' a.
Ext Sheath/Shear % .o! %i�_:ii; :
Int Sheath/Shear %
if
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL m
PLUMBING b W II nit- k mac+ Ine .. et 1 5'
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer a I IL- - - DO1 /
Rain Drains C�
Catch Basin / Manhole , v O
Storm Drain L V
Shower Pan v 3
Other:
Final
PA FAIL
Post & Beam /
.. •. -In
Gas Line
Smo e Dampers
n 111 PART FAIL
ELECTRICAL
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 El Please call for reinsp tion RE: ❑ Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk Date � v '‘N--) Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL