Permit CITY OF TIGARD
MECHANICAL PERMIT
;.r DEVELOPMENT SERVICES PERMIT #: MEC2001 -00261
° „� � ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/26/01
PARCEL: 25101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 400
SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 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: Tenant Improvement
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 7/26/01 $245.78 2720010000
PORTLAND, OR 97224 PLCK CTR 7/26/01 $61.45 2720010000
5PCT CTR 7/26/01 $17.26 2720010000
Phone: Total $324.49
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 233 -6911 Duct Inspection
Reg #: LIC 38868 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 - 001 -0080.
You may obtain opies of these les or direct questions to OUNC • callin• (503)246 -9189.
Issue B / � „ , , � t � Permittee Signature: , wry
Call (503) 639 -4175 by 7:00 P.M. for inspections neede. the net business day
. 1: (1°( � i t?,o 1 ,04 .
Ali Mechanical Permit Application
Date received: d Pe I.. Az -1:0 AC
),1;'Y:h City of Tigard Project/appl. no.: Expire date:
Add 13125 SW Hall Blvd, Tigard, OR 97223 �'�
City of Tigard Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 -. 3UPSo6/ -G pZCe / Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family It i enant improvement
❑ New construction 0 Addition/alteration /replacement 0 Other: `
•
JO11 SITE INFORNIATION COMMERCIAL VALUATION SCHEDULE
Job address: ' 96 c7 SW' �R�'h �,0 i WA/ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: / I Suite no.: 00 value of all mechanical materials, equipment, labor, overhead, -.k'
Tax map /tax lot/account no.: profit. Value $ /OO 00 <5
Lot: ii { ', il . 'Block: I Subdivision: *See checklist for important application information and
Project n. e: AJ/ry L'! / 46.04 OA/ jurisdiction's fee schedule for residential permit fee.
City /county: Ti ,e ,t) IZIP: 1 & 2FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location tion of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENi'SCHEDULE
Q5 LvATE,c. 5 Celery c 4T P,,,,iP5 r/ 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 conditione Y es 1:1 No
Air conditioning (site plan required)
Is existing space insulated ?.es ❑ No Alteration of existing HVAC system
1%1ECIIANICAL CONTRACTOR Boiler /compressors 1
Business name: L •Nc State boiler permit no.:
/�/�d TL�li1P �S.SO HP Tons BTU /H
;
Address: F 7 ti c G Fire/smoke dampers/duct smoke detectors
City: /"?/X... p..0 , p I State, I ZIP: g --7,Q . 3.2 Heat pump (site plan required) `\
Phone:0/ 3 ,.�9// 1 Faxa3g E - mail:
Install/replace BTU /H lit
CCB no.: Including ductwork/vent liner 0 Yes 0 No
3 v. £Ss" C - Install/replace/relocate heaters - suspended,
City/metro lic. no.: `l'5.--5'4„ wall, or floor mounted
Name (please print): QIP7 v,,, j Vent for a liance other than furnace
e era on:
Absorption units BTU/H
Name: �,�,€�;•�rl`/ Atiz 1 II ► l pp e ressots HP
Address: Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
Hoods, Type U IUres. kitchen/hazmat
hood fire suppression system
Name: /��t -- -7. Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E - mail: Fuel i ing each additional over 4 outlets
p (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: 1 State: I ZIP: Insert- type
Phone: • : E -mail: Woodstove/pelletstove
Other:
Applicant's signature. _ A ki4pIr . Date: 7 / - iG "'Aber: w . 106 , Qe , . d.--A7- sit
Name (print): ,,, ',b .." a-' .
Not all jurisdictions accept credit cards, please call jurisdiction for most information' Permit fee $
O Visa ❑MasterCard Not Th perm appl Minimum fee $
expires if a permit is not obtained Plan review at % (�j� _
Credit card number: Expires h
wi thin 18 0 days after it has bee ( ) $
State surc harge (8%) .... $ �
Name of cardholder as shown on credit card accepted as complete. '1
TOTAL $
$
Cardholder signature Amount , 440-4617 (6 0/COM)
MECHANICAL PERMIT FEES t .. -,,,
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: 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) Furnace 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 induding vent 14.00
fraction thereof, to and induding 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. 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 or Pump Cond •
fraction thereof. footnotes below. Comp **
7) <3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00
8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9) 15-30 HP; absorb
Fumace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00
ducts & vents 10) 30 -50 HP; absorb
Fumace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
ducts & vents 11) >50HP: absorb
Floor fumace induding vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not included in applicance 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct
3-15 hp; absorb. unit, 1,700 6.80
101k to 500k BTU 16) Ventilation system not included in
15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30 -50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU 18) Domestic incinerators
>50 hp; absorb. unit, 5. 17.40
>1.75 mil. BTU 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, induding wood stoves
Non - portable evaporate cooler 656 10.00
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $
Commercial or industrial incinerator 4,590
Other unit, induding wood stoves, 656 8% State Surcharge . $
inserts, etc.
Gas piping 1-4 outlets - 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: • ' $
VALUATION: 1(p
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
•
3. Additional plan review required by changes, additions or revisions to plans (minimum
charge-one-half hour) $72.50 per hour
•
* State Contractor Boller Certification required for units >200k BTU.
. * "Resldental A/C requires site plan showing placement of unit
iAdsts\formsknech- fees.doc 10/11/00
SETTING THE STANDARD FOR SERVICE EXCELLENCE
Facsimile
A PI' ehill
To: Jeremy Hunt
Company: ProTemp Association
Phone: 503 - 233-6911
Fax: 503- 238 -9767
From: Robert Poskin, CET, CBO, Senior Plans Examiner
Company: City of Tigard
Phone: (503) 639-4171 X 392
Fax: (503) 684-7297
Date: July 20, 2001
Pages including this page: 1
RE: NW Evaluation —12909 SW 68'" - MEC 2001 -00261
Jeremy:
Your plans for the Mechanical Improvements to the subject address have been reviewed; the following requires your
attention:
I presume the units will be hung from the pan deck above. The decks above are all one -hour and sprayed with
fireproofing. Two things will be required for inspections purposes, (a) The suspended ceiling grid if installed prior to your
work must be open for the inspectors visual, and (b) all areas where fireproofing has been scraped from the deck will
require the voids to be hand packed with said fireproofing.
If you have questions, please call me.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
244lour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 — �'� AM PM BLD
Location l a- 6 / O f 6 5 4 ' Pkw Suite 3O /'/OU MEC X00 ( ° U -2- Q(
Contact Person Ph 57 - PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall. Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:•
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
PART FAIL
"IliSTRICAL •
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA /
Approach/Sidewalk Date �` 91 `� Inspector 44,-. Ext
Other
Final kz,
PASS PART FAIL DO NOT REMOVE kills inspection record from the job site.
CITY Of TIGARD BUILDING INSPECTION DIVISION MST
24;Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ( ,../
BUP
Date Requested 2-7 AM PM
Location /a35=04 1'2 a S ( 3 p Suite 3D 0A/0 C) p / j d a(Ql
Contact Person �f�1 Ph 2 - 3 c 1 L PLM
Contractor U Ph — ,rte SWR
BUILDING Tenant/Owner w �� r,Q 0�� 1! 4 ELC
Retaining Wall • ELR
- Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear ' I f -
Framing -tv� • A. —.it v -A N- -■ —
Insulation w� —i A D all Nailing �
Firewall
Fire Sprinkler \ /►.�_ l , l R•• 5 6
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Bea
oug
Ga Line
Smoke Dampers
F
PART FAIL
RICAL
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 C O - 2 - : - ) 1 Approach /Sidewalk Date o G ? _- h 1 Inspector ` Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection reco _�f e Ar
"IIT1 TIGARD BUILDING INSPECTION DIVISION
Business Inspection Line: 639 -4175 Business Line: 639 -417 ST
BUP
Date Requested 7 — Z I AM PM BLD
Location 1D-90 6 ` rk� ult L 'zQ MEC -Ud ( 00 0--(0
3
0
Contact Person Ph - PLM
Contractor pi) i) \ vim Ph 2-3 3 C ` (( SWR
BUILDING Tenant/Owner � t ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notest a C) lA ' S
Slab SIT
Post &Beam r�Y' i _ _ l
Ext Sheath/Shear -F/'�' /
Int Framing th/Shear 1! / , ■ ,� _ n s
Insulation
v`I -- C nn :�4�
Drywall Nailing �-x c
Firewall � n
Fire Sprinkler 0". e � `�-�V1 5 t ,Q L
Fire Alarm
Susp'd Ceiling
Roof 2) , p �$-
,t(.3, ' ; _ �/�/1 lN\ Q�QA/ t
Misc:
Final %- L L JZ
PASS PART FAIL
PLUMBING r _ l
Post & Beam \� / .
I
Under Slab , ,(k, IA l 1 4-'-P C 7 ` A �� s k.....," Top Out V / Q� p f
Water Service �(iv ∎:44- __ c A W ` C -.ef L..,J 0 -e/ ,.
Sanitary Sewer ff '__
Rain Drains 1..•Q_S.
Final
PASS PART FAIL
MECHANICAL 1.1 +7 �Q „ e eK l
Post & Beam '�' U D "� C
&MP, c -r ,
Gas Line
Smoke Dam
Fi -� �. = - . �_ _ . "��S ,�
PASS MP FAIL `j p 2.-it-
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm ` al 1 I
i/ .... — - - 1 -46. •
Final
PASS PART FAIL 1 1 - S c!../ C $ '
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA 5‘)-121/1 1 1
Approach/Sidewalk Date 6 Inspector Ext3
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.