Permit C ITY OF TIGARD MECHANICAL PERMIT
Nov ELOPMENT SERVICES PERMIT #: MEC2005 -00261
''I I - ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/20/2005
PARCEL: 25101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 500 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: HVAC Value: $6968.00
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: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 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:
Owner: FEES
TIGARD TRIANGLE I LLC Description Date Amount
4650 SW MACADAM AVE STE 220 [MECH] Permit Fee 5/20/200f. $177.50
PORTLAND, OR 97201 [MECPLN] Plan Rev 5/20/200f. $44.37
[TAX] 8% State Surchar€ 5/20/200: $14.20
Phone: Total $236.07
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST, STE. 1 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Phone: 503- 239 -4600
Reg #: LIC 33135
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 calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By:
/ Permittee Signature G � nci C f
� .
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.
i . /.,U /J ^0 /
Me .al Permit Application FOR OFFICE USE ONLY
City of Ti and Received
` g E I V E® DDate/By: , V (6 Pernut No. 0 &........ 40 5 .0Do) (O/
13125 5 SW Hall Blvd., Tigard t Plan Review .
Phone: 503.639.4171 Fax: 513. / : f ,: ; ri Date/By: Other Pernut:
Inspection Line: 503.639.4175 ,�I,4. IA I Date Ready/13y: Mill ® See Page 2 for
Internet: www.ci.tigard.or.us MAY F 0 2005 Notified/Method: Supplemental Information
} /
��T l Yi' b -- • • • - - - • COMMERCIAL FEE• SCHEDULE - USE CHECKLIST
• B �G � 10N Mechanical permit fees* are based on the value of the work
❑ New construction Additio a teratto replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: t mechanical materials, equipment, labor, - - overhead and profit.
� . . . Value: $ 6 9d } . OG
• r ,., y� CATEGORYOF CONSTRUCTION .�; • .
1- and 2-family dwelling Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1:3 y g ❑ Accessory building
❑ Multi family Master builder ❑Other: For special information use checklist.
Description 1 Qty. I Ea. I Total
, ": ,, CS: r JOB SITE - INFO,RMATION ;AND_LOCATION Heating/cooling
.4Cc� ��h Air conditioning or heat pump
Job site address:
f Qi-� (requires site plan showing placement) 14.00
City/ State/ZIP: ?' Fumace 100,000 BTU ( ducts/vents) 14.00
g a.rc
J J U � Fumace 100,000+ BTU (ducts/vents) 17.90
Sui ldg. /apt no.: ` I Project name: y eft) Gas heat pump 14.00
Cross street/directions to job site: CJ6f'1 y 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
Flue/vent for any of above 10.00
Subdivision: I Lot no.: ,
Other 10.00
Tax map /parcel no.: Other fuel appliances
-' '+t. " 4 ' " ^" ' 1 W ater heater 10.00
x +• . z..4 ,i: -. . . -- . . r . DES RIPTION:rO1F WO. . . i . .-
Gas fireplace 10.00
Flue vent for water heater or gas
1 I V C 1 (I ` 0 fireplace 10.00
IT hn O QGl Y'1 e.49- / O>7 S i-ofa Log lighter (gas) 10.00
J t Y1(X r i+ I m p (r) Vie- yn _y1 i rl Wood/pellet stove 10.00
g i S ''l eN01 L L.4..! )C f ,1q Wood fireplace/insert 10.00
J J Chimney/liner/flue/vent 10.00
• O t ,. � JZOPERTY`.OWYER; : e;l I i❑ .TEN ` i _. y
- .,`� �.. x x ,,, . ti .z.� r Oth er: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax ( ) toilet compartments, utility rooms) 6.80
A . ; W -eXpi 'YGANTt' \ , - V s r CONTACT PERSON ;;-,'; : Attic/crawlspace fans 10.00
Business name: ��/ �/ Other: 10.00
/9/ ;/e2T / .Zh'- F uel piping
Contact name: ,/,/ � $5.40 for first four; $1.00 for each addi t nal
Address: /33 9 SE �jc/�0h S� Furnace, etc. J /
`�, Gas heat pump
City/State/ZIP: J„,, /Q.h 1 Q� 97Zo Wall/suspended/unitheater
Phone: (533) 9 , t.) 6 00 Fax:: “b3) Z - 7038 Water heater
Fireplace
E - mail:
Range
•f 4 ,,! �, '! ' ' R .. . CON TRACTOR Barbecue •
eo
„„ ( II Clothes dryer (gas)
Business name:
/n, er I CQn /4-ea Other:
Address: ) 33 9 S E 6 t cJ n ,1.4- -:` , ' , •. ' . ` MitCHA 1 PERMIT FEES*
City/ State/ZIP: '-' (46,1 cv , OR' 97202 Subtotal
i Minimum permit fee ($72.50)
Phone:) 2 3'9 _ Fax: (03) _ 793 8 —
Plan review (25% of permit fee)
CCB Iic.: 33)33- State surcharge (8% of permit fee)
TOTAL PERMIT FEE �( .�
��.,^' This permit application expires if a permit is not obtained within 180
Authorized Signature: ?..7". days after it has been accepted as complete.
1 Print name:-.:)ale #plin re?e f74— I Date:4ca • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PerrnitApp.doc 12/03 440 -4517T (1I /02 /COM/WEB)
I ,
CITY O.F TIGARD
BUILDING DIVISION PERMIT #:
/13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: MEC2005-00261
Phone: (503) 639 -4171 5/20/2005
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
6/1/2005 7:15AM 62
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 13221 SW 68TH PKWY 500 LOT #: TYPE OF USE:
PROJECT NAME: TRIANGLE CORPORATE PARK 002
DESCRIPTION: UNIVERSITY OF PHOENIX EXPAN
HVAC Value: $6968.00
OWNER: PHONE #:
CONTRACTOR: TIGARD TRIANGLE I LLC, PHONE #:
AMERICAN HEATING INC 503 - 239 -4600
Inspection Request Scheduled For: Date: Pour Time:
6/1/2005
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 008042 -02 503-572-1669 N
Corrections /Comments /Instructions:
rTh
I '
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL IN CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
kam
Inspector: I Date: hone #: (503) 718-