Permit CITY TIGARD MECHANICAL PERMIT
,t'� ;e DEVELOPMENT SERVICES PERMIT #: MEC2001 -00200
- -� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/7/01
PARCEL: 25101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 200
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: OTR 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:
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: 1 GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of NC unit for computer room.
Owner: FEES
PACIFIC REAL ESTATE MGMT Type By Date Amount Receipt
6650 SW MACADAM AVE. 200 PRMT CTR 6/7/01 $72.50 2720010000 ,
PORTLAND„ OR 97201 5PCT CTR 6/7/01 $5.80 2720010000
Total $78.30
Phone: 503 - 224 -1460
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202 Mechanical Insp
Phone: 239 -4600 Cooling Unt Insp
Reg #: LIC 33135 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 adopte n the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OA' s52- 001 -0080.
You may obtain opies of these rules or direct questions to OUNC by c- A % • I . • 189.
Issue By: , /_`_� . �,
,, Permittee Signature: , 1 w03 � oo
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next • usiness day
Mechanical Permit Application
. 4111,,, Date received. /Arm Permit no.: dr. . ,/, to - •• 0
4) ,1;''y:14' City of Tigard Project/appl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Emwom
Phone: (503) 639 -4171 Date issued: Receipt no.:
Fax: (503) 598 -1960 ---0,4 Case file no.: Payment type:
Land use approval: Building permit no.:
I'V PE OF PERMIT
0 1 & 2 family dwelling or accessory 00Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction O'Addition/alteration/replacement 0 Other:
J013 SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: k) , T (i ..Asj Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: • value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 1 4 5 O --." .
Lot: Block: Subdivision: *See checklist for important application information and
Project name: , , jurisdiction's fee schedule for residential permit fee.
City /county: , , ZIP: - . 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and loca %n of work on premises: C field AND CONIN1ERIC L /INDUSTRIAL EQUIPMENTSCIIEDULE
O M ) OT IL • WI. Fee(ea.) Total
Est. date of completion/inspection: Descri . l on Qty. Res. only Res. only
Tenant improvement or change of use: H AC: g unit CFM Q e --
Is existing space heated or condtioned? C'Yes 0 No Air handling
Air conditioning (site plan required)
Is existing space insulated? es 0 No Alteration of existing HVAC system
1IECIIANICAL CONTRACTOR Boiler/compressors
b ,■■
State boiler permit no.:
HP Tons BTU/H
Address: , Fire/smoke dampers/duct smoke detectors —
State: QR WIENIERM Heat pump (site plan required) =
Phone: . _ 47 0 ; E -mail: Install/replace furnace burner BTU /H ■ --
Including ductwork/vent liner 0 Yes 0 No
CCB no.: 13 Install/replace/relocateheaters- suspended, ■ --
City/metro lic. no.: i 7 7 wall, or floor mounted
Name (please print): won (anq J ntr Vent for a.'fiance other than furnace
CONTACT PERSON Absorption units BTU/H III
Chillers HP
xE =N - /Co iressors HP =
nmental exhaust an. ventilation:
State ZIP: A ;tip Z. Appliance vent ■
Phone: g - 14 6c 4 IIMEMEEM E -mail: Dryer exhaust MI
OWNER Hoods, Type I res. kitchen/hazmat ■ __
hood fire suppression system
112SEMPEMMEME Exhaust fan with single duct (bath fans) -
Mailing address: _ , Au _ _Ay a - ;Zp,1 Exhausts stem a. art from heating or AC I=
State: at ZIP: 97 a° l Type: Ype : p ' ' ' on up to 4 out ets) ■ _ -
T LPG NG Oil
Phone: _,, t - _ , Fax24 670 E -mail: Fuel . i. ing each additional over 4 outlets =
ENGINEER ' , ; p p (schematic required) - MI
Name: Number of outlets
O er 1 _ . app , ce or eq pment:
Address: Decorative fireplace ■
City: State: ZIP: Insert -type =
Phone: Fax: E -mail: Woodstovelpelletstove II.
Other = MN
Applicant's signature: Date: Other:
Name (print): -
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
❑ Visa 0 MasterCard Not Th permit application Minimum fee $
/ expires if a permit is not obtained Plan review (at _ %) $
Credit card number: Expires within 180 days after it has been
State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $
Cardholder signature Amount 40-4617 (6i00/COM)
MECHANICAL PERMIT FEES
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 QV (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. 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, 5,725 17.40
Air handling 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
Non - portable evaporate cooler 656 20) Other units, including wood stoves 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, including 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:
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 Boiler Certification required for units >200k BTU.
** Residential A/C requires site plan showing placement of unit
i:ldstsVorms\ nech- fees.doc 10/11/00 .
CITY OF TIGARD BUILDING INSPECTION DIVISION f MST
24 -Hour Inspection Line: 639 -4175_ Business Line: 639-41 %1
i / BUP
.,k Date Requested AM PM BLD
Location 1 ?2l 64' Peg e / Suite L MEC /� :1220
Contact Person UJ Ph PLM
Contractor /' Ph X63 gq D 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
PA FAIL
ost & Beam
Rough In
Gas Line •
S,• = ■ampers
PART FAIL
- TRICAL
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 &/(107 Approach /Sidewalk Date Ins 41 Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.