Permit CITY TIGARD MECHANICAL PERMIT
ihi DEVELOPMENT SERVICES PERMIT #: MEC2005 -00523
n 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/2/2005
PARCEL: 2S 101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 120 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: HVAC modification. Valuation: $16,742.
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: 5 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 ?: U 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: 2 OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
TIGARD TRIANGLE I LLC Description Date Amount
4650 SW MACADAM AVE STE 220 [MECH] Permit Fee 9/2/2005 $323.30
PORTLAND, OR 97201 [MECPLN] Plan Rev 9/2/2005 $80.83
[TAX] 8% State Surchar€ 9/2/2005 $25.86
Phone: Total $429.99
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 I.aw 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: �n1_2/ „Z Permittee .
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.
/32..71 6teek- Qtr
Mecftanical Permit, C.a Q / "IS FOR OFFICE USE ONLY
a n i Receive Pe mu[ No.: -
City of Tigard ' ' 's ,' L V� Date/By, % D S lam` �ECZo)) O0��Z3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Re
Phone: 503.639.4171 Fax: 503.598.19(}0' ' ? O K 4s• li� ,A Date/By a \ t1a s OtherPernit:
Inspection Line: 503.639.4175 U � cl ■ 1 I I I — Date Rea. At 1 — Juris: El See Page 2 for
u
Internet: www.ci.tigard.or.us Notified/Method:f 2 45- ...r 1 it Supplemental Information
C! 1- Y OF : iiUA 11?0'(L (- .'/ 70 \&Z✓
. 3 Nit i wiiiiiQfq COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Addition/alteration/replacement Mechanical t fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ /4 7/72
CATEGORY, OF CONSTRUCTION .. • ,: . ' J
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
. •JOB SITE.INFORMATIO AND LOCATION.' , - Heating/cooling
/3 �0 7 l �� r / ) Air red site plan showing ing pump placement) site address: , i (requires site Ian showin lacement 14.00
City/State/ZIP: 7 Qr . G / (7� 9? 2Z 3 Furnace 100,000 BTU (ducts/vents) 14.00
9 -' • Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt no.: f i .. 'h /A0 Project name: "��k . / — o 42 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
Flue/vent for any of above 10.00
Subdivision: Lot no.: Other: 10.00 •
Tax map /parcel no.: Other fuel appliances
s DESCRIPTION OF WO1tK
Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
�J / , . l .•,, fireplace 10.00
'1Y)?( / .77 C'C' - , - J ,/,_ (ti.. �l1r' "'LA./ /e/ ? a 71 Log lighter (gas) 10.00
/ G40 .1 / Wood /pellet stove 10.00
.r Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00 •
.'-,•;':'-- ' ❑ - PROPERTY.�OWNER' • /S ;. . •' : D TENANT'' ,
Other: 10.00
Name: Environmental exhaust and ventilation
• Range hood/other kitchen
Address: - • equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
a ` _APPLICANT ..: , PERSON Attic /crawlspace fans 10.00
!' Other: 10.00
Business name: A)')-, pl � , .2:' piping
Fuel
1 1 ..i
Contact name: j a/J /14 A „ n. r � $5.40 for first four; $1.00 for each additional
�� Furnace, etc.
Address: /339 se 47dc°on St Gas heat pump
City/ State/ZIP: 2- Wall /suspended/unit heater
Phone: a3 X39 -4'60 Fax: : (3) ...,a3 fa Water heater
Fireplace
E -mail: Range
CON (TOR.', = Barbecue
y� Clothes dryer (gas)
Business name:
Am CGri - r+rit'/ Other:
Address: / 339 J 6 / ") clf . . • - MECHANICAL PERMIT FEES*
City/State/ZIP: /CJ/"7Jaf.p 42,e •9% L Subtotal
f Minimum permit fee ($72.50) 3 p-3, 3 d
Phone: (5 ---a ? �.4/BOU Fax:423) 9..2e B Plan review (25% of permit fee)
CCB lic.: 333 State surcharge (8% of permit fee) $ p 'p
TOTAL PERMIT FEE ?� f
This permit application expires if a permit is not obtained Malin 186
Authorized signature: days after It has been accepted as complete.
�!
Print name: � o / C e l m �. D a t e : • Fee methodology set by Tri-County Building Industry Service Board
i:\ Building \Permits \MEC•PemdtApp.doc 12/03 440- 4617T(II /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200S -00523
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 912/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 9/16/2005 TIME: 7:01AM PAGE: 73
SITE ADDRESS: 13221 SW 66TH PKWY 120 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: ETHICS POINT •
DESCRIPTION: HVAC modification. Valuation: $16,742.
OWNER: TIGARD TRIANGLE I LLC, PHONE #:
CONTRACTOR: AMERICAN HEATING INC PHONE #: 503.239.4600
Inspection Request Scheduled For: Date: 9/1612005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 015902 -01 503 - 793 -2260 N
Corrections /Comments /Instructions:
ea-Le T C� 4
-- L aLa0
,• jv' C90 rir% S II 63 / %' i'
■ 1
11 i , vi ► I I \ '7 , 7--
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR IN PECTION ❑ ADDITI /NAL ES ASSESSED
I
Inspector: D . ° ` Phone #: (503) 718 -
,