Permit t� /vE
C I1 " Y O F TI GARD MECHANICAL PERMIT
�,, DEVELOPMENT SERVICES PERMIT #: MEC2003 -00246
t�J �I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/28/03
PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY IMP
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 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: 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: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: TI mechanical,new and relocation of supply and return registers. Valuation: $10,284.00
Owner: FEES
TIGARD TRIANGLE I LLC Description Date Amount
4650 SW MACADAM AVE STE 220 [MECH] Permit Fee 5/28/03 $72.50
PORTLAND, OR 97201 [MECPLN] Plan Rev 5/28/03 $18.13
[TAX] 8% StateTax 5/28/03 $5.80
Phone: Total $96.43
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202
Duct Inspection
Phone: 239 -4600
Duct Inspection
Reg #: LIC 33135 Duct Inspection
Duct Inspection
S.D. Shut -down inspection
S.D. Shut -down inspection
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 ►4 les are set forth in OAR 952 -001 -00
Issued By: Permittee Sign.1 ; �)*
�
Call (503) 639 -4175 by 7:00 P.M. for inspections " eed 'the next business day
,3221 Sly 68 'T 1* �
Mec ` am cal Permit Application OFFICE USE ONLY
� � b.—. t R' e, Date received: j -I 1-0 � Permit no.:M�jUy-vV 0�7-tO
�,'j'J'�` City of Tigard k— d Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 r � `' Y : / . , ..s A+ Date issued: By:66 I Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Ca T IGAiRD
Land use approval: c f. 1 fE f11��r OF � Building permit no.:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory )lieCommercial/industrial 0 Multi - family *Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
3011 SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: l32) 664/ 68 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: B . e.r,t.en4 2,,,1.24 value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: a{. 3,. )p profit. Value $ M . , zeV .
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: h A/�71- jurisdiction's fee schedule for residential permit fee.
City/county: 44t.r-d I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCIIEDULE
Description and locati6n of work on premises: )h'. - zsa...eia,e077' AND COMIMIERICAL /INDUSTRIAL EQUII'MI ENT SCIIEDULE
.2 rL .)a2 � 3rd Pe Fee (ea.) Total
Est. date of completion/inspection: - Description Qtr. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 No Air handling unit CFM
space insulated? ta'�es 0 No Air conditioning (site plan required)
Is existing p Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
Business name: Amer Heating. State boiler permit no.:
�n9 HP Tons BTU/H
Address: 1339 SE Gideon St. Fire/smoke dampers/duct smoke detectors •
City: Portland I State: OR 1 ZIP: -2418 Heat pump (site plan required)
Phone: 239 -4600 I Fax: 239 -70381 E -mail: Install/replace furnace/burner BTU/H
CCB no.: Including ductwork/vent liner 0 Yes 0 No
X3135
Install/replace/relocate heaters - suspended,
City /metro lic. no.: 6 01 14 wall, or floor mounted
Name (please print): _ _ .44 _ Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name2, /. ', a te ' Chillers HP
Address: 3_39 SE �/ o . Compressors HP
� Environmental exhaust and ventilation:
--
City: i- "li • 1 Stater 1 ZIP: 9»e Appliance vent
Phone: „.g - .44/, Fax: - — ; E -mail: Dryer exhaust
OWNER Hoods, Type I/11/res. kitchenlhazmat
hood fire suppression system
Name: 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 piping each additional over 4 outlets
Process piping (schematic required)
• Number of outlets
Name:
e.e''y eQd r Other listed appliance or equipment:
Address: /33, �E 4%"./ , e ®' .' Decorative fireplace
City: AS,,,....144 I State ZIP: Insert - type
Fax' 743E1 1 E -mail: Woodstovelpellet stove
Phone: Z31- V4 0 1 Other:
Applicant's sigLture: F�'�f` Date: 5 0
Name (print): j. Gt,sa.sx4es 11
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ S V
O Visa ❑MasterCard Notice: This permit application Minimum fee $
Credit card number:
/ expires if a permit is not obtained Pl re view (at 2S %) $ / r /3
Expires within 180 days after it has been State surcharge (8 %) .... $ .5 'O
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 74. y3
Cardholder signature Amount 440 -4617 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested — AM PM BUP
Location /3 D-0- b g " I c Suite MEC 3 (//<
0?
Contact Person � Ph ) S 702 /c'&°(' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam pe-0=-4_,
Ext Sr ea Anchors h e �h _-nC� -i • 4722e,
Ext Sheath/Shear C .
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough-In
Gas Line
Smoke Dampers
in
PASS 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 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ( 0) Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL