Permit •
CITY TIGARD MECHANICAL PERMIT
41 DEVELOPMENT SERVICES PERMIT #: MEC2000 -00208
DATE ISSUED: 06/13/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 01 AA- 02900A
SITE ADDRESS: 12123 SW 69TH AVE
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOA JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 5
OCCUPANCY GRP: 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: 1 OTHER UNITS: 15
> 10000 cfm: GAS OUTLETS:
Remarks: Mechanical for tenant improvements.
Owner: FEES
SPECT PROPERTIES Type By Date Amount Receipt
15400 SW MILLIKAN WAY PRMT KJP 06/13/20C $151.75 0002896
BEAVERTON, OR 97006 PLCK KJP 06/13/20C $37.94 0002896
5PCT KJP 06/13/20( $12.14 0002896
Phone: 503-646-2202 Total $201.83
Contractor:
MACDONALD MILLER OF OREGON
5711 SW HOOD
PORTLAND, OR 97201 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 230 -8991 Mechanical Insp
Reg #: LIC 137340 Mechanical Insp
Duct 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 rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246 -9189. ,
Issue By: �. Permittee Signature: 14474-4/ c= /� l
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Check # I f" 5
CITY OF TIGARD Mechanical Permit Application Recd By -
13125 - SW HALL BLVD. Commercial and Residential Date Rec'd 6 .-- / 5 - -
TIGARD, OR 97223 Date to P.E. d
(503) 639 -4171, x304 Date to DST /,"DAP
Print or Type Permit #AfF. 2.0 -0
Incomplete or illegible applications will not be accepted c �� oo ��` 41
Name of Development/Project Description
Ti cp. l n (o2Poi2-ATE c-ec re 2 Table 1A Mechanical Code Qty Price Amt
Job Street Address - suite# A) Permit Fee 16.00
1) Furnace to 100,000 BTU
Address 1 2.! L3 St,-) WV" including ducts & vents see footnote 1,2 9.65
Bldg# City/State Zip 2) Furnace 100,000 BTU+
A- rce•rL tn'c oR. Y7223 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner S PE CI-IT Fizz P - r2'TI E S including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
1 S`foc) St.; d'-% i tt-t ICja,,,h) w r■-Y 5) Vent not included in appliance permit 4.75
City/State Zip Phone Check all that apply: *Boiler Heat Air
1 . ? )Eeyvr2•roni OrC. 9 7cOte - 4,(i Z2cz For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
RREtvrriSSrfirvCC lick- otk>t -S 100K BTU 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
gym; st,... gr AyEerct`: - H I cl.sa•3 e- Fiu> Y 100k to 500k BTU 17.65
City /State Zip - Phone 8) 15 -30 HP; absorb
&CtivCtZrD t r17ou. - 293- 8 lot) 9 )
unit -5 0 HP; absorb
mil BTU 24.15
9) 30 -5
Contractor Name unit 1 -1.75 mil BTU 36.00
Mt }C �G,,,p t.k7 ✓►1 t LL El 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy S"] (t Sw Hoc (' 11 Air handling unit to 10,000 CFM
of all licenses City /State Zip Phone I 7.00
are required if PcerL.taw i. br, 9) k t Z.3C - `b ►`i 1 12) Air handling unit 10,000 CFM+
•
expired in COT Oregon Const. Cont. Board Licit Exp. Date 11.85
database 1 3/ 3`i0 to( z2,10 3 13) Non - portable evaporate cooler
Architect Name 7.00
Lk S Al_ c I-t cm( TS 14) Vent fan connected to a single duct
or Mailing Address 5 4.75
l Lt 5 1;; 4d}LMoN 15) Ventilation system not included in
appliance permit 7.00
Engineer City/State Zip Phone 16) Hood served by mechanical exhaust
PCC - tiro c(` /724 Z,2t-tI2_ t 7.00
Describe work to be done: 17) Domestic incinerators
12.00
New 0 Repair 0 Replace with like kind: Yes O No O 18) Commercial or industrial type incinerator
Residential 0 Commercial • 48.25
19) Repair units •
Additional information or description of work: 8.40
20) Woed- eteve/gas-FP/other units /clethe-dryerfetc:
lrti - .' 14 A..)1.1 S I5 7.00 1
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL /'
I hereby acknowledge that I have read this application, that the information 7% SURCHARGE ��
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL i �1
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
TOTAL 4 n
Sig of Owner /Agent Date -
/ Other Inspections and Fees:
- A n ,- . • - ` / 1 7 g 7 . i "1/ S / f 7 /CD 1 . Inspections outside of normal business hours (mininum chj - o , i
Contact Person Name Phone hours) $50.00 per hour X10 t
2. Inspections for which no fee is specifically indicated (minimum O'
/r3 ,' /r HL'( -(- z3o- t 99/ charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. 'State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:\mechperm.doc rev 7/19/99
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