Permit C ITY OF TIGARD MECHANICAL PERMIT
rn DEVELOPMENT SERVICES PERMIT #: MEC1999 -00564
�` '� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01/04/2000
PARCEL: 2S 101 AA -09100
SITE ADDRESS: 12259 SW 69TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 030 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 2 DOMES. INCIN:
ELE 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: 26
FURN > =100K BTU: < =10000 cfm: 4 GAS OUTLETS:
> 10000 cfm:
Remarks: Mechanical for tenant improvement.
Owner: FEES
TIGARD CORPORATE CENTER LP Type By Date Amount Receipt
15400 SW MILLIKAN WAY PLCK BON 01/04/20( $65.33 MANUAL
BEAVERTON, OR 97006 5PCT BON 01/04/20( $20.90 MANUAL
PRMT BON 01/04/20( $261.30 MANUAL
Phone: Total $347.53
Contractor:
MACDONALD MILLER OF OREGON
5711 SW HOOD
PORTLAND, OR 97201 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 503 - 230 -8991 Duct Inspection
Reg #: LIC 137340 Fire Damper Insp
S.D. Shut -down
r Final Inspection
a P. —
t
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 callin (503)246 -9189.
Issue By: f LtA/1/ � ( ,- -- 1 Permittee Signature: �C
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
09/13/99 MON 14:39 FAX 503 598 1960 CITY OF ;TIGARD 0 002 i
/ O C
a
. CITY OF TIGARD Mec Permit Application Plan Ch
Recd 8 •
13125 SW HALL BLVD. Commercial and Residential /�50 Date Recd 9-- /a-/ -
TIGARD, OR 97223 qV" Date to P.E. , i -9 p�
(503) 639 -4171, x304 - P la Date to DST IA T�i &-
Print or Type Permit #/Ilf-e ' ff9. 9
Incomplete or illegible applications will not be accepted -3 - 00 ,,,,, T ,_,
Name of Development/Project Description
776•440 CO/WOR/tTE CEN feR able 1A Mechanical Code Qty r rice Amt
Job Street Address Sumo* A• Permit Fee i' F', 16.00
2 2 S q SW 4 9 7K 1) Fumace to 100,000 BTU
Address • chiding ducts & vents see footnote 1,2 9.65
Bldgit Clty/state Zip 2) rnace 100,000 BTU+
8 71 oi e 972 23 in luding ducts & vents see footnote 1,2 12.00
Name (or name or business) 3) Fl • or Fumace
Owner S PE r OPd ri Es in ding vent see footnote 1,2 / 9.65 •
Mailing Address 4) Sus ..ended heater, wall heat /
or fl• •r mounted heater see footnote 1, 9.65
/S9'Oo SW /ill /U aN l-j r 5) Vent of included in appliance permit 4.75
City /State ap Ph Check all at apply: 'Boiler. Heat. •4r
For Items i�EgvERtAN c 87006 6�I6"I2o2 fo 20, see Comp
or Pump • Qty Price Amt
N (or name of business) footnotes ..
6) <3HP;ab -rb unit to /
REN.4i SSAING 6 HOcOtl?FS INC. 1 oOK BTU / 9.65
Occupant Mailin 7) 3-15 HP;ab • rb unit g Add - .
jgoo SN j ,+ti1*o-• -Ii Wb�a(c goy 100k to 500k B 17.65
City/State Tip Phone 6) 15-30 HP; abs • rb
unit . 5-1 mil BTU e
8�t•�.t,,, DE 9�o° Ly3 -BSQV / 24.15 �3� -. ■ 9) 30-50 HP; abso •
Contractor Name ,� - 1/ unit 1-1.75 mil BTU 36.00
/ W.. Den/Aio /lA,..,...--1( eF , QIry 10) >50HP; absorb u it
Prior to permit Mailing Address >1.75 mil BTU j 60.15
issuance, a copy S711 SW Hoof 11 Air handling unit to 19,000 CF
of all licenses 90/State zip Phone 7.00 ?�j
are required if /o+1KG OR y9Z91 230 - 8981 12) Air handling unit 10,00e CFI' +
expired in COT Oregon Const Cont Board Licit Exp. Date i 11.85
database 13 73 q0 as= /Os 13) Non - portable evaporate Toler
Architect Name r 7.00
b RS i7 PG4r'7C. fj 14) Vent tan connected to a;sin•le duct
•
•
. %1-084.) - + 4.75
or Mailing Address `, ' / A► 15) Ventilation system notrindude•• in
/1 Z SW SO //hart appliance permit / 7.00
Cit
Engineer O � Hard ��{ 9�l s Zu Phone 16) Hood served by mechanical exh - ust
I fI I / 7.00
Describe work to be done: 17) Domestic incinerators
12.00
New • Repair 0 Replace with like kind: Yes 0 No O 18) Commercial or industrial type inciner- or
Residential 0 Commercial • / 48.25
19) Repair units/ •
Additional information or description of work 8
20 - = i . �� = A' 7.00 3‘ r
NOTE: For Commercial projects only Units over 400 lbs. require 21) Gas pipi • one to four outlets
■
structural gas talcs. See foo. ote 1 ,- 3.75 /
Type of fuel: oil 0 natural gas 0 LPG 0 electric • 22) More th :n 4-per outlet (each) .75 J
Minimum - ermit Fee $50.00 SUBTOT - `2 .` ;II Watt
• 1 hereby acknowledge that I have read this application, that the information - - -��Wf - ''
• given is correct. that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL _„','' ;� ° ' ; ` . , '.
•
the owner, that plans submitted are in compliance with Oregon State laws. Re •wired for ALL commercial permits only ! r . i. "
'• • • TOTAL ,- a-" : , - r •
• •'Signature of Owner /Agent Date - " , :W. , :.i.: - .......770. ?w
. • 0 / Other Inspections and Fees: d ip. IMOI ! • 1 ,
• / Bls►'9 1. Inspections outside of normal business hours minmum charge -two
Conte- Person Name Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
E< <- 2 3 0 - 8 99/ charge -half hour) 560.00 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 fine and pressure. plans (minimum charge - one-half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical 'State Contractor Boiler Certification required
units.
"Residential A/C requires site plan showing placement of unit
I:4nechpemi.doc rev 7/19/99
/..--
Plan Che
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 �p �� 07 oVN/1 Date to DST
��" Print or Type Permit #
Incomplete legible applications will not be accepted coiled
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Street Address rune# A) Permit Fee , . 16.00
Job 1) Fumace to 100,000 BTU
Address including ducts & vents 9.65
slag# City/State Zip 2) Fumace 100,000 BTU+
including ducts & vents 12.00
Name (or name of business) 3) Floor Fumace
Owner including vent 9.65
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater 9.65
5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: 'Boiler Heat Air
For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
6) Repair units
8.40 _
Occupant Mailing Address 7) <3HP;absorb unit to
100K BTU 9.65
Clty /state Zip Phone 8) 3-15 HP;absorb unit
115
100k 100k to 500k BTU v 17.65
9) 15-30 HP; absorb
Contractor Name unit .5-1 mil BTU 24.15
10) 30 -50 HP; absorb
Prior to permit Mailing Address unit 1 -1.75 mil BTU 36.00
issuance, a copy 11) >50HP; absorb unit >1.75 mil BTU
of all licenses City /state Zip Phone 60.15 ,
are required if 12) Air handling unit to 10,000 CFM G
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date A 7.00 aO �
database 13) Air handling unit 10,000 CFM+
Architect Name 11.85
14) Non - portable evaporate cooler
or Mailing Address 7.00
15) Vent fan connected to a single duct •
4.75
Engineer City /state Zip Phone 16) Ventilation system not included in
appliance permit 7.00
Describe work to be done: 17) Hood served by mechanical exhaust
7.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Domestic incinerators
Residential 0 Commercial 0 Modification 0 CIdd00 12.00
19) Commercial or industrial type incinerator
Additional information or description of work: 48.25
20) Other units, including wood stoves 6
7.00 igt
NOTE: For Commercial projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets
roof, require structural calks. prepared by licensed engineer. 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) More than 4 -per outlet (each) .75
I hereby acknowledge that I have read this application, that the information Minimum Permit Fee $50.00 SUBTO
given is correct, that 1 am the owner or authorized a ent of 8 %SURCHARGE GE - 0147 1. $�
g PLAN REVIEW 25% OF SUBTOTAL �� 33
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
Signature of Owner /Agent Date TOTAL I Vit .0
Other Inspections and Fees:
Contact Person Name Phone
1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$50.00perhour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge - half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
units. "Residential A/C requires site plan showing placement of unit
I:Mechperm.doc rev 11/1/99