Permit . A CITY OF TIGARD mFrHANICAL
DEVELOPMENT PERMIT
m�m��*��~�o n�on�o�o SERVICES PERMIT #.......: MEC96-0373
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- ' - '=-- ` - DATE ISSUED: 02/12/97
PARCEL: 2S101AA-09800
SITE ADDRESS...: 12570 SW 69TH AVE
SUBDIVISION : MLP95-0013 ZONING: MUE
BLOCK..........: LOT.............:001
_____ ____
CLASS OF WORK..:NEW FLOOR FURN....: 0 E.AP COOLERS: 0
TYPE OF USE :COM UNIT HEATERS..: 0 VENT FANS...: 4
OCCUPANCY GRP..:B VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES ^ 2 BOILERS/COMPRESSORS HOODS ^ 0
FUEL TYPES---- 0-3 HP....: 8 DOMES. INCIN: 0
:/GAS/ / / 3-15 HP - 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP....: 0 REPAIR UNITS: 0
FIRE DAMPERS?..: N 30-50 HP ^ 0 WOODSTOVES..: 0
GAS PRESSURE...: M 50+ HP....: 0 CLO DRYERS..: 0
NO. OF UNITS ---- AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 8 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN >=100K BTU: 0 > 10000 cfm: 0
Remarks: Construction of a new 8,217 sq ft two story professional office buildin
g
1
Owner: FEES
J T ROTH JR type amount by date recpt
12540 SW 68TH AVENUE #B PRMT $ 122.00 B 02/12/97 97-290314
PLCK $ 29.50 13 02/12/97 97-290314
TIGARD OR 97223 5PCT $ 5.90 B 02/12/97 97-290314
Phone #: 639-2639
Contractor:
TRI-COUNTY TEMP CONTROL
13651 SE AMBLER RD
CLACKAMAS OR 97015 -
Phone #: 654-3115 t. 157.40 TOTAL
Reg #..: 000726
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This persit will expire if work is not started .
within 180 days of issuance, or if work is suspended for sore
than 180 days.
Permittee Sig atur
' I
"u���m���`
Issued By: e
Call for inspection - 639-4175
Flir; ( IVA 16 • � -
PP Recd Z :
CITY OF TIGARD Mechanical Permit Application Plan By rl i'
r.� t111,tL
13125 SW HALL BLVD. Commercial and Residential IqP ate Rec'd I ' ° 10
TIGARD, OR 97223 I b ate to P.E.
(503) 639 -4171, x304 11' Date to DST
Print or Type Permit * MEC- % -03/3
Incomplete or illegible applications will no ,be .ac a ted Called 0//05.4- 43o
- P g /cJ ,l -,��
d iWWprgx! ,, /i D Description
/� Oly/ () e.G &lig Table I Code QTY PRICE 7A
A) Permit Fee - -0 - 0.00
Ad ss 1570 5W 69
_ M ° r:7 yd g 72 B) Supplemental Permit 3.00
J
Name (or nap 6
� ---� s d business) 1 .) Furnace to 100.000 BTU
Owner/ M 1 'V \ct ,..49,, ind. du
l a.5yp SW (arB�' g 2.) Furnace 100.000 BTU + 7.50
ind duets & vents
coulee Zip I Phone 3.) Floor Furnace 6.00
IT ra OR 9'12233 71031 ind vent
NWna Orr al 1 4.) heater. heater 6.00
� A or flaw mourded hater
Occupant Mareg aamr 5.) Vent not
incl. in 3.00
app Permit
city/suds zip 1 P1f ors 6.) Boiler or comp, heat pump, air cond. 6.00 I' g
to 3 HP: absorp unit to 100K BTU r1
Name 7.) Boiler or comp, heat pump, air pond 11.00
- r t • Co . �rw.P �'o wtTTtao L. 3-15 HP: abseils and to 500K BTU
Contractor Mali AM"SS 8.) Boiler or comp, heat pump, air cond. 15.00
I 346 1 5E Aw.bl -2.:1 a 9.) 1530 HP: absorp unit .s-1 mi BTU
Attach copy of atrium op '
Current Les Lac ka•�ac • Oc - 9 654 3115 30-50
Licenses heat pomp, Sir cond. 2250
atmsrup and 1 -1.75 mil BTU
Oregon Conn C. Boat tier Exp. Date 10.) Boiler or comp, heat pump, air card. 37.50
7.24,.. 3.28 -9 7 > 50 HP: absorp unit 1.75 mi BTU
COT Weems T$ M Exp. Otte 11.) Air handing and to 4.50
• //a6 13-01 -97 10.000CFM
Architect Nana 12.) Air handling unit
- P. 'I). u...1 . t.,19$&- to.000 CTM + 7.50
or eV Moog menus . /3y A• • • 13.) Nan portable -.•° 4.50
evaporate =der
Engineer Phae 14.) V connected v 3.00
� • at 9 7,233 3 80/5 to a single duet 'i I Z`
Desate worts New1g. Addition 0 Alteration 0 Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 Non-residential$ induded in appfrance permit
Additional Description of wort 16.) Hood served by
+t 'A w
C ow.ti r✓c.ft %- 2 s- 04( 44. 'It1•49 .
mechanical 4.50
stb 9 3"tw► ga4S Qn■k. t.Ph- {S 17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial
big or property /4/64t 30.00
type incinerator
19.) Clothes dryers. etc. 4.50
Proposed use of 20) Other units
/y� 4.50
building or ProPedy pro- re CRT ce _
Type of fuel - of 0 natural gas to LPG 0 electric 0 • 21) Gas piping one to four outlets 1; 2.00 �".
I1
�
I hereby acknowledge that I have read this application. that the 22) More than 4-per outlet (each) .1 .50 v
infw'.atvrr given is correct that I am the owner or authorized agent of K
the Ownef. that ptans submitted are in compfiance with Oregon State QTY. SUBTOTAL
laws.
Signature ofe A Dates 'SUBTOTAL 1 0 • Of - 6- / - / q C 5% SURCHARGE • .. . x.90
erson a Phone PLAN REVIEW 25% OF SUBTOTAL
77; 6 9 09 a %-
\hpmtdoc TOTAL 1 - _ tea
"Minimum permit fee is 525 + 5% surcharge Q6:
I ,,A W!t/Laa-a 5D R- t
CITY OF TIGARD BUILDING INSPECTION DIVISION
^--D 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: k 1 1 C A.M. P.M. MST:
Location: 6 5 7_, BUP: G}
Tenant: Suite: Bldg: MEC: / 0 3/ 3
Contractor. / ,....z.-yi/L..) Phone: (e• 3 9 Z Co 3 PLM: 7‘, O 3 oZ7
Owner Phone: ELC:
La £2.1.1'. ..mil _ / 5 h (IC. S ELR:
— - — —..mwouni........" - '.'.. SIT: .
BUILDING BLDG (con 41 Li R 113 Ill `Cel MEC ' • CAL ELECTRICAL
Site Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pum • Low Volt
Approved .1. oved a • •rov • Approved Approved
Appr /Sdwlk Not Approved of A u. • ved Not • ji. ' ed Not Approved Not Approved
FINAL =NB 1' • I FINAL I •
/// edzCe c &_•dri,/e Tr____
O Call for re'vr 4 4/' O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: f. Date:0/ 77 Page of