Permit r
C ITY OF TIGARD MECHANICAL PERMIT
�� iz� D SERVICES PERMIT #: MEC2005 - 00266
' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/24/2005
PARCEL: 25101 DC -00200
SITE ADDRESS: 13535 SW 72ND AVE 150 ZONING: C -P
SUBDIVISION: 72ND AVE OFFICE BUILDING LOT: JURISDICTION: TIG
Project Description: Relocate grilles. Valuation: $1875.
CLASS OF WORK: OTR 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:
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: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PACIFIC NW PROPERTIES LTD PTNSHP Description Date Amount
9665 SW ALLEN BLVD STE 115
BEAVERTON, OR 97005 [MECH] Permit Fee 5/24/200` $72.50
[TAX] 8% State Surcha 5/24/200f. $5.80
Total $78.30
Phone: 503- 626 -3500
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST, STE. 1
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
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 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 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Permiftee Signature: i
Issued By: 7�� fl { M" c--- S e
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.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard i ' '�� Daffy - 1 • PernutNo.Q�,- a� Ili
13125 SW Hall Blvd., Tigard, 4ti9 � -' u \� Plan Review r
Phone: 503.639.4171 Fax: 503.598.1960 ..41-. bair,7,I r . \M1 1 r\ Date/By: Other Permit:
Inspection Line: 503.639.4175 vt I \q w L ` (,��'5 , ", ' I Date Ready/fly: ® y: Juris: See Page 2 for
Internet: www.ci.tigard.or.us b -
Notified/Method: 1 i Supplemental Information
• f _ rr .et4gt41 D � ,
.:, ',,y_ {� • , ; iANN - . ;,' COMMERCIAL':F,EE* SCH USE+CHECKLIST
❑ New construction Addition/alteration/replacement ` Mechanical permit 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: $ � � "� 5
F �^ .f YCAT
°EGOR3l O$ eci 'I .Urea ON ` l
: RESIDENTIALEQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ac ommercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. I Total
i F, / a' ,i:t % t ti din" JOB STI El T 10tO t iND LOCATION: r ', `r `, . " Heating/cooling
' r , l ---7 r - 1 Air conditioning or heat pump
Job site address:
3 5 15 .-:,1 vv / ck rick ro k v t , (requires site plan showing placement) 14.00
City/State/ZIP: T-- f id 062-.. Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
• Suite/bldg. /apt no.: ,G, Project name: uf�,(}i 1 Gas heat pump 14.00
Cross street/directions to job site: i I 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
-, •' „ r a:," ' rDE N O � io g, w R IC ; ' k t' t ; . : ;1: „ ..r ...,4: -, '.,,i Water heater 10.00
t�:.., ... , r .. ! 7,. .. ., _ .,, ,1,41... ,v ., , .1..-7. .... -
� -1 Gas fireplace 10.00
V Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
ar ,,, i 1 , , r - ,: t , Chimney/liner/flue/vent 10.00
:$ _ z., `., 5: ;' , ER2'X rQt W K`:d.::h.7... ( r
,1. - ,'V . t :,t' E$ 9A If �x, 1,: M fr , ` 10.00
. Other:
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
1 4 r +i 1 jd tsfr ,. -< ju o`= r b 4 'a� :`3 ,na' Attic /crawlspace fans 10.00
y `. ' Other: 10.00
Business name: A RA i ( ( l�i4 kv j / ;•11.1 , Fuel piping
Contact name: '7) Y 0� �•� jA J $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: l + 3 t C � t t t Gas heat pump ,
City/State/ZIP: I b-,. . -{ ojt • 0 4 '. it D Wall/suspended/unit heater
,mil / ` Fax: ^ r, ' i , , Water heater
Phone: (Gyp) ” ' I.•- LE 00 U : �a �) t%' ✓
Fireplace
E -mail: Range
t R 5 `4 ti „ '�Ql! 7 O R i t. � ' _ u - 5 -- Barbecue
1 Clothes dryer (gas)
Business name: l r� ,if i 7( 711C i Other: 7j t
Address: in, `' M ECB.t1NiCAL PERMIT,FE •
City/ State/ZIP: Subtotal
Minimum permit fee ($72.50) 7�
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: '5 ? , ' C C. State surcharge (8% of permit fee) °i .�
r ., i TOTAL PERMIT FEE �'. 0
Authorized signature: �, ' F it ,O4 ;; 1 j ` ,(� Y��_ This permit application expires if a permit is not obtained within 180
i ���CCC JJJ days after it has been accepted as complete.
Print name: . 1 t , 1'1 i i 11 (.t 6 Date: t_ . ..) • Fee methodology set by Tri-County Building Industry Service Board
: .rn..:Idi..o5Permihc\MFC.Pe..nn Aen. 1210a 440.461n(11 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00266
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/24/2005
Phone: (503) 639 -4171 in agp i41y lji , l �
Inspection Requests (24 Hrs.): (503) 639 -4175 �'
INSPECTION WORKSHEET FOR DATE: 5/25/2005 TIME: 7:12AM PAGE: 57
SITE ADDRESS: 13535 SW 72ND AVE 150 CLASS OF WORK:
SUBDIVISION: 72ND AVE OFFICE BUILDING LOT #: TYPE OF USE:
PROJECT NAME: CREDIT UNION HOME LOAN
DESCRIPTION: Relocate grilles. Valuation: $1875.
OWNER: PACIFIC NW PROPERTIES LTD PTNSHP, PHONE #: 503. 626.3500
CONTRACTOR: AMERICAN HEATING INC PHONE #: 503-239-4600
Inspection Request Scheduled For: Date: 5/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007691 -01 503 - 572 -4988 N
Corrections /Comments /Instructions:
L �• Wit
-47
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I♦ CALL FOR INSPECTION ❑ ADDITION ._ L FEES SESSED
tl1 Inspector: ' Date: one #: (503) 718-