Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00466
13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 DATE ISSUED: 10/2/2006
PARCEL: 2S 113AA -00400
SITE ADDRESS: 16270 SW 72ND AVE ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 018 JURISDICTION: TIG
Project Description: Pressure check gas line & green tag. Valuation: $400.
CLASS OF WORK: OTR 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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 10/2/200E $72.50
[TAX] 8% State Surcha 10/2/200E $5.80
Total $78.30
Phone:
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -519 -6199
FAX 503- 238 -9767
Reg #: LIC 38868
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature:
Call 503 -639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY TIGARD MECHANICAL PERMIT
A$ �� i DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00466
°�J II 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 DATE ISSUED: 10/2/2006
PARCEL: 2S 113AA -00400
SITE ADDRESS: 16270 SW 72ND AVE ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 018 JURISDICTION: TIG
Project Description: Pressure check gas line & green tag. Valuation: $400.
CLASS OF WORK: OTR 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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 10/2/200E $72.50
[TAX] 8% State Surcha 10/2/200E $5.80
Total $78.30
Phone:
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -519 -6199
FAX 503- 238 -9767
Reg #: LIC 38868
This permit' 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.
Issued By: Permittee Signature:
_
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 4 ,
City of Tigard , )) It— J _ . 1 1 1 , . 1 :- Received Permit No G •
J `� + n Date/By: � t.J C (N U (N e�0
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 '441411i Date/By:
Inspection Line: 503.639.4175 r ( Ready/By: 65 See Page 2 for
Internet: www.ci.tigard.or.us OCT 0 9 11 ' _ - - Date kris:
g Notified/Method: Supplemental Informadon
�� r . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
_
k1�P1 ( VfORK ° ,r " (I >f v ' ■i "• ° ' ' _ 11" 1 ' Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ C J (/ U.
dwelling Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 g ❑ ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description I Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling '
Job site address: /l2_7t 4 'Z, ..,7 / Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP:
..../ jp Dome y-) Z I-9- Furnace 100,000 BTU (ducts /vents) 14.00
` f Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: (, JS - '�,i4e-e.-- Gas heat putnp 14.00
Cross street/directions to job ste: 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
Subdivision: Lot no.: Flue /vent for any of above 10.00 ' i
Other: 10.00
Tax map /parcel no.: Other fuel appliances •
DESCRIPTION OF WORK . Water heater 10.00
�/
/ r Gas fireplace 10.00
Mezc.S ✓.� (r d e .( G-/4 ,r z 4, d.... (;,.„rw,) Flue vent for water heater or gas
— / ti fireplace 10.00
/ � // j Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER 1 ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation --
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: PiZo7 d,j' 'slid 0 C_//). / C Other: 10.00
Fuel piping
Contact name: n ft J 4 �A/,e__/L $5.40 for first four; $1.00 for each additional
Address: 9 7 8 8 S / 2 /A /1'144_ Furnace, etc.
�,
(� Gas heat pump
City/State /ZIP: P .. \ Qoc - Wall /suspended /unit heater
Phone: (j j) S i _ f 1 S � Fax: : (S(M — 2/ 8 s > ( -.5 Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: ,_...c4/s1 Other: dryer (gas)
/� /�'Oo Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) I Fax: ( ) Minimum permit fee ($72.50) . - -..
� Plan review (25% of permit fee) _.....
CCB lic.3f�er7 / State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1 34
Authorized signature IV iza. This permit application expires if a permit is not obtained within 180 f
I
days after it has been accepted as complete.
Print name: Date: / -�� Fee methodology set by Tri- County Building Industry Service Board
is Bui lding \Penniu \MEC- PertnitApp.doc 1 V03 440.4617T(1 l /02/COM/WEB)
CITY AF TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00466
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/2 /2006
Phone: (503) 639 -4171 qg �'
Inspection Requests (24 Hrs.): (503) 639 -4175 1 L
INSPECTION WORKSHEET FOR DATE: 10/4/2006 TIME: 7 : 02AM PAGE: 23
SITE ADDRESS: 16270 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 018 TYPE OF USE:
PROJECT NAME: WAREHOUSE SPACE
DESCRIPTION: Pressure check gas line & green tag. Valuation: $400.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503 -519 -6199
Inspection Request Scheduled For: Date: 10/4/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 037652 -01 503 - 519 -6199 Y
Corrections /Comments /Instructions:
A - '•" I
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[PASS Ill PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FIR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , � � I�a _ Date: Phone #: (503) 718 ,
UV