Permit C ITY OF TIGARD MECHANICAL PERMIT
A A DEVELOPMENT SERVICES PERMIT #: MEC2000 -00281
A DATE ISSUED: 7/20/00
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 13AA -00900
SITE ADDRESS: 16540 SW 72ND AVE B -07
SUBDIVISION: ROSEWOOD ACRE TRACTS ZONING: I -L
BLOCK: LOT: OOD JURISDICTION: TIG
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: 4 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
i FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 0 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 0
> 10000 cfm:
Remarks: Install (4) rooftop units
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PLCK DEB 7/20/00 $21.65 0003847
PORTLAND, OR 97224 PRMT DEB 7/20/00 $86.60 0003847
5PCT DEB 7/20/00 $6.93 0003847
Phone: Total $115.18
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 233 -6911 Mechanical Insp
Reg #: LIC 00038868 Duct Inspection
ELE 201JHA 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 m in opies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue y: Permittee Signature: ntin 0 .__S)
Call (503) 639 -4175 by 7:00 P.M. for inspections need the next business day
Plan Check #
CITY OF TIGARD Mechanical Permit Application. Recd By
131.251W HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 JV 2000 Date to P.E. �D j2C( /�
(503) 639 -4171, x304 /' Date to DST
Print or Type MMUNITY DEVELOPMENT Permit * C Zc%)c'-75,
Incomplete or illegible applications - will not be accepted t � �, d , s s S ° c
Name of Development/Project Description
to I utKe_b.u.t.it Table 1A Mechanical Code Qty Price Amt
Job street Address Suite# • A) Permit Fee 16.00
ddress 1' "` ' � O 1) Fumace to 100,000 BTU
d _ _ 1 dr 4La(ga0 `-'1A/ 721Alik a- including ducts &vents see footnote 1,2
u p L i,/ Bldg# city /state / zip 2) Fumace 100,000 BTU+
J ` j ? (( j t� Q � including ducts & vents see footnote 1,2 12.00
• Name (or name of business) 3) Floor Fumace
Owner 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
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
footnotes 1,2 Comp
Name (or name of business) 6) <3HP;absorb unit to
100K BTU 9.65
Occupant Mailing Address 7) 3-15 HP;absorb unit
p 100k to 500k BTU '"' A- 17.65 1 b 7
City /State Zip - Phone 8) 15 -30 HP; absorb
• unit .5-1 mil BTU 24.15
9) 30-50 HP; absorb
Contractor Name unit 1 -1.75 mil BTU 36.00
j•� iF7 /117C-. / /VC. 10) >50HP; absorb unit .
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy 107 Na..... COl tGii 11 Air handling unit to 10,000 CFM
of all licenses City /State Zip Phone 7.00 .
are required if , R ll.A1 4Z 9732 033 9 (1 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board LIc.# Exp. Date 11.85
database 3 'f56 $ /0 D/ 13) Non - portable evaporate cooler •
Architect Name 7.00
14) Vent fan connected to a single duct
4.75
or Mailing Address
15) Ventilation system not included in
• appliance permit 7.00
Engineer City/State Zip - Phone 16) Hood served by mechanical exhaust
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) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
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 O 22) More than 4 -per outlet (each) .7f_._i�
Minimum Permit Fee $50.00 SUBTOTAL
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE
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. Required for ALL commercial permits only ' ' ,L
• TOTAL . ID �D/
Signature of Owner /Agent Date - - -
Other Inspections and Fees:
1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
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 NC requires site plan showing placement of unit
I:\mechperm.doc rev 7/19/99
/2_0Sc.4/ .cfrc Tr4.G1-
OVER- THE - COUNTER (OTC) PERMIT
,~ COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: TT
•
Class of Work: Floor Furnace: Evap Coolers:
'Type of Use: Cara Unit Heaters: Vent Fans:
Occupancy Grp: 4?i Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - . 0 - 3 HP. f Repair Units:
/ / / / 3 - 15 HP. g- ti Wood Stoves:
Max Input: Btu: Air Handling Units .. Io Dryer:
Fire Dampers: <_ 10000 cfm: - Oth Units:
Gds Pressure: H / M / L > 10000 cfm: Gas Outlets: c
Np. Of Units:
Furn < 100k Btu: l •
Furn >_ 100k Btu:
• NOTES:
C INSPECTION ACTIONS FEE MENU
Gas me Ins • ec tio, c g O $ ce9 r` , d� (� Permit Fee 77
- _ $ 'T� Plan Review
(4,--1-
2 I ' 69-
$ - 4er 8% State Surcharge c-4.--6 • Cooli g Unit Ins•e «'•
Shaft Inspection V $ Additional Permit Fee
Hood Inspection $ Additional Plan Review Fee
Fire Suppr Inspection $ Inspection Fee
,"r nspecti• • $ Miscellaneous Fee
Fire Alarm Inspection
REMARKS:
Fire Damper Inspection
Miscellaneous Inspection
Fire Alarm Inspection
in spection
•hoeE Silel i Dodi
FOR OF ONLY:
TYPE OF USE OPTIONS (COM = commercial; CMS = commercial manufactured structure) . ,
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW = new; ADD = addition; ALT = alteration; ACS = accessory;
FND = foundation; OTH = other, DEM = demolition; REP = repair, FPS = fire protedion system. NOTE =USE OTH FOR FENCES, RETAINING
WALL, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES) - . -
l: /dst/forms /otcmech.doc 9/99
is \dsts \forms \otc- mech.doc9 /99 1 _
CITY _OF TIGARD BUILDING INSPECTION DIVISION MST •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 PAW
'3O6 g Date Requested �� AM PM BLD V r �
Location /c) `7 70 Suite MEC o � CO DG B ,
Contact Person Ph 3 3 6.9// PLM
Contractor / Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing etze /�� 4e/C— Foundation Access: FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING _
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ligitELANICA
Post & Beam
Rough In
Gas Line .
Smoke Dampers
PART FAIL
RICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspect' • n RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date 2 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection re rd from the job site.