Permit ' CITY OF TIGARD MECHANICAL PERMIT
liA DEVELOPMENT SERVICES PERMIT #: MEC2005 -00132
. - ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/12/2005
PARCEL: 2S113AD -01800
SITE ADDRESS: 16752 SW 72ND AVE B14 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 011 JURISDICTION: TIG
Project Description: (1) new 3 -ton roof top unit, ducts, grilles & the same for (1) existing RTU including gas pipe extension for
existing gas line. Valuation: $3600.
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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 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: 1 GAS OUTLETS:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 4/12/200 °. $109.30
PORTLAND, OR 97224 [MECPLN] Plan Rev 4/12/200: $27.33
[TAX] 8% State SurcharE 4/12/200; $8.74
Phone: Total $145.37
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97222
Phone: 233 - 6911
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: A Zdi Permittee Signature: )6
all 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.
/6 252 SUu _A- oc ia-1z / kfe
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tieltd Fl ii r I� � �� Received _ Permit No. . G �
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review /
Y /� `
Phone: 503.639.4171 Fax: 503.598.1960 Other Permi
Inspection Line: 503.639.4175 //i a 'r Date/By: m � 00 V "(� --P-. Internet i Line. www.ci.tigard.or.us - ■ ,r.,i 1 "-- c '' II D ReadyBy: Juris: See Page 2 for `�
g Notified/Method: . 17er Supplemental Information 1
. . • i'iib i!' -: C.OMMERCIAL.'FEE* :SCHEDULE - USE CHECKLIST Q
Mechanical permit fees* are based on the value of the work
1:1 New construction ..Q
v\
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
- ; ; ..CATEGORY. OF- ,.�. , Value: $3 p 6_ . d o '
l- and 2-family dwelling �Coltlmercia1Iindustrial RESIDENTIAL. EQUIPMENT /SYSTEMS FEES*
El y g ❑ Accessory building '
For special information use checklist.
❑ Multi ❑ Master builder ❑ Other: Description I Qty. Ea. Total
p
•, . r .. , JOB SITE .IIWFORMATION : AND LOCATION' � .. Heating/cooling
Job site address: / j Air conditioning or heat pump
/6 ? V � ( ? ���^^^���_ (requires site plan showing placement) • 14.00
City/ State/ZIP: �('� ., O/ _- 92 AL y Furnace 100,000 BTU (ducts/vents) 14.00
Project nam�/�J �j L.1
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.:
Li 7' /L /L Zf filar G►Cas heat pump 14.00
f...
Cross street/directions to job site: 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
Other: 10.00
Tax map /parcel no.: Other fuel appliances
f:r F .. 1 , ,i� r7 . .."..'2',..!.:1',:q x Water heater 10.00
S DE OF WORK r + v p u
y �i Gas fireplace 10.00
1 ++ Iue..4.J 3 7a43` R o/ at) //, Aid- v i. r Flue vent for water heater or gas
AA49- at R pV �/ s CD /- i '' kr 11r d ' fireplace 10.00
� � � Ate �s Log lighter (gas) 10.00
a f u, / )c 0,1444 k 8 G44-d Pr pe.. �)e�rn»in0 rN Wood/pellet stove 10.00
P . (s77.1)( a ( .1NZ Wood fireplace/insert . 10.00
;F ❑ <. ,_., Chimney/liner/flue/vent 10.00
"1 , i •J ! ROPERTihoti NR ., ttr, d� ] TEF.1 . 7 , ; %., t ' v
.. ? .,4,.•,- r,, .��.�.� ,�,, E _ , ,. ,,. .. . ..a 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
'f; s; .'' li :;, ; i-r r �.°
�s4� 1°1�E �:�. .,.. �_ ,� : , u �',CO_ NTA�'T PERSOIk�- Attic /crawlspace fans 10.00
' < "" ?: °,' .
Q ' Other: 10.00
Business name: iv R a / ,,,... Assoc.. / „prof' ,L,l, f Fuel piping
Contact name: 6A u G & lj L .,7-,..1/ e ,,, $5.40 for first four; $1.00 for each additional
Address: - Sc_ 97es g' . ! 7r`, 41/,y , Fumace, etc.
•
Gas heat pump
City/ State/ZIP: /Or i ( "Lit 0/1-ec C J 9/1, Wall/suspended/unit heater
� 5 5 ._ G / ? ® 5 03) � 7 c , Water heater
Phone: 'V' / Fax: : (
Fireplace
E -mail: Range
''%'''''i''''1 , � t . 1 .
/- 4 5r ' -' GO AI'TRACTOR p - s 1"'11: 1"y.� , 5 . 4. t . , s:~ , Barbecue
r . . � f�i L , .� -. •_ .
� 2.- !d . ..._ --r,,... ...,. ,,
.r , kc, ?t'!. Tell ..,- ,1 _
w Busnness name: S'441 S 4 !_ Ord_
Clothes dryer (gas)
Other:
Address: ra, ', MECHANIEAL.PERMITFEES*
City/State/ZIP: Subtotal
Minimum permit fee ($72.50) id
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) ,R 7,33
CCB lic.: 3 t State surcharge (8% of permit fee) g,7
TOTAL PERMIT FEE f yf.3
Authorized signature: -a, a�, This permit application expires if a permit is not obtained within 180
days after it t has been accepted as complete.
mplete.
Print name: 8R u c /2 ✓ i "Je__A__ Date: • Fee methodology set by Tri County Building Industry Service Board
i:\ Building \Permits \MEC- Pem,itApp.doc 12/03 440.4617T(1l /02/COM/WEB)
CITY O F TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1212005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 , 1!1.
INSPECTION WORKSHEET FOR DATE: 4/27/2005 TIME: 7:11AM PAGE: 98
SITE ADDRESS: 16752 SW 72ND AVE B14 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE:
PROJECT NAME: MCKENZIE ATHLETICS
DESCRIPTION: (1) new 3-ton roof top unit, ducts, grilles & the same for (1) existing RTU including gas pipe extension
for existing gas line. Valuation: $3600.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 233 -6911
Inspection Request Scheduled For: Date: 4/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 005383.01 503 -519 -6199 Y
Corrections /Comments /Instructions:
WilgT„r
•
•
wa
^r f iT
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL , • CALL FOR I -PECTION ❑ ADDITION FEES A SESSED
Inspector: 407 ` Date: — PProne #: (503) 718-