Permit CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2000 - 00233
c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/12/2000
PARCEL: 2S113AB -00800
SITE ADDRESS: 16135 SW 74TH AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 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: 1
Remarks: Install gas piping in commercial building.
Owner: FEES
JOHN DUNCAN Type By Date Amount Receipt
7060 SW PALMER WAY
BEAVERTON, OR 97007
Total
Phone:
Contractor:
REQUIRED INSPECTIONS
Gas Line Insp
Phone: Final Inspection
Reg #:
ORIGINAL
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 may obtain s of'these rules or direct questions to OUNC by calling (503)246 -9189.
it
Issue By:6_,..) Permittee Signature: ` 0 \
`
Call (503) 639 -4175 by 7:00 P.M. for inspections nee; ;the next business day
Plan Check #
CITY OF TIGARD Mechanical Permit Application Reed B,C-
13125 SW HALL BLVD. Commercibl and Date Recd s 5 �
TIGARD, OR 97223 ?-03 Date to P.E.
Date to DST �ZS'/db
(503) 639 -4171, x304 . � � P ermit # �tiC � -Ua�
Print or Type g
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
DoNc-A B 1 LD / IJ C Table 1A Mechanical Code Qty Price Amt
Job Street address suite# A) Permit Fee 16.00
Address I (o l 3 S t/t) 74 I 1) Furnace to 100,000 BTU
Bldg# City /State Zip including ducts & vents 9.65
2) Furnace 100,000 BTU+
, TiGA-e D 02972
including ducts &vents 12.00
Name o r name of business) 3) Floor Furnace •
Owner W fl Jo 14- . r1,c ,k Tax including vent 9.65
Mailing Address 4) Suspended heater, wall heater
70 (Q J C^ 1 1 , into VV a t or floor mounted heater 9.65
VV ! 5) Vent not included in appliance permit 4.75
/State Zip Phone G -1 Check all that apply: `Boiler Heat Air
beaver I V r' 0 12970)7 g 7 For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp �'
t1 OW Bu I t_!) i n* -i 6) Repair units 8.40
Occupant Mailing Address 7) <3HP;absorb unit to
100K BTU 9.65
_-
City /State Zip Phone 8) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
Contractor Name 9) 15 -30 HP; absorb
R I(. -- v ' �
fnci - / unit .5 -1 mil BTU , 24.15
fT c/ �/"�� 10) 30 -50 HP; absorb
Prior to permit Mailing • - AA � d dd dr � e ] ss Yv���/�^ I/--- D unit 1 -1.75 mil BTU 36.00
issuance, a copy . Jo`��TS �• T �r 11) >50HP; absorb unit >1.75 mil BTU
of all licenses City /State zip hone 60.15
are required if 641\-
e O/ 97O/ 5 1 - °/� 12) Air handling unit to 10,000 CFM
expired in COT Oreggn Const_.on�oard Lic.# Exp. Date 7.00
database to 44 33 0` 13) Air handling unit 10,000 C FM+
Architect Name Y 11.85
hJ /COL_/ r/�T/A 14) Non - portable evaporate cooler
or Mailing Address 7.00
9U 25 6 lit/ c N -ST 15) Vent fan connected to a single duct
4.75
J7 ), "� '✓
Engineer City /State / � j � 722 zip Phone �,.p
N i J 3 / - � Oci / 16) Ventilation system not included in
1 ( !(J b appliance permit 7.00
Describe work to be done: I 17) Hood served by mechanical exhaust
7.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Domestic incinerators
Residential 0 Commercial 0 Modification 0 12.00
19) Commercial or industrial type incinerator
Additional information or description of work: 48.25
20) Other units, including wood stoves
7.00
NOTE: For Commercial projects only; Units over 400 lbs., located on the Q Gas piping one to four outlets
roof, require structural calcs. prepared by licensed engineer. 3.75
Type of fuel: oil 0 natural gas LPG 0 electric 0 22) More than 4 -per outlet (each) .75
I hereby acknowledge that I have read this application, that the information Minimum Permit Fee $50.00 SUBTOTAL 2
given is correct, that I am the owner or authorized agent of 8% SURCHARGE i $ -
the owner, that plans submitted are in compliance with Oregon State laws. PLAN REVIEW 25% OF SUBTOTAL iniii,
t;
Required for ALL commercial permits only :
Signature er /Agent • Da TOTAL S
C a' Person Name
Phone / Other Inspections and Fees:
t I ���1 �O7 - { 7 S 1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
Cl / "" 2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
Foonotes for commercial projects only: $50.00perhour
1. Provide full schematic of existing and proposed gas line and pressure. 3. Additional plan review required by changes, additions or revisions to plans (minimum
2. Provide drawings to scale showing existing and proposed mechanical charge - one - half hour) $50.00 per hour
'State Contractor Boiler Certification required
units. "Residential NC requires site plan showing placement of unit
I: \mechperm.doc rev 11/1/99
OVER - THE - COUNTER (OTC) PERMIT
•
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: 61 2 ta e.J
Class of Work: (97 Floor Furnace: Evap Coolers: .
Type of Use: m Unit Heaters: Vent Fans:
Occupancy Grp: 6 Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Flo Dryer:
Fire Dampers: 10000 cfm: Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets: /
No. Of Units:
Furn < 100k Btu:
Furn >_ 100k Btu:
NOTES:
COMMERCIAL INSPECTION ACTIONS FEE MENU
as $ Permit Fee
echanical Inspection $ � Plan Review
Cooling Unit Inspection $ L 8% State Surcharge
Shaft Inspection $ Additional Permit Fee
Hood Inspection $ • Additional Plan Review Fee
Fire Suppr Inspection $ Inspection Fee
Duct Inspection $ Miscellaneous Fee
Fire Alarm Inspection
REMARKS:
Fire Damper Inspection
Miscellaneous Inspection
Fire Alarm Inspection
Final Inspection
OR` ICE U USE ONL > ,x ,� v
F
TYPE OF U,SEOPTIONS (COM commercial _iCMS t commercial r anuf .� ,�
CLASS OF . ORK OPTIONSFOR ALLL PEER�MITS (NEEW near DD ads ion ALT Iteration; ARCS — accessory ,n ,
if i f uundationO.TH. othe DEM e 5 olition REP re air FP =fire protection s ystem' NOTE USE * OTH,FOR FENCES, RETAININGr
WALL� DECKS SIGNs,. AWNINGS CANQPIES) 4 , i'. g -
1: /dst/forms /otemech.doc 9/99
i:\dsts\forms\otc-mech.doc9/99 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Li /Ob AM PM BLD
Location 1 Lo 1 ; Suite MEC Za - 002-S3
Contact Person - 1)Y' Ph TO 7 1 PLM
Contractor Ph SWR
BUILDING ;' _ = Tenant/Owner ELC
Retaining Wall ELR •
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing -" /ii/.es- - 7 - F) 7Q L
Firewall
Fire Sprinkler
Fire Alarm 7/4/-e Al 7
Susp'd Ceiling L
Roof
Misc:
Final _
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHANICAL
Post & Beam
Rou•h In
m• e Pampers
Finaf
�� PART FAIL
ELECTRICAL
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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date /V /O Inspector / rfr Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.