Permit � � CITY OF TIGARD MECHANICAL PERMIT
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g . COMMUNITY DEVELOPMENT Permit #: MEC2009 -00461
TiC 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/02/2009
Parcel: 1 S136DA02300
Jurisdiction: Tigard
Site address: 6900 SW ATLANTA ST
Subdivision: OEA Lot: 0
Project: Oregon Education Association
Project Description: Replace, relocate and repipe boiler. State Boiler Permit: 109 -41621
Owner: FEES
OREGON EDUCATION ASSN Description Date Amount
6900 SW ATLANTA ST
TIGARD, OR 97223 Permit Fee 09/02/2009 $959.00
12% State Surcharge - Mechanical 09/02/2009 $115.08
PHONE:
Contractor:
MCDONALD MILLER FACILITY SOLUTIONS
12801 NE AIRPORT WAY
PORTLAND, OR 97230
PHONE: 503 - 262 -5402
FAX: 971- 244 -0902
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 1 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $1,074.08
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to O' C by calling 503.246.6699 or 1.800.332.2344.
Issue By: i l ' Permittee Signature: I
Call 503.639.4175 by 7:00 a.m. for an inspection 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 Applicati FOR OFFICE USE ONLY
City of Tigard ��� � Date/By: ` � BrD ! I' Permit No.: We e: 9069-60 c/
- ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review `�-vY
Phone: 503.639.4171 Fax: 503.598.1960 E 0 2 7.009 DateBy: Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris' El See Page 2 for
Internet: www.tigard- or.gov CITY OFTIGARD Notified/Method: / /0 Supplemental Information
Iii JILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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 , o rhead and profit.
CATEGORY OF CONSTRUCTION Value: $
1- 2-family dwelling RESIDENTIAL EQUIPMENT / I YSTEMS FEES*
❑ y g ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 6900 SW ATLANTA
(requires site plan showing placement) 14.00
City/State /Z1P: PORTLAND, OR 97233 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.:4 Project name: OREGON EDUCATION ASSOCIAT Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 'SIC 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of ( �bove 1 6.80
Other: ( ADf}rtie 1'i Pi r.X t o 4/- /'f1 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
REPLACE & RELOCATE & REPIPE BOILER Flue vent for water heater or gas
fireplace 10.00
le ^ 1 ) - Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: OREGON EDUCATION ASSOCIATION Environmental exhaust and ventilation
Address: 6900 SW ATLANTA Range hood /other kitchen
equipment 10.00
City/State /ZIP: PORTLAND, OR 97233 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)720 -0685 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: MACDONALD- MILLER FACILITIES SOLUTIONS Fuel t m
P g
Contact name: RICK RIEHL $5.40 for first four; $1.00 for each additional
Address: 12801 NE AIRPORT WY Furnace, etc.
Gas heat pump
City/State /ZIP: PORTLAND, OR 97230 Wall /suspended/unit heater
Phone: (503) 969 -3802 Fax: : (971) 244 -0902 Water heater
Fireplace
E -mail: RICK.RIEHL @MACMILLER.COM Range
• CONTRACTOR Barbecue
Business name: MCADONALD- MILLER FACILITIES SOLUTIONS Clothes dryer (gas)
Other: I
Address: 12801 NE AIRPORT WY MECHANICAL PERMIT FEES*
City/State /ZIP: PORTLAND, OR 97230 Subtotal 951 'PC
Phone: (503) 262 -5402 Fax: (971) 244 -0902 Minimum permit fee ($72.50)
Plan review (25% of permit fee) ---e
CCB lic.: 154368 State surcharge (12% of permit fee) // it , Og
TOTAL PERMIT FEE A7 �/ l�'
Authorized signature: ' This permit application expires if a permit is not obt a within 180
days after it has been accepted as complete.
Print name: RICK RIEHL Date: 8 -25 -09 * Fee methodology set by Tri- County Building Industry Service Board
C\Building\Permits\MEC- PermitApp.doc 01/19/07 440 -4617T (I1 /02 /COM /WEB)
Fax:5033784101 Aug 10 2009 02:34pm P001/002
•;muter /rressure v essei Installation, mai' payment to:
•' � DCBS — Fiscal Services
rr+ .It eration, or Repair Permit
0 17 , y F.O. Box 14610
z . ° e artment of Consumer and Business Services
'�' �" � Department p Salem, OR 97309-045
s, : ' .�` Building Codes Division • Boiler Section
1535 Edgewater NW, Salem, OR
Mailing address: P.O. Box 14470, Salem, OR 97309 -0404
503- 373 -7538, Fax: 503- 378 -4101 -
Web: bcd.oregon.gov
Any installations, alterations, or repairs crust be done according to the Oregon Boiler Specialty Code. The authorized inspector
must sign this permit and return it to the Building Codes Division (BCD) with their inspection information.
pt CONTACT YOUR AUTHORIZED INSPECTOR BEFORE STARTING WORK.
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Permit no. 109 -41621 Issue date: 8/10/09
Issued to: MacDONALD- MILLER FACILITIES SOLUTIONS _ I B03 -1138
Contractor name License number
For: OREGON EDUCATION ASSOCIATION
Site name
6900 SW ATLANTA ST PORTLAND 97223
Site address ry City ZIP
Authorized inspector: MARIO RAMIREZ `
Phone: 503 - 201- 1471 Fax - - E- mail: `
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Description of vessel: 1,500,000 BTU /H BOILER_ NB state no.:
Size and length of piping: 3" - 20'
Nature of work: INSTALL NEW BOILER
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n Satisfactory I I Reinspection required (state reason for reinspection):
Date: _�.
Inspector name (print)
inspector signature
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Request for reinspection for Permit no.: 109 - 41621
Submit this reinspeetion request with payment, then contact your Authorized Inspector to schedule the reinspection.
Contractor's business name, address, and phone: MacDONALD- MILLER FACILITIES SOLUTIONS
Job site address: OREGON EDUCATION ASSOCIATION 6900 SW ATLANTA ST, PORTLAND
Fiscal code Surcharge code
Reinspection fee: $75 70311/1195 plus 12% surcharge 5 9.00 70311/1291 = $ 84.00
Secure fai for credit card payments: 503 - 947 - 2333 Make check or money order payable to Department of
1f paying by credit card, applicant must sign credit card information box. Consumer & Business Services. Do not send cash.
❑ Visa ❑ MasterCard ❑ Discover Phone: DCBS FISCAL USE ONLY
— Credit cud number Esp r,cion d.to � �
Ndrns orcerdholdc. eve elm. on crodrl card
Cardholder eignature ,Vneu nt
r DEPART NT F
r I
IXSERVICES
440-4853 (7 /09 /COM)
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CITY OF TIGARD
Shaping A Better Community
MEMORANDUM
CITY OF TIGARD
13125 SW Hall Blvd.
Tigard, OR 97223
Phone 503 - 639 -4171
Fax: 503 - 684 -7297
TO: Address distribution list
FROM: Kit Church
DATE: 02/08/00
SUBJECT: Change of address
Please correct your records to indicate the following change of address for the Oregon
Education Association building at the corner of SW Atlanta and SW Haines St.
I EW ADDRESS OLD ADDRESS .
6900 SW Atlanta St. 6900 SW Haines St.
If you have any questions please contact me by calling 639 -4171 x377.
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