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Permit CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 -00608 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/13/2004 PARCEL: 1S126DC-03300 SITE ADDRESS: 09900 SW GREENBURG RD 220 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: ALT 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: 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: Remarks: Relocation of diffusers for TI. Project Value: $880.00 Owner: FEES ATHERTON REALTY PARTNERSHIP Description Date Amount MARTHA ATHERTON [MECH] Permit Fee 9/13/200 $72.50 2100 S WOLF [TAX] 8% State Surcharl 9/13/200 $5.80 DES PLAINES, IL 60018 Phone: 847 298 - 8600 Total $78.30 Contractor: OREGON AIRE INC 7715 NE 33RD DR., STE. A PORTLAND, OR 97211 REQUIRED INSPECTIONS Phone: 503 Mechanical Insp Final Inspection Reg #: LIC 64235 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 • . to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 9 -• 01 -0010 throb , OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 03)246 -6699. ued By: l��j� /' Permittee Signatu • 4P�C n Call (50 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application . OFFICEUSE ONY . City of T R eceived permit No.: ���� 13125 SW Hall Blvd., Tigard, OR 97223 RD'/By: Gle0 on( Phone: 503.639.4171 Fax: 503.598.1960 D ate Review 4e s al , v � `?., ate/B � Other PernPermit: Inspection Line: 503.639.4175 j y Date Ready/By: Ju`' 0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: / / � _ Supplemental Information �. +�,�"i:; - "� , ,, .aw : ';.:,:,� �.5�:u�',^ - , �rr:= x 7,.a -• _:s1:: -�' Q..�xn��a:. «:r: :,:xy . G,. . � z - TYPE4- ,..4`WORT{ =. - W C „ CTAL. F w CHEI), — I ISE r C I3ECICI IST'' .. �^ o, :���� . _: ..�....�r�"� _�. n �_ . �t....�t a. �,a�f;r - - _.,�_. .��:,_.� , .. . .. s_ ; Q1 _, ,EE...:5' ❑ New construction V Addition/alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other: mechanical materials, t is equipment, labor, overhead,�d t. X Off`•,,, I2IJCTIOIY r Value: $ �(r1/� ��� ,.. laaaar_ «..d.�.} .. ,.K» .,.. .. , ... . ��.. `9.. � ._...;�, ^t va- :.s c=��_, - ,. -. . . r . F- , (6,,r, -• - . ,�: „. ,:..«. u _ . ` RESIDE PI TI ?cI A9 P ; k r W . NT` /=S ,§01 EEES* ❑ 1- and 2- family dwelling V Commercial /industrial ❑ Accessory building ” °" ° "` " " . "` "' ' " ' ❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist. Description Qty. Ea. Total . 4T rv'a, ry. :�; / 64gr ; :ig =:.a ; w.; .: .r sv .._;t, ;x 1 ,. „�. ,..z;1; S,t l .s ,C i " - •' -::J®B ITr F > RM AT ON AND Is I1L®N. ''' "" � 7 .- _,_ :1`„';;' ��t;`:.a�r.��^ �::�;°�.�-� - „,S ESN O I. ,h. �ss .� �p.v.._...�� -,»�. Heating cooling Job site address: , 5 , 66 ed 04 G ,I but.n Rio Air conditioning or heat.pump ' L° (requires site plan showing placement) 14.00 City/State/ZIP: ) � Airt0 Fumace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 1 7.90 Suite/bldg. /apt. no.: a &0 Project name:` -, , 5 ...,tic Gas heat pump 14.00 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 4x +. Si , fi x r " . -.,,- c T> En }k `^�. :k:i; ze:, , ltl- z:..7' . `k;',.F ,g Water heater � � t � 10.00 r � av D.E, 'ION ' WO ' g : .. .,2ti�". . ,.�� r4 .,'.i;F.� ��� :��...:...a�x� .�-.� -a..e�rk u . :�.� ,.',fix .,�, . es"'a� Gas fireplace 10.00 :_ ' .0 ,0 - a , ■ �_ ,/ t ` a Flue vent for water heater or gas fireplace 10.00 ' Log lighter (gas) _ 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 Q E RT�Y ;OWNER ar t ` TENANT ' . " z. Chimney/liner /flue /vent 10.00 �-, . �� 1 s zaa�,a , - � mw w° y, _� .� ;,:'�,`8 a s � .yam `a..r s - � ���� « -� Oth 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 ss y �AAI'I'L' IC 'ANT a E GONT IERS ON� " ' Attic /crawlspace fans 10.00 • /� /� Other: 10.00 Business name: 6 /C- �°,rl®�' b /,,l7 C r Fuel piping Contact name: R 1, � I, $5.40 for first four; $1.00 for each additional Address: 77 IS Y I IF 3 /3,® Da Furnace, etc. /*t � Gas heat pump City/State /ZIP: 7` L 0 2 F' (9 iJ Wall/suspended/unit heater Phone:, Fax: : Water heater E -mail: . Fireplace Range I ..- ak ,f ::. . # . N TRI " MV : S 7 ° , .-, _ � ,� u,�` Barbecue Business name: Clothes dryer (gas) Other: Address: s ,., :- .1 : ; 1IECH'AN,ICAL N, :0FIJ City/State /ZIP: Subtotal Phone: ( ) Fax: Minimum permit fee ($72.50) Zp� * JD ( ) Plan review (25% of permit fee) CCB lie.: 6 Lj a State surcharge (8% of permit fee) 5. to TOTAL PERMIT FEE 7 . Oa Authorized si atllr This p e rmit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name , e„ ( Z41 - 4, — .L - Date: 4._1?., U v * Fee methodology set by Tri- County Building Industry Service Board i:\Building \Permits \MEC- PemiltApp.doc 12/03 440 -4617T (I I /02 /COM/WEB) Mechanical Permit Application - City of Tigard , 4.... Page 2 - Supplemental Information • Commercial Fee Schedule: of Qtal uat on .,_E- $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. ' $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i :\Building\Permits\MEC- PermitApp.doc 12/03 2 ft PIP • I PAY rrY11"KWI WIWI') W�Mr TL7wwo7ow 1 a r- 11.1/3" r I N F J=: *E: N E II a o 1 t 1 .. x ra II � II I t 1 ; ! 1 0 I I �` ! : COVE - n: � ' ''' *Er x 16 ) -_- "-off �. 0 EI t � !- _ _ E E i! i la © - i. K 1 t T * a. 1� `, i � o I k I � x 6' _ ,FN' Ry `(- is . r Z — ■ >✓ � ®�. NI. - TELEi4ONE �S 1 '1 N � N .7 . aa- -�?�� � ... tea \ l + � N N ; r C t Ir X 11' WOMEN k - x 12 in .-i -0" v p . Ir 90 IZIEEM ` R �Or o , N �N / e © E^ '�" CZ x14'_ . . - 1 ? y 1<,, f = =a.6 : 4. ..i4s«: -""----"• Al E _ 'i . E � _ a - • 11-,-- , ,, 1 r I ,, .0 „ f© C N tTxT -5 N c . � E! t • +7 x 7Ay - l '.,1 4 , a A EXIT !9 E i _ •I` 1 N 148` • ...rms.= - y - y 9 1 N�0 - (1 1 - 't , 11 POSED FLOOR P Vii e 1 SCALE- 1/8 .. 1.-0,. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST (1-/°°3 BUP vYJ� g Received rr,� Date Requested / AM ✓ PM BUP L [ Location ! v �1 �!�4 L 4 Suite 2 MEC , i --60 (an 6 Contact Person h ( ) 5 40 3 " b 13 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling � — Roof g —I) ASS ' PART FAIL I PLUM G I1 / Beam \ ��. 1o•_ �' Under Slab '� ` Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL _ MECHANICAL Post & Beam Rough -In Gas Line Sm• • - 'ampers PART FAIL - ' RICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: El Unable to inspect – no access Fire Supply Line ADA Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL