Permit CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00452
11 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/26/2005
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 420 ZONING: C -P
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT: JURISDICTION: TIG
Project Description: Mechanical TI, relocate (1) supply diffuser, (1) return grill, & (1) thermostat. Add (1) return grill. Project
Value: $883 .
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:
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:
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA #300 [MECH] Permit Fee 7/26/200E $72.50
PORTLAND, OR 97258 [TAX] 8% State Surchars 7/26/200E $5.80.
Phone: 503- 293 -2745 Total $78.30
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97218
Phone: 503 331 - 0234
Reg #: LIC 40981
•
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-,33123 A .
Issued y: il• � �� /!j1L Permittee Signature:
�
Call 503 - 639 -4175 by 7:00 a.m. for inspections th 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.
1
M. . Permit Application . FOR OFFICE USE - ONLY ,• .
Ci O ' igard Received 5 Permit No.: gC
13125 SW Hall Blvd., Tigard, OR 97223 ✓ �"
Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 �mp��;.,, I � It, Date/By: Inspection Line: 503.639.4175 , 1 J e,f l Date Ready/By: Juris: El See Page 2 for
Internet: www.ci.tigard.or.us "''" ""
g Notified/Method: Supplemental Information
u.;. 3rt., 3x^ >.:�,,.,_:� r =�.xm. ..::..:...,.�Z .::. , <F�_�*�,�� <Y, :. ,;;::.,. ,W_�,,�,,... �...�..,, :x-,.�dzy� >..a�? °•,w >pr°;E �,:.,,s- ,;s, ^.P ��a,m ��:::z�:
Tl'PE,:O1;' QR , r �,�<, r .., a= ; - 9A ERCIA. FEE . 04 • LII V SE GHECKI:0 ;
:_._: �_- .. �y� ..� . �.. _.,��v,�c. �b:e__s, �... � ._.�.:.� : ,:,nr =�_,.� = s_<;�•.x..� .� -` -=� � .�,,�o�.� m:�,�.�a.,a .. ,.. .. _ ,. _..,...:. _... _ _, e . _ ..., .. _ .�o -,�€� s,...e.�.,_�..._ v
❑ New construction ® • Add Mechanical permit fees* are based on the value of the work V
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labs overhead, and •rofit.
: ::: ._. :.. ,_•.,,,- ., -, :v::,: ttte. Value: $
,.,_ < _ . , ,.:::_:._ A�T OF, S'I?RIJG'I'lO1�T' .� -:�
E SIDT~Nxl : 1 41 QL :0; , < :51 §i EES ` *=
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❑ 1- a nd 2 - fam dwelli ® CommerciaUi n dustr i a l 0 Accessory bu -`� ° ^° °"°` '�`'" � '� -'" "' ,�`
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
FORMATIIF?N °AND L,OCATION:.a- �.M W �.; ; ,t Beating /cooling
�
,.,..... :.. �... � ... � =. ` , �
Job site addressa ,x 0 Greenburg Rd Air conditioning or heat pump
. fol (requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: LA Weight Loss 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
r .` w:` `, Water heater 10.00
�.� Gas fireplace 10.00
Relocate one supply diffuser, relocate one return air grill, relocate one thermostat, Flue vent for water heater or gas
Add one return air grill fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
.g :_ _.i> _:: Chimney /liner /flue /vent 10.00
- YROPER> OWNE$` s °:s TENA1iC° <.:. ,
�; 2, `� ::��d�»� uq>,Y.nt+a�� ._�A - *i4��;�?�, .l :i .':2'.�F:,_ _ _ .__..: �y Y °.,- aoy��,,. -:-
Other: 10.00
Name: C. Schiewe and Associates Environmental exhaust and ventilation
Address: 6615 SW 111` Ave Range hood/other kitchen
equipment 10.00
City /State /ZIP: Beaverton, OR 97008 Clothes dryer exhaust 10.00
503 646 -6617 Fax: 503 644 -9679
Single-duct compartments, rtme nts (bathrooms,
Phone: rooms) ) ( ) toilet compartments, utility rooms) 6.80
'' ;;,' -1 = Titi ,�`"._ ".,_,_°,.' , ' "'" Attic /crawls ace fans 10.00
.041CrTNT ' 'r; " =.L CO , A - --1 .;RSO , P
,s:. ..W,_s.b.... ° " x ,i,.. .... W- =:::.:e_� <;zt����tm 1� ..,, = .3...i3'�exE..:.....,y.?:��,:: = . ti
Business name: McKinstry Co. Other: 10.00
Fuel piping
Contact name: Jason Carver $5.40 for first four; $1.00 for each additional
Address: 12021 NE Airport Way, Ste. G Furnace, etc.
Gas heat pump
City /State /ZIP: Portland, OR 97220 Wall /suspended /unit heater
Phone: (503) 331 -2461 Fax: : (503) 331 -6906 Water heater
Fireplace
E -mail: jasonc @mckinstry.com Range
. ; ONT — , ,,,m4 ; s 1 Barbecue
tr Business name: McKinstry Co.
Clothes dryer (gas)
Other:
Address: 12021 NE Airport Way, Ste. C �? I$T0 (ICA11`I';EI 017.0 ES * =' "
City /State /ZIP: Portland, OR 97220 Subtotal
Phone: (503) 331 -2461 Fax: (503) 331 -6906 Minimum permit fee ($72.50) 7 ,..
Plan review (25% of permit fee)
CCB lie.: 40831 State surcharge (8% of permit fee) 5 Sv
TOTAL PERMIT FEE - - , 5r)
Authorized signature: Thi perm app expires if a permit is not obtain within 180
— days after it has been accepted as complete -
Print name: Jason Ca r Date: 7/26/05 * Fee methodology set by Tri- County Building Industry Service Board
i:\Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (11 /02 /COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00452
' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2005
Phone: (503) 639 -4171 / v , 01 I "N +I
Inspection Requests (24 Hrs.): (503) 639 -4175 h'I -..
INSPECTION WORKSHEET FOR DATE: 8/1/2005 TIME: 7:05AM PAGE: 74
SITE ADDRESS: 10220 SW GREENBURG RD 420 CLASS OF WORK:
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT #: TYPE OF USE:
PROJECT NAME: LA WEIGHT LOSS
DESCRIPTION: Mechanical TI, relocate (1) supply diffuser, (1) return grill, & (1) thermostat. Add (1) return grill.
Project Value: $883
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503.293.2745
CONTRACTOR: MCKINSTRY CO PHONE #: 503- 331 -0234
i
Inspection Request Scheduled For: Date: 8/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012499 -02 503. 572.7975 Y
ce) 3 - s7). -797s
Corrections/Comments/Instructions:
a ,-•
----- 1\k_V i 4- _ m
/PASS ❑ PARTIAL APPROVAL . ❑ CANCEL n NO ACCESS
❑ FAIL I I CALL FOIrPECTION ❑ ADDITI AL FEES ASSESSED
id iL Inspector: A t AK D ate: l- Phone #: (503) 718 -
.F