Permit ,/1
r CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00685
A 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/1/03
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 610
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P
. BLOCK: LOT: 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: Add (1) VAV box, relocate (1) t - stat, install (4) air transfer boots, add (4) return grilles. Project value: $6,000
Owner: FEES
EOP LINCOLN, LLC Description Date Amount
10260 SW GREENBURG RD
SUITE 100 [TAX] 8% State Surchari 12/1/03 $12.76
PORTLAND, OR 97223 [MECH] Permit Fee 12/1/03 $159.50
Phone: Total $172.26
Contractor:
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Phone: 331 Mechanical Insp
Duct Inspection
Reg #: LIC 40981 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
Issue By: •'PI Permittee Signature: ( 4,e
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
I 4ehani ca1 Per mit Application -__ ' -- -FOR OFFICE -USE ONLY -
Received Mechanical •
x` Date /By f / 43 Permit No.: f ` / te.�do. 3 - 5
City of Tigard Planning Approval Building
Date /By. Permit No.:
1125 SW Hall Blvd. Plan Review Other
i igard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 A �. Post- Review Land Use
Internet: www.ci.tigard.or.us ' ; ��� i Date /By: Case No.:
L W Contact Jyp$- Z See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method / F� Supplemental Information.
TYPE OF WORK ' COMMERCIAL FEE* SCHEDULE -USE CHECKLIST ; _
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
ddition/alteration/replacement ❑ Other: - - • •• icate the value (rounded to the nearest dollar) of all
' . . 'CATEGORY OF CONSTRUCTION" <:; ;', mechanical materia —7a . a or overhead and profit.
❑ I & 2- Family dwelling ❑ Commercial/Industrial Value: $ 0 1 M • ,(31. 'ee Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family H • LE ' •.STEMS-FEE* SCHEDULE.
Description Qty Fee(ea.) Total
❑ Master Builder ❑ Other:
Heating/Cooling
JOB SITE INFORMATION.and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: 10220 SWC 'IVBE2t9 te0, Gas heat pump 14.00
Suite #: (0/0 . Bldg. /Apt. #: Duct work 14.00
Proj ect Name: TWO LINCp1 —FU SC) I'r�� (g, b0 Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision:1'r, ° I„ IN CL?L, U Lot #: Repair units 12.15
Tax map /parcel #: Other Fuel Ap !lances
Water heater 10.00
^ - _. DESCRIPTION OF'WORK:' : i ; : ; :.'•.' '-• - . Gas fireplace 10.00
A dd_CL' V A -V BO K p j.( -- 0) T STA T Flue vent (water heater /gas fireplace) 10.00
X i 0 AI t?-71ZAi'11S Frar- F3001-5 Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Add' (5 f be-1L . S Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
, :PROPERTY.`OWNER:'g. •.:.Q =;TENANT: >' <:'_''`. Other: 10.00
Name: Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 10.00
Address:
City/State/Zip: Clothes dryer exhaust 10.00
Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
AAPPLICANT: ,,..,:: ' ❑,:CONTACT.PERSON', . .. utility rooms) 6.80
Name: Mc..ILI NSyfZ.V C.0 Attic /crawl space fans 10.00
Address: 5 N e CoL. t ,rn .g L V r) Fuel 10.00
Fuel Piping
City /State /Zip: eT► Nf0,v2 * *($5.40 for first 4, $1.00 each additional)
Phone: 553.33f,QZ.3'f Fax: Spa, . ( (o Furnace, etc. **
Gas heat pump **
E-mail: d/ h
CONTRACTOR ;. -. ,.: :' ,,•:, . -. ,;.:.,, .., . Wall/suspended/unit heater * *
Wall /suspende
"- _ - ',, water heater **
Business Name: -1 1AJS11 ... CO , Fireplace **
Address: s -t00 NC GOLUM131A ®i LV I) Range **
City /State /Zip: � yp, 61 c .
BBQ **
Clothes dryer (gas) **
Phone: S ? 0 z31 Fax: 6 35 , (, j( Other: **
CCB Lic. #: `-0iplil Total:
Authorized Mechanical Permit Fees*
0 iature: 6 /YI Date: /��2403 Subtotal: $
Minimum Permit Fee $72.50 $
0 , - 1 - 6 , ,, , Pi 1 Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i; \Dsts\Permit Forms\MecPermitApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503)139 -4171 MST
BUP
Received Date Requested M a AM PM BUP
Location / 0 22...o Pc
��w✓� t Suite &nl U MEC 3 - 006
Contact Person pc-Q Ph ( ) 3(. - 0S (p-3 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
Other:
Final , \
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
FAIL
ECHANICW
P am
„Rough -In
Gas Line
oke Dampers
PART FAIL
(4),9
TRICAL
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: Unable to inspect — no access
Fire Supply Line
ADA J��2 /
Approach /Sidewalk Date - 3 Inspector t Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL