Permit ,. 0G\\L
. CITY OF TIGARD MECHANICAL PERMIT
r
tr DEVELOPMENT SERVICES PERMIT #: MEC2000 -00257
� -- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/28/00
PARCEL: 2 S 103 D D -01000
SITE ADDRESS: 13939 SW PACIFIC HWY * **
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: 6 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: (6) 3 -15 HP absorbtion units in new commercial building
Owner: FEES
WALGREENS Type By Date Amount Receipt
13939 SW PACIFIC HWY PRMT DST 6/28/00 $121.90 0003334
TIGARD, OR 97223 PLCK DST 6/28/00 $30.48 0003334
5PCT DST 6/28/00 $9.75 0003334
Phone: Total $162.13
Contractor:
EDISON SOURCE GROUP
5506 SE INTERNATIONAL WY
MILWAUKIE, OR 97222 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 652 -0754 Mechanical Insp
Reg #: LIC 137632 Mechanical Insp
Mechanical lnsp
Mechanical Insp
Mechanical lnsp
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 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246 -9189.
Issue By: Permittee Signature: " �_
Call (503) 639 -4175 by 7:00 P.M. for inspections nee• -d the next business day
•
Plan Check # f0 -7°1 °1
CITY OF TIGARD Mechanical Permit Application Rec'd By
• 13125 SW HALL BLVD. Commercial and Residential Date Rec'd , - 6 - �
TIGARD, OR 97223 Date to P.E. • -2 • -3 -e
(503) 6394171, x304 Date to DST 6 frifir .
Print or Type � � 14 �Uy 2 Permit # mix- 000- /92 y �
Incomplete or illegible applications will not be accepted Called C2 ysT�- ��z
Name of Development/Projed Description
r v J , ' c ro Table 1A Mechanical Code Q Price Amt
Job Street A6dress Suite# A) Permit Fee 16.00
r � 1) Furnace to 100,000 BTU
Address / 3 y / .c. uvy _ including ducts & vents see footnote 1,2 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
r a / C r � including ducts & vents see footnote 1,2 12.00
Name yor n me of business) / , 3) Floor Furnace
Owner Va /limit eo including vent see footnote 1,2 9.65
Mailing Ad diess 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance permit 4.75
City/State Zip Phone Check all that apply: *Boiler Heat Air
For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
/ J /� PP C 6) <3HP;absorb unit to
I R,� 100K BTU 9.65
Occupant ' _ Mailing Address 7) 3 -15 HP;absorb unit X C
100k to 500k BTU 0 17.6 it,
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
N ame 9) 30 -50 HP; absorb
Contractor unit 1 -1.75 mil BTU 36.00
Ec� � r C L 10) >50HP; absorb unit
Prior to permit Mailing Address
mil BTU 60.15
issuance, a copy 6-5cc S r Tt4VrtG w "`9 11 Air handling unit to 10,000 CFM
of all licenses Cf ' rate Zip Phone 7.00
are required if j , ( c , O ( '? 65-.e• s y 12) Air handling unit 10,000 CFM+
expired in COT O so_Const. Cont. Board Lic.# Exp. Date 11.85
database '� / : : i• _1-10 -0 3 V 13) Non - portable evaporate cooler
Archject Name 7.00
M !Erb � i - 14) Vent fan connected to a single duct
L£� J f i 4.75
W' Mailing Address
15) Ventilation system not included in
appliance permit 7.00
Engineer City /State Zip - Phone 16) Hood served by mechanical exhaust
Q I p ,� I SOHO 04-1 7.00
u) A-166(01 rf' _,sir ; 1, )01-0-1-1
Describe work to be done: 17) Domestic incinerators •
12.00
New A Repair 0 Replace with like kind: Yes 0 No O 18) Commercial or industrial type incinerator
Residential 0 Commercial* 48.25
19) Repair units
Additional information or description of work: 8.40
20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calks. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL p
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE - �a
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
TOTAL ' n 15
Signa Owner /A • Date
v '
,' , Other Inspections and Fees:
� (j jam-( 1. Inspections outside of normal business hours (mininum charge -tw
Co - Person Nafne Phone hours) $50.00 per hour r .
2. Inspections for which no fee is specifically indicated (minimunir 1.
Or A 1 p 9 _l -07 5
charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour
2. Provide drawingsto scale showing existing and proposed mechanical
units. 'State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:\mechperm.doc rev 7/19/99
07/11/2000 Activities for Case #: MEC2000 -00257
2:13:53 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 06/16/2000 KJP RECD No Hold GWL 06/23/2000
MECC008 Permit created 06/23/2000 GWL DONE No Hold GWL 06/23/2000
MECC011 Routed to Plans Examiner 06/23/2000 GWL DONE No Hold GWL 06/23/2000
MECC014 Plan checked /Approved by P.E. 06/27/2000 06/27/2000 06/27/2000 RDP DONE No Hold RDP 06/27/2000
MECC015 Reviewed Plans Routed to DSTS 06/27/2000 RDP DONE No Hold RDP 06/27/2000
MECC706 Mechanical lnsp 07/10/2000 TLP PASS No Hold TLP 07/10/2000 previously inspected
MECC799 Final Inspection 07/10/2000 TLP PASS No Hold TLP 07/10/2000 _
MECC016 DST Post - Review Completed 06/27/2000 DLH DONE No Hold DST 06/27/2000
MECCO50 (F) Ready to issue 06/27/2000 DLH DONE No Hold DST 06/27/2000
MECC090 (F) Issue permit 06/28/2000 DLH DONE No Hold DST 06/28/2000 •
MECC800 Case Finaled 07/11/2000 HAP DONE No Hold HAP 07/11/2000
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