Permit .4
4 1 11$ CITY OF TIGARD MECHANICAL PERMIT
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PERMIT #: MEC2000 -00365
r' DE sE l H BME S RV 2CES 639 -4171 DATE ISSUED: 9/11/00
PARCEL: 2S1 10 D C -02200
SITE ADDRESS: 15660 SW PACIFIC HWY A-4
SUBDIVISION: WILLOW BROOK FARM ZONING: C -G
BLOCK: LOT: 011 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:
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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: alteration of Ductwork
Owner: FEES
TIGARD, CENTER LP Type By Date Amount Receipt
9777 WILSHIRE BLVD #609 PRMT CTR 9/11/00 $72.50 2720000000
BEVERLY HILL, CA 90212 5PCT CTR 9/11/00 ' $5.80 2720000000
Phone: Total $78.30
Contractor:
OREGON HEATING + A/C INC
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PO BOX 397
DUNDEE, OR 97115 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 538 -2953 Duct Inspection
Reg #: LIC 125815 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 rul :- • direct questions to OUNC by
calling (503)246-9189.
Issue By: G /
am- Permittee Signature: / LI'
ce " •
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
CITY OF TIGARD Mechanical Permit Application Plan Check #
PP Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit to tV G 20BD -(2,224- s
Called
Name of Development/Project Description
-776,, Imp pam - 460 aas Table 1A Mechanical Code Qty Price Total
Job Street Address Suite # 1) Furnace to 100,000 BTU
Address /6 SW jqL/&Poi 4- Lf including ducts & vents 14.00
Bldg# City /State Zip 2) Furnace 100,000 BTU+
including ducts & vents 17.40
3) Floor Furnace
Name (or name of business) including vent 14.00
Owner T r G(r / ` r vt }t - ( f 4) Suspended heater, wall heater
g �A or floor mounted heater 14.00
Mailin ddress
977 7 O ,1 h r , --t, Give' 7 a't9 9 5) Vent not included in appliance permit 6.80
City /State Zip one
r',ci �;))s ( .4 ?02,Z 6) Repair units 12.15
y�/ Check all that apply: *Boiler Heat Air
Name (of name of buslness) For items 7 -10, see or Pump Cond Qty Price Total
HP/ - footnotes 1,2 Comp -
Occupant Mailing Address 7) <3HP; absorb unit to
/646° SG✓ PA f / /JWy $76 Al 100K BTU 14.00
City /State Zip Phone 8) 3 -15 HP; absorb unit
- 112 .0 100k to 500k BTU 25.60
N ame 9) 15 -30 HP; absorb
Contractor unit .5 -1 mil BTU 35.00
0664941 //6#11N6 t Alit CosVir/W) /N6,- t: 10) 30 -50 HP; absorb
Prior to permit Mailing Address unit 1 -1.75 mil BTU 52.20
issuance, a ill) 6o ' 317 11) >50HP; absorb unit >1.75 mil BTU
copy 87.20
of all licenses City /State Zip Phone 12) Air handling unit to 10,000 CFM
are required if Dv,v 6 97/15 3 1953 10.00
expired in COT Oregon Const. Cont. Board Lic.# Exp. ate 13) Air handling unit 10,000 CFM+
database 12SS/s 9/0/ 17.20
Architect Name 14) Non - portable evaporate cooler
10.00
or Mailing Address 15) Vent fan connected to a single duct
6.80
16) Ventilation system not included in
Engineer City /State Zip Phone appliance permit 10.00
17) Hood served by mechanical exhaust
10.00
Describe work to be done: 18) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes 0 No O 17.40
Residential 0 Commercial • . Modification P 19) Commercial or industrial type incinerator
69.95
Additional information or description of work: 20) Other units, including wood stoves
10.00
NOTE: For Commercial projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets
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roof, require structural calcs. prepared by licensed engineer. 5.40
Type of fuel: oil 0 natural gas 0 LPG 0 electric O 22) More than 4 -per outlet (each)
1.00
Minimum Perm Fee $72.50 SUBTOTAL 12,5 9
I hereby acknowledge that I have read this application, that the
information given is correct, that I am the owner or authorized agent of 8% SURCHARGE j. 0
the owner, that plans submitted are in compliance with Oregon State PLAN REVIEW 25% OF SUBTOTAL
laws. Required for ALL commercial permits only
dr
Signature ofi • r /Agent Date TOTAL l aft _
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d r/ 4- /1--trb Other Ins • • - :. . • . Fees: 1P-7c2.3.0
1. pe io outside . normal business hours (minimum charge -two hours)
Contact Person Name Phone 72.50 per hour
S TAN S?upo,t 53 8 •Z953 2. Ins.: '.ns for , ••o no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
Footnotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge -one -half hour) $72.50 per hour
2. Provide drawings to scale showing existing and proposed mechanical 'State Contractor Boiler Certification required
units. "Residential A/C requires site plan showing placement of unit
I:dsts \forms\mechperm_rev.doc 9/8/00