Permit � , CITY OF TIGARD MECHANICAL PERMIT
:1 DEVELOPMENT SERVICES PERMIT #: MEC1999 -00465
Ail I I 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 DATE ISSUED: 10/28/1999
PARCEL: 2S 110DC -02200
SITE ADDRESS: 15660 SW PACIFIC HWY A -6
SUBDIVISION: WILLOW BROOK FARM ZONING: C -G
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: A3 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 4
Remarks: Gas piping.
Owner: FEES
TIGARD CENTER LP Type By Date Amount Receipt
9777 WILSHIRE BLVD PRMT KJP 10/28/19c. $50.00 99- 319394
SUITE 609 PLCK KJP 10/28/19E $12.50 99- 319394
BEVERLY HILLS, CA 90212 5PCT KJP 10/28/19c $4.00 99- 319394
Phone: Total $66.50
Contractor:
REQUIRED INSPECTIONS
Gas Line Insp
Phone: Final Inspection
Reg #:
ORIGINAL
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 -0Q1 -0080.
You may obtain co ' of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: j -&/ t,a---) Permittee Sig nature:)0,& . off."
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
10/26/99 TUE 13:36 FAX 503 598 1960 CITY OF TIGARD fj 002
Plan Check #
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CITY OF TIGARD Mechanical Permit Application Redd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd •
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 B f l 9 qs9 - Oo. i Date to DST 1 (.04*%4
Print or Type Permit u /h cc- Ng? - o o yc
Incomplete or illegible applications will not be accepted , cam
lune of oevetopmefi Joe Description
I/l ),, 5 Table IA Mechanical Code • Price And
skb 8ueetAddams Sullen A) Permit Fee 1,f04 . ^-.;,..';- 16.00
Address 15660 SW Pacific Highway 1) Furnace to 100,000 BTU
' andgar Cbvstete - zp Including ducts & vents see footnote 1,2 9.65
l
Tigard
including 100,000 i && ends see footnote 1,2 12.00 ,
Name ire name d tuskless) 3) Floor Furnace
Owner T „ , Ce h 1 ems. t Q including vent see footnote 1,2 _, 9.65
team A 4) Suspended heater, wall heater
9 7 , I S 1 n `✓ n or floor mounted heater see tbo4nota 1,2 a65 - -
ill a t i 5) Vent not hduded in a7Pl®rtoa permit 4.75
�` r 1' Check all that apply: `Boller Heat Air
� ly ITt 4 s CA o 2 l a For Items 8-10, see or Pump Cond Qty Price Amt
taa footnotes 1,2 Comp "'
r�l/ u 7 °u ' 6) <3HP;absorb unit to
100K BTU 9.65
Occupant Malang Address e.nj• ' ;ebtt unit
/ 7) 3 -15 HPsorit
/ e -64 0 v Ce l w ✓ 1-7 100k to 500k BTU 17.65
City/state Zip Phone 8) 15-30 HP; absorb
.g?l unI.5.1 mil BTU , 24.15
�l v �[ 9) 3050 HP; absorb
Contractor Pen insula Plumbing Co unit 1-1.75 ma 811) 36.00
1 0) >50HP; absorb unit • .
Prior to permit It 1630 7 >1.75 trail BTU 60_.15
Issuance, a Copy 11 Air handling unit to 10,000 CFM
are a i l and Or 9 7 9 2'1-O5 D� 12 Air nand! 7.00
dad } big unit 10,000 CFM+
expired � � / O 1 13) Non - portable evaporate cooler 11 65 •
Architect Nwne 7.00
14) Vent fan connected to a single duct
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pT Mating Address 4.7
15) Ventilation system not Included in
appliance permd 7.00
Engineer CVSutte ap I Phone 16) Hood served by medtanicai exhaust
7.00
Describe work to be done: 17) Domestic incinerators •
12.00
New O Repair O Replace wdh ike kind: Yes O No O 18) Commercial or industrial type Incinerator -
Residential O Commercial 0 48.25
19) Repair units
Additional intonation or description of wok 8.40
20) Wood stove/gas FPlother units/clothe dryer/etc.
7.00
NOTE For Commerdal projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas talcs. See footnote 1 1 3.75
Type of flak cO O natural gas O LPG O electric O 22) More than 4 -per outlet (each) - .75 .44:.,
ck
Minimum Permit Fee $50.00 SUBTOTAL °-` ,Z. :-7, '. 5 2 • E V
I hereby acknowledge that I have mad this application, that the information ' 8% SURCHARGE f ; t-O �
r _ w{ i _
ghoul' ghoul' Is correct, that 1 am the owner or authorized agent of • PLAN REVIEW 25% OF SUBTOTAL 1 � � , i , . �� _ _ - -. _- ' ":
the owner, that plans submitted re ed e in mmptianoe with Oregon State laws. LL R tired for A commercial perms on1}r ' ,E i I' x • P , ' T
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10 -26 -99 TOTAL - r.�..� ; ;7. • b . . 0
Signature of Owr Date " t i `
7 61- 0 5 0 0 Other Inspections and Fees:
Mi Wright 1. Inspections outside of normal business hours ( mininum charge -two
Contact Person Name Phone hours) $50.50 per hour
2. Inspections for which no fee is apectfeally indicated (minimum
' charge -half hour) $50.00 per hour
t oonotaatot commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic plodding and proposed gas line and pressure. plans (minimum charge - one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
unit 'State Contractor Rodger CerUflratbn required
"Residential A/C requires site plan showing placement of unit
i:4nechpehm.doc rev 7119199
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• " ' ' OVER- THE - COUNTER (OTC) PERMIT
COMMERCIAL MECHANICAL PERMIT CHECK LIST
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Description of Project: e
Class of Work: tZ Floor Furnace: Evap Coolers:
Type of Use: C.On Unit Heaters: Vent Fans:
Occupancy Grp: 43 Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: <_ 10000 cfm: Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn >_ 100k Btu:
NOTES:
COMMERCIAL INSPECTION ACTIONS FEE MENU
Gas Line Inspectio $ —. Permit Fee
Mechanical Inspection $ / Plan Review
Cooling Unit Inspection $ 44 8% State Surcharge
Shaft Inspection $ Additional Permit Fee
Hood Inspection $ Additional Plan Review Fee
Fire Suppr Inspection $ Inspection Fee
Duct Inspection $ Miscellaneous Fee
Fire Alarm Inspection
REMARKS:
Fire Damper Inspection
Miscellaneous Inspection
Fire Alarm Inspectibn
anal Inspectio
FOR OFFICE USE ONLY:
TYPE OF USE OPTIONS (COM = commercial; CMS = commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW = new; ADD = addition; ALT = alteration; ACS = accessory;
FND = foundation; OTH = other, DEM = demolition; REP = repair, FPS = fire protection system. NOTE =USE OTH FOR FENCES, RETAINING
WALL, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
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12/17/1999 Activities for Case #: MEC1999 -00465
2:08:28 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 10/28/1999 KJP RECD No Hold • KJP . 10/28/1999
MECC008 Permit created 10/28/1999 KJP DONE No Hold KJP 10/28/1999
MECC011 Routed to Plans Examiner 10/28/1999 KJP DONE No Hold KJP 10/28/1999
MECC015 Reviewed Plans Routed to DSTS 10/28/1999 RP DONE No Hold KJP 10/28/1999
MECC705 Gas Line Insp 10/28/1999 10/28/1999 10/29/1999 GS PASS No Hold GES 10/29/1999 tag #373547
MECC799 Final Inspection 10/28/1999 10/28/1999 12/07/1999 TLP PASS No Hold TLP 12/07/1999
MECC090 (F) Issue permit 10/28/1999 KJP DONE No Hold KJP 10/28/1999
.MECA800 Case Finaled 12/17/1999 JMT DONE No Hold JMT 12/17/1999
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST Inspection Line: 639 -4175 Business Line: 639 -4171
(0°-'e`YY\ Date Requested r 7 AM PM BLD
Location / ((C) r - uite A-6 MEC '( 9� er
Contact Person h -- 7r? I -,3/ 73 PLM f gcf9ez c
Contractor Ph 130P (c q q — au. q t-
D Tenant/Owner L() u ELC
-" ing Wall LR
Foong
Foundation Access: • o r (FPS
Ftg Drain (� 1q 00.57 -7 /6ov � , �',I J SGN
Crawl Drain Inspection Notes: ection No - �•:.
p t ��� F ii � i'p.� a'it: ∎ 1
Slab
SIT
Post & Beam GG ,��
Ext Sheath /Shear r� 1 1 l'OD4 /C/
Ina Sheath /Shear
Framing1
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm P
Susp'd Ceiling
Roof
Misc:
RT FAIL _
1 : r
:earn
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
4 I
a), PART FAIL
L
Rough In
Gas Line
Hoke Dampers
:' PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Other oach /Sidewalk Date / / 2 / 7 / co Inspector (0/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record. from the job site.