Permit ,A CITY OF TIGARD MECHANICAL PERMIT
11 PERMIT #: MEC1999 -00414
� DEVELOPMENT SERVICES DATE ISSUED: 10/05/1999
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S110DC -02200
SITE ADDRESS: 15660 SW PACIFIC HWY A -6
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: A3 VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 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: Adjust difuser location and adding. No new equipment. S.V. shut down, economizer control with T -7300
thermal.
Owner: FEES
TIGARD, CENTER LP Type By Date Amount Receipt
9777 WILSHIRE BLVD PRMT GEO 10/05/19c $50.00 99- 318846
#609 PLCK GEO 10/05/19c $12.50 99- 318846
BEVERLY HILLS, CA 90212 5PCT GEO 10/05/19c $4.00 99- 318846
Phone: Total $66.50
Contractor:
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BEWLEY MECHANICAL
5591 SW ARCTIC DR •
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 626 -8986 Final Inspection
Reg #: LIC 000635
ORIGINA
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 0 • R 952 - 001 -0080.
You may obtain of these rules or direct questions to OUNC ' ;Ding (50 - 1r6 -9189.
Issue By: • Permittee Signature: i
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day dr
Plan Check #
CITY OF TIGARD Mechanical Permit Application Redd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 b C -Date to DST / O 4 s
Print or Type
Permit #J1� VW - W y( y
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
5AFEW M Y ahe(Alli-DE -- Table 1A Mechanical Code Qty Price Amt
S treet Address Suite# A) Permit Fee 16.00
Job 1) Furnace to 100,000 BTU
Address /54.6c7 5w PiAt cpc, P _O including ducts & vents see footnote 1,2 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
i l e-0 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
owner including vent see footnote 1,2 9.65
Mailing Address 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)
L footnotes 1,2 Comp
6) <3HP;absorb unit to
'�"J / �U� S 100K BTU 9.65
•
Occupant Mailing Address Q� ' / // 7) 3 -15 HP;absorb unit
/ S ,&C) S l¢.� f /iet aC- �'('W Y 100k to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
Tr - unit .5 -1 mil BTU 24.15
CC(( / I 9) 30 -50 HP; absorb
Contractor Name unit 1 -1.75 mil BTU 36.00
b uL ,[1.i- Aki (CAt. 10) >50HP; absorb unit
Prior to permit Mailing Address /J !� >1.75 mil BTU 60.15
issuance, a copy . 5 - 5 ( i )4leC (r T ( ale, 11 Air handling unit to 10,000 CFM
of all licenses C' /state � Zip Phone P 7.00
•
are required if 54 v ��,,�� v� lo24c CS(.0 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.85
database (.357e137� 13) Non - portable evaporate cooler
Architect Name 7.00
&q.046 A( lAfeke, 14) Vent fan connected to a single duct L i ) 5 '
or Mailing Address DC) c- ( p,l> Ly ( 4.75
15) Ventilation system not included in
• appliance permit 7.00
Engineer City/State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
12.00
New 0 Repair 0 Replace with like kind: Yes O No O 18) Commercial or industrial type incinerator
Residential 0 Commercial 48.25
19) Repair units
Additional information or ylescription of work' 8.40
D .io ci _ H VAC. 0 - ce{" 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 talcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL y'v, d✓
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE iL/
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL rti
Required for ALL commercial permits only 1 3- °--
the owner, that plans submitted are in compliance with Oregon State laws. TOTAL re
Signatu. of 1 er/ Date L G
Al i f v - ( _ gC Other Inspections and Fees:
,v. C9 AO / ( 1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name dr Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
DC'- Ste .--� l>zl�
) fi 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 drawings to scale showing existing and proposed mechanical
*State Contractor Boiler Certification required
units.
"Residential NC requires site plan showing placement of unit
I: mechperm.doc rev 7/19/99
OVER- THE - COUNTER (OTC) PERMIT
• COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: A-1)414 ' / ^1 G D //---t4 .J /r eA >Li o r, 4 t2t )
o)." ?To P2e 1.v k r
t 1 , JL ) 2dr? (bi OA ‘)J t t4 7'VS tAir -044...1
Class of Work: AL-t Floor Furnace: Evap Coolers:
Type of Use: ( Unit Heaters: Vent Fans:
Occupancy Grp: A - .) Vents w/o Appl: Vent Systems: J
Stories: (J'h ,• Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
l4"rJ / l l 3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units . lo 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 Inspection $ j v / Permit Fee
Mechanical Inspection $ ( } % Plan Review
Cooling Unit Inspection $ L .f ` 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 G
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
, Fire Alarm Inspection
Final Inspection
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)
I: /dst/forms /otcmech.doc 9/99
is \dsts \forms \otc- mech.doc9 /99 1
12/17/1999 Activities for Case #: MEC1999 -00414
2:08:01 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 10/05/1999 KJP RECD No Hold GEO 10/05/1999
MECC008 Permit created 10/05/1999 KJP DONE No Hold GEO 10/05/1999
MECC011 Routed to Plans Examiner • 10/05/1999 GEO SENT No Hold GEO 10/05/1999
MECC015 Reviewed Plans Routed to DSTS 10/05/1999 JF DONE No Hold GEO 10/05/1999
MECC706 Mechanical lnsp 10/05/1999 10/05/1999 12/07/1999 TLP PASS No Hold TLP 12/07/1999
MECC799 Final Inspection 10/05/1999 10/05/1999 12/07/1999 TLP PASS No Hold TLP 12/07/1999
MECC090 (F) Issue permit 10/05/1999 KJP DONE No Hold GEO 10/05/1999
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
t
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
(1r( p BUP t � � g�
Date Requested r �I7 AM PM BLD
Location /. l (olao uite / — to MEC '19q q e:6* Contact Person h - 7r? / -,3/ 73 PLM f' (796
Contractor Ph ,svisr OOP lc? q - aoy q
D Tenant/Owner l_.t) (,(ti. ELC
-" irig Wall LR
Footing
Foundation Access: � ,, '' ! FPS
• Ftg Drain [' �"�' ���?�?0��7� /�pOv �� r / U
Z t ,, . ,, j SGN
Crawl Drain Inspection Notes: ��� , ., „p�: �
Slab
SIT •; „ -
Post & Beam
Ext Sheath /Shear 444/7
Int Sheath /Shear L[ /[ /
Framing (6'� ! UJC
Insulation
Drywall Nailing
Firewall
Fire Sprinkler )
Fire Alarm 5(5- F/A.1L—
Susp'd Ceiling
Roof
Misc:
•RT FAIL
- e
beam
Under Slab
Top Out
Water Service
Sanitary Sewer
R.in Drains
e- PART FAIL
L
Rough In
Gas Line
Hoke Dampers
4J
PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] 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
Approach /Sidewalk
Other / Date /2 1 7 / co Inspector (0/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record. from the job site.