Permit CITY TIGARD MECHANICAL PERMIT
` r4t1 DEVELOPMENT SERVICES PERMIT #: MEC2002 -00261
I 13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/20/02
PARCEL: 2S113BA -00400
SITE ADDRESS: 07632 SW DURHAM RD 120
SUBDIVISION: SW CENTER SDR1999 -00020 ZONING: I -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: Extension of ducts and additional grilles for tenant improvement. Valuation of work is $3,000.
Owner: FEES
OPUS NORTHWEST Type By Date Amount Receipt
111 SW COLUMBIA STE 870 PRMT CTR 6/20/02 $72.50 2720020000
PORTLAND, OR 97201 5PCT CTR 6/20/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202 Mechanical lnsp
Phone: 239 -4600 Duct Inspection
Reg #: LIC 33135 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 !cat • Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952- 01 -0080. Yo ay obtai copies of these rules or direct questions to OUNC by calling
ran.
194R -a1 R*
Iss By: .,I IJ� / ! Permittee Signature: �/'j 1 �
Call (503) . • -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application OFFICE USE ONLY
Date received: 6/60 dL Permit no.: Hie4b0a —a) 9/
�
i i` City of Tigard �� �' ., y g • Projecdappl. no.: xpr date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family `tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 7C.3 Z Set) O i Aw tZ , .i-� AO Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: [ Suite no.: /c9 d value of all mechanical materials equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 3oeo, .
Lot: (Block: 'Subdivision: *See checklist for important application information and
Project name: 6 b j G &M'C6a _ 4 t9 1 p jurisdiction's fee schedule for residential permit fee.
City /county: Tga4d I ZIP: 1 & 2 FAMILY DWELLING PERMIT FIT SCHEDULE
Description and location q j work on premises: AND CONIMERICALIINDUSTRIAL EQUIPMENT SCHEDULE
/.4).57.1Z C UGt G T Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air handling
io unit CFM
Is existing space heated or conditioned? 1 Yes ❑ No
space insulated ?,1 Yes ❑ No Air conditioning e (site plan required)
Is existing P Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: State boiler permit no.:
A mer i can H Inc. HP Tons BTU/H
Address: 1339 SE Gideon St. Fire /smoke dampers/duct smoke detectors •
City: Portland [ State: OR I ZIP: 97202 -2418 Heat pump (site plan required)
Phone: 239 - 4600 I Fax: 239 Install/replace furnacelburner BTU/H
CCB no.: Including ductwork/vent liner ❑ Yes ❑ No
131 Install/replace/relocate heaters - suspended,
City /metro lic. no.: 60114 wall, or floor mounted
Name (please print): L. , _ A I . Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: Chillers HP
Address: Compressors HP
City: I State: I ZIP: Environmental exhaust and ventilation:
Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type U lures. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: F • E -mail: Woodstove/pellet stove
y Date: Other:
Applicant's signature:
/I G s'� L Other:
Name (print) 1709,60eog e c
Not all jurisdictions accept credit cards, please call jurisdiction for more information.
Permit fee $ 7a 150
❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ 5- to
Name of cardholder as shown on credit card accepted as complete. TOTAL $ `1
Cardholder signature $ Amount 169, 440 -4617 (6/00/COM)