Permit - ~ CITY OF TIGARD
MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2003 -00704
� I DATE ISSUED: 12/10/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 112DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 220
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 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:
> 10000 cfm: GAS OUTLETS:
Remarks: Relocating ducts & grilles for tenant improvement. Project value: $1,500.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WM I
PORTLAND, OR 97224 [MECH] Permit Fee 12/10/03 $72.50
[TAX] 8% State Surchart 12/10/03 $5.80
Phone: Total $78.30
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 233 -6911
Duct Inspection
Reg #: LIC 38868 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
require o -fou•w rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
Iss ed B 16,„„„__,_,,:.-4 � ! Permittee Signature: __ _ f.
Call (50 .39 -4175 by 7:00 P.M. for inspections neede. the ne ibusiness day
Mechanical Permit Application FOR OFFICE USE ONLY
Received � Mechanical
Date/By: / /D /O5- A . # Permit No.: ( fzj " 9 70 /
City of Tigard Planning Approval Building
y g Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
Date/By: e No.:
Internet: www.ci.tigard.or.us y ri i' f Contact ... • ® See Page 2 for
a.
24 -hour Inspection Request: 503 -639 -4175 " ' Name/Method: C /a Supplemental Information.
• TYPE OF WORK . - COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
p New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ /.S) 0 See Page 2 for Fee Schedule
El Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE •
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: c,,,,,�50 Sw R DIn/daP L/ Gas heat pump 14.00
Suite #: Z 0 Bldg. /Apt. #: Duct work 14.00
Project Name: G S $ Hydronic hot water system 14.00
job site: (or Residential boiler
Cross street/Directions to
7 (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Subdivision: _ Lot #: Repair units 12.15
Tax map/parcel #: Other Fuel Appliances
Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
Malt li, IL) z £4- Pim- .vim FLodif_ Flue vent (water heater /gas fireplace) 10.00
p` 1D Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
_ ❑ PROPERTY OWNER ( ❑ TENANT Other: 10.00
Name: Pier c vSr Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 10.00
Address:
Clothes dryer exhaust 10.00
City /State /Zip:
Single duct exhaust
Phone: ,zy• X 5 8O Fax: (bathrooms, toilet compartments,
❑ APPLICANT 0 CONTACT PERSON utility rooms) 6.80
Name: Attic/crawl space fans 10.00
Address: Other: 10.00
Fuel Piping
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Phone: Fax: Furnace, etc. **
Gas heat pump **
E -mail: Wall/suspended/unit heater **
CONTRACTOR Water heater ••
Business Name: PA, o em N A SSe, _27. Fireplace ••
Address: 9 788r 5 L / 7 A VE , Range •*
BBQ •*
City /State /Zip: pft7ZrOrvo Qk . 47.7 Clothes dryer (gas) **
Phone: `L33 - &9/i Fax: a S - 97G 7 Other: *•
Total:
CCB Lic. #: ire-6,6 Mechanical Permit Fees*
Authorized
Signature: Date: /2/ 4 03 Subtotal: $
Minimum Permit Fee $72.50 $ - 7a, , SO
J de . lny AA/Air Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ 5 , 80
TOTAL PERMIT FEE $ 7 t , So
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPerrnitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
TOTAL VALUATION: PERMIT FEE:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each
additional $100.00 or fraction thereof, to and
including $5,000.00.
$5,001.00 to $10,000.00 $1 41.50 for the first $5,000.00 and $1.80 for
each additional $100.00 or fraction thereof, to
and including $10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for
each additional $100.00 or fraction thereof, to
and including $50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for
each additional $100.00 or fraction thereof, to
and including $100,000.00.
$100,001.00 and up $1,396.50 for the first $100,000.000 and
$1.10 for each additional $100.00 or fraction
thereof.
All New Commercial Buildings require 2 sets of plans.
i:\Building\Permit Forms \MecPermitAppPg2 09- 01- 03.doc
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
• 7/I BUP
Received / 24 F/ Date Requeste• imv 2 A AM PM BUP �y
Location .- _. !I 1 A.!..._ uite 4/ 2 2-0 G..5,t3 M E -. � " � � �/ 7"
Contact Person - - _I '.0 ..•• . Ph ( O 572 — la l' el PLM
Contractor . ./Li3*.ivix-f9 Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm •
Susp'd Ceiling
in
Roof
Other:
Final
PASS PART FAIL -
PLUMBING
Post & Beam /'
Under Slab
Rough -In
Water Service /
Sanitary Sewer f i ,
Rain Drains f '
Catch Basin / Manhole
Storm Drain ,
Shower Pan j .
Other: �,
Final
P ASS PART FAIL / 4
MECHANICAL i
Post &Be•s cy
R••g -In
Gas ine i
Smoke Dampers
4 M0
PART FAIL
f ' -4 RICAL
Service
Rough -In _
UG/Slab ---
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 11 Please call for reinspection RE: / 0 Unable to inspect —.no access
Fire Supply Line /02 / '
ADA Date � / / / �� Inspector 761'1
Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL