Permit v
CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00578
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/2/2009
PARCEL: 25101 DD - 00101
SITE ADDRESS: 06975 SW SANDBURG ST ZONING: C -P
SUBDIVISION: TIME SQUARE LOT: JURISDICTION: TIG
PROJECT: VERIZON WIRELESS
Project Description: Installation of back - up generator and gas line. Project Value: $4,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: U2 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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: 1
Owner: FEES
WESTON HOLDING CO LLC Description Date Amount
2154 NE BROADWAY
PORTLAND, OR 97232 [MECH] Permit Fee 1/2/2009 $118.50
[MECPLN] Plan Rev 1/2/2009 $29.63
[TAX] 12% State Surch 1/2/2009 $14.22
Phone: Total $162.35
Contractor:
TECHNOLOGY ASSOCIATES INTL CORP
, 72ND
OR 972 24
PORT LAN D, OR 97224 REQUIRED ITEMS AND REPORTS
PORTLAND,
Contact #: PRI 503 -549 -0001
FAX 503- 626 -9239
Reg #: LIC 172067
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu d By: Permittee Signature: b /�� °� ■
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
11. 14ehanical Permit Application FOR OFFICE USE ONLY
City of Tigard DaDate/By: r �� �� Permit N o.: � f L /
RECEIVED Received ,.. f -.00.5- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
II D
a
Phone: 503.639.4171 Fax: 503.598.1960 ( Z.C, 0E3 Other Permit:
T I G A R D Inspection Line: 503.639 NOV 2 4 2008 Date Ready/By: �.uric: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: /�$ g �,7 ' / la Supplemental Information
CITY OFTIGARn 44_ ar izx - 1
TYPE OF 1111I4.DING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Jew c9ttstruction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
,Li -- - / performed. Indicate the value (rounded to the nearest dollar) of all
emolition ❑ Other: gLcbaniaterials, equipment, labor, overhead, and profit.
CATEGORY O -ONSTRUCTION AA'' � Value:
RES EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling mmercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. L Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
( C r �/ 4 (requires site plan showing placement) 14.00
City /State /ZIP: / 4v 4 C Z r Furnace 100,000 BTU ( ducts/vents) 14.00
d �'� l Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: D )2- L
. , 1Ir 17`-- Gas heat pump 14.00
Cross street/directions to job site: 5 `, i 7 2 A _ , Duct work 10.00
Hydronic hot water system 14.00
".:11-*i-' .4- 4:-1 , o� cp.. 4-6.e.«4c' Residential boiler (radiator or
�/ hydronic) 14.00
Ci-I '.." j • Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.: 14, 6,2-149 Z Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
4- - %hl i tr 1 _ ! a-CgZ, mi a e- � , Flue vent for water heater or gas
cJ fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER D NANT
Other 10.00
Name: v . 1 , � n ' �
y� s Environmental exhaust and ventilation
Address: � &) F� I � ^ - Range hood/other kitchen
`- l equipment 10.00
City/State /ZIP: ' 7 ir -4- _ _ /' e _ ' -2 a Clothes dryer exhaust 10.00
-T ( a Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
PLICANT ( eONTACT PERSON Attic /crawlspace fans 10.00
Fuel 10.00 _
Business name: . �O.�i�0 � ��; ��-� Fuel piping
Contact name: \-�?/ 'N4-0- _ $5.40 for first four; $1.00 for each additional
Address: 1 6-� i ee- 61-4) .� d Furnace, etc.
"" �� Gas heat pump
City /State /ZIP: pe r- 4-L i / r 6-12_ 6-12_ ' �-7 7 4- Wall /suspended/unit heater
Phone: (,S'�3) 31q _ Fax: : (S'i'r! (o.i -72,39 Water heater
(� Fireplace
E -mail: �L.� -cr.„ c. 44_,.. -., ��. , wig Range
CONTRACTOR Barbecue
+ / e 44----<_:: Clothes dryer (gas)
`�' ��
Business name: vt�C CG z
Other:
Address: ` 1 554, L
) e -s.-J -Z y / .4- MECHANICAL PERMIT FEES*
City /State /ZIP: -7 f , k _. ar i '2-72 L,/ Subtotal
) Fax: / Minimum permit fee ($72.50)
Phone:
�.3 h R i-'b'a) 1 ( � Cpii --q2, 9 Plan review (25% of permit fee)
CCB lic.: i ^'7,0 ( �-' (/ C --- i ��� State surcharge (12% of permit fee)
�TT [[ TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print nam ,�,, mote: 1 1 2,4 D217, • Fee methodology set by Tri -County Building Industry Service Board
1:\Building TermitAMEC- Permit oc 01/19/07 4404617T(11/02/COM/WEB)
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 $141.50 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.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
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I:\ Building\ Permits \MEC- PermitApp.doc 01/19/07 2
From: • 06/15/2009 12:13 #755 P.001/001
Letter of Transmittal.. .
Date:
Monday, June 15, 2009
_c
To: From:
City of Tigard Technology Associates International Corp.
Attn: Mark VanDomelen Benjamin Freeman, Project Coordinator
13125 SW Hall Blvd 15618 SW 72 " Ave.
Tigard, OR 97223 Portland, OR 97224
503- 639 -4171 (503)549-0001x4019
FAX: 503 - 598 -1960 (503)620 -9239 FAX
Re: POR Tualatin (6975 -SW Sandburg St., Tigard, OR)
Please accept extend the two following building /mechanical permits. (BUP2008 -00378 : -d MEC2008- 00578).
I'm sorry to have to ask for an extension for this permit but the leasing portion has • a'ged out a lot longer
than we'd care for it to. I hope that the extra 180 days should do it. I know the pr• ec actually went out to
bid even before we had the permit but they can't even touch the site until the /::sing portion is fully agreed
to. But if it helps it should be any day now.
If you have any further requirements please do not hesitate to contact me
Kind regards,
�3e
'in n freeman \_/)
Project Coordinator,
Technology Associates International Corporation
15618 SW 72 Ave.
Portland, OR 97224
(Ofc. 503-549-0001x4019)
(Mobile: 503.319.7554)
(Fax: 503.620.9239) •
Email: bfreeman@taic.net Website: www.taic.net