Permit C ITY OF TIGARD MECHANICAL PERMIT
AmotEvOI DEVELOPMENT SERVICES PERMIT #: MEC2004 -00764
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/19/2004
PARCEL: 1S134BC-00300
SITE ADDRESS: 12272 SW SCHOLLS FERRY RD
SUBDIVISION: GREENWAY TOWN CENTER ZONING: C -G
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:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: 120 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: New rooftop unit to replace existing & ductwork.
Owner: FEES
BPP RETAIL LLC Description Date Amount
BY BURNHAM PACIFIC PROPERTIES [MECH] Permit Fee 11/19/20( $168.50
ATTN: JOHN WATERS [TAX] 8% State Surcharl 11/19/20( $13.50
SAN DIEGO, CA 92101 [MECPLN] Plan Rev 11/19/20( $42.10
Phone: Total $224.10
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222 REQUIRED INSPECTIONS
Phone: 462 - 4822 Gas Line Insp
Duct Inspection
Reg #: LIC 50897 S.D. Shut -down inspection
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 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.
Issued By: 7 i � j Permittee Signature: \ p�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application FOR OFFICE USE ONLY ■
City of Tigard eceived /� � f _
131 Hall lvd., Tigard, OR 97223 Date/By: /) — 1 7 `V 'ermit No. a (�/ O0 76 („/ Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 o� ,�\ Date/By: i/ — / 41/103) Other Permit:
d 41
Inspection Line: 503.639.4175 r•' Date Ready/By: kris: la See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: I -) ( Supplemental Information
- TYPE OF WORK COMMERCIAL .FEE*. SCHEDULE U CHECKLIST -
ECKLIST -
❑ New construction Additio �. •� eraho placement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, la or, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ . (Q • •
RESIDENTIAL EQUIP S
NT / SYSTEMS, F
FEES*
❑ 1- and 2- family dwelling I___L_____rimer ❑ Accessory building
For special information use che
❑ Multi- family ❑ Master builder ❑ Other: checklist.
I E
Description I Qty. Ea. I Total
JOB 'SITE INFORMATION AND LOCATION ' . - Heating/cooling
Job site address: ^� e' , ` S P e 0 y— I Air conditioning or heat pump
j , a� a -�(�C Sc- ti IY 1—�/ -v 1 (requires site plan showing placement) 14.00
City/State/ZIP: 77: q� j 0 9 -- 7 2_2-3 Furnace 100,000 BTU (ducts/vents) 14.00
J r Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project Bamt e W
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
1 � � { Gas fireplace 10.00
- \ i 5 I +,()t e & f _) a V\ Flue vent for water heater or gas
e Iy) I S4lA X ■ �� Log lighter fireplace 10.00
� Log ghter (gas) 10.00
C `" d ADZ 1 11 ay I C Ct L o w ���Ca�a) Wood/pellet stove 10.00
C Wood fireplace/insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation _
Address: Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
,❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR ' . Barbecue
Business name: 4k)/10.___ - c Clothes dryer (gas)
Other:
Address: 1 - c S a 1 - ��Q eI Dtx MECHANICAL PERMIT FEES*
City/State/ZIP: [ V A..t_e jaj.} e Or o-,„ 49-7 as -_ Subtotal !kg. To
Phone: (03) 4( _(.+� Fax: ( * - '4 (-1(0)— & S55 Minimum permit fee permit fee) Plan review (25% of permit fee) y2 . 10
CCB lic.: SON '7 State surcharge (8% of permit fee) ( 3 .s0
TOTAL PERMIT FEE 2_24 . f This permit application expires if a permit is not obtained wi thin 180
Authorized signature: P
�+ (� 1.�1n4tN days after It has been accepted as complete.
Print name: Jvle-lt l _01,0(Also - Date: t\/ (Q 104 • Fee methodology set by Tri -County Building industry Service Board
i:\Building\Perntits\MEC- PermitApp.doc 12/03 440. 4617.(11 /(32/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.
i:\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Q7764-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A � � 1� o
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I��
INSPECTION WORKSHEET FOR DATE: /4 Q,5 TIME: PAGE:
SITE ADDRESS: r0.Z7tz I1Qe_LS ZG CLASS OF WORK:
SUBDIVISION: L T #: TYPE OF USE:
PROJECT NAME: ak�A.NA //US
DESCRIPTION:
OWNER: 1 i PHONE #:
CONTRACTOR: fi VAC. 1,.- PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
br Ft Imo - W-cc+
Corrections /Comments/ Instructions:
+ 42%
ammitiowil E ZtN`"U u - ' . -
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F0 INSPECTION ❑ ADDITIO AL FEES ASSESSED
Inspector: / � 't Date: 1 t hone #: (503) 718-