Permit A r CITY OF TI GA R D MECHANICAL PERMIT
I'r DEVELOPMENT SERVICES PERMIT #: MEC2005 -00160
cal I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/14/2005
PARCEL: 2S112AD -01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 ZONING: I -P
SUBDIVISION: PACIFIC CORP. CENTER LOT: JURISDICTION: TIG
Project Description: (1) 2 ton RTU w /disturbution duct, grilles & re - duct to existing units. Valuation: $4500.
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: N 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: 1 OTHER UNITS:
> 10000 cfm: 0 GAS OUTLETS: 1
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 4/14/200: $130.00
PORTLAND, OR 97224 [MECPLN] Plan Rev 4/14/200`. $32.50
[TAX] 8% State Surchaq 4/14/200; $10.40
Phone: Total $172.90
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97222
Phone: 233 - 6911
Reg #: LIC 38868
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 i n 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 -33 - 344.
Issued B • / � Permittee Signature: 440.1,4-30
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.
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Mechanical Permit ilectiv ED FOR OFFIC E USE ONLY City of Tigard Received �_
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: V Q Permit No.QhL,��0, Od /(
Plan Review �� `�-� V
Phone: 503.639.4171 Fax: 503.598.1960 /� V I Other Permit
APR 0 I 2 0 05 *9 Date/By:
Inspection Line: 503.639.4175 e. Date Ready /By: lutis El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGAR i iyef —,� JU Supplemental g
11 Notified/Metllod: lnformation
RUILDING nIVISION ' e fit. w/i; cu. c,-v
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El New construction (Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ L/C 0 , 0 c)
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling [Commercial /industrial ❑ Accessory building
(u /� For special information use checklist.
❑ Multi - family Master builder ❑ Other:
Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION ' - Heating/cooling
�+ Q /�y" Air conditioning or heat pump
Job site address:
I t / S Yt5 e5� set Lib / 4 / / �(,Vy ��o (requires site plan showing placement) 14.00 •
City/ State/ZIP: 11 � _ / Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Q Project name:j Furnace 100,000+ BTU (ducts/vents) 17.90
Q� / J RSPl�!/! S _ 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
n ✓ L✓i Gas fireplace 10.00
2 // TDA) R i 0 , t 4 AD t,1 iuth dp7p,t,r ;au L 7 • Flue vent for water heater or gas
� fireplace 10.00
4419 C+aa (/ ! AWit -- /Z - v e- . :6 1 f16.(iii f 0 44 Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
• ❑ PROPERTY OWNER • ❑ TENANT Chimney /liner /flue /vent 10.00
• Other: 10.00
Name: Environmental exhaust and ventilation
Range hood /other kitchen
Address: equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6.80
PPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: 7 ,o-�� /9,0064; Fuel t to
P g
Contact name: 840 `-€..-- Q(4.—A1•L0,-, $5.40 for first four; $1.00 for each additional
c/ Furnace, etc.
' S / 7
Address: 9 7 / y �l�-
p Gas heat pump
City/State/ZIP: p/*l.I� lJ� 0/4-e._ 9 22 LL Wall /suspended/unit heater
Phone: ( 02jj / �/ ) . _61 / Ci 5 Fax:: (613)23 (613)23 6 / t 1 Water heater
E -mail: 7 Fireplace
Range
• - ' CONTRACTOR Barbecue
Business name: S'y,,,,e Clothes dryer (gas)
Other:
Address: ' • • . ' MECHANICAL PERMIT FEES* ,
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) /3 0,00
Plan review (25% of permit fee) 3 , , 50
CCB lic.:,, R' •( ' State surcharge (8% of permit fee) / Q , 90
1 ��1G TOTAL PERMIT FEE r 2,%
Authorized signature: / This permit application expires if a permit is not obtained within 18
days after it has been accepted as complete.
Print name: 1 R dam_ Q vl" ti Date: c D y • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (11 /02 /CCOM/WEB)
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: MEC2005 -00160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/14/2005
Phone: (503) 639 -4171 A ziolp1 i %. ;.`
Inspection Requests (24 Hrs.): (503) 639 -4175 . �! `:_..
INSPECTION WORKSHEET FOR DATE: 5/4/2005 TIME: 7:15AM PAGE: 60
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: JC REEVES
DESCRIPTION: (1) 2 ton RTU w /disturbution duct, grilles & re -duct to existing units. Valuation: $4500.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE it: 233.6911
Inspection Request Scheduled For: Date: 6/4 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 006057 -01 503 -519 -6199 N
Corrections/Comments/Instructions:
ICI , isx s w- ,,,,,,. ..-- ...,-
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO . L FEES ASSESSED
_AA,__L____ ..
Inspector: Date: / �� wa Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/14/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 76
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: JC REEVES
DESCRIPTION: (1) 2 ton RTU w /disturbution duct, grilles & re -duct to existing units. Valuation: $4500.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 233 -6911
Inspection Request Scheduled For: Date: 4/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 004828 -01 503 -519 -6199 N
Corrections /Comments /Instructions:
40
ONBILONIMmrsiggrimuiri
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NAL FE S ASSESSED
dy 4
Inspector: Date: L hone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEG2005 -00160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/14/2005
Phone: (503) 639 -4171 :Ntivolll .
Inspection Requests (24 Hrs.): (503) 639 -4175 1_ I
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 75
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: JC REEVES
DESCRIPTION: (1) 2 ton RTU w /disturbution duct, grilles & re -duct to existing units. Valuation: $4500.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 233-6911
Inspection Request Scheduled For: Date: 4/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 004828 -02 503 -519 -6199 N
Corrections /Comments/ Instructions:
. � / / _ `s11 _ ar •
All . . AN I
4 IVI1 - '
iffIlIZIWAWl ,....- 1 -
Z PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
El FAIL . ❑ CALL FOR INSPECTION El ADDITI• AL FE ASSESSED
Inspector: , Date: , N Phone #: (503) 718 -