Permit , CITY OF T I GA R D MECHANICAL PERMIT
'I ^c DEVELOPMENT SERVICES PERMIT #: MEC2004 -00578
..� I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/7/2004
PARCEL: 2S112DD -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 100
SUBDIVISION: PACIFIC CORP. CENTER 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: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: 17,900 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: Y 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: < =10000 cfm: OTHER UNITS: 2
> 10000 cfm: GAS OUTLETS:
Remarks: Modify system for new floor plan. Value: $10,000.00 includes Fire /smoke dampers
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI [MECH] Permit Fee 9/7/2004 $231.50
PORTLAND, OR 97224 [MECPLN] Plan Rev 9/7/2004 $57.88
[TAX] 8% State Surcharl 9/7/2004 $18.52
Phone: Total $307.90
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Phone: Cooling Unt lnsp
hone: 233 -6911
Duct Inspection
Reg #: LIC 38868 Duct Inspection
Fire Damper Insp
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 -00 i ■ gh OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(50. 246 -6699.
Is ed By: _ ����� � 4 l( _ f Permittee Signature: (1)Zt00.�4,
Call (503) : 9-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of igard Date/By: /a Permit �i
ritNo.: y� �'
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie � /� c
Phone: 503.639.4171 F 0 ke i, Date/By: ! 2 -0 �>,9 Other Permit:
Inspection Line: 503.639.1 5 L V E ® _..g. Ail Date Ready/By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: I Q Supplemental Information
A: . 2 u4 .
. TYPE WORK COMMERCIAL TEE* SCHEDULE' USE •CHECKLIST •
❑ New construction i
(;I I F dd t4 M e Mechanical permit fees* are based on the value of the work
BU 9Pp rf�j p' t on/replacement performed. Indicate the value (rounded to the nearest dollar) of all `
❑Demolition �I L �1 • lP. mechanical materials, equipment, labor, overhead, and profit.
Value: $
: ' • CATEGORY OF CONSTR /Q
UCTION ;. �
RESIDENTIAL EQUIP1MENT / SYSTEMS FEES* O
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 'c
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total e •
JOB SITE INFORMATION AND LOCATION ' „ . ' ' Heating/cooling 11
Job site address: Air conditioning or heat pump
/,5'5`75' S w . Z2 v0 / n / (requires site plan showing placement) 14.00
City/ State/ZIP: - / rt e. _ . L Furnace 100,000 BTU (ducts/vents) 14.00
c 1 - Furnace 100,000+ BTU ( ducts/vents) 17.90 f
Suite/bldg. /apt. no.: / 0 0 Project name: 7 ��
�( vr� Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00 J
Residential boiler (radiator or
hydronic) 14.00
i:
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 i
' DESCRIPTION OF WORK ,- . Water heater 10.00 1
Gas fireplace 10.00
/`iCiL'Lt.. ,, - rrJ T` LA-41 lP.pp vt �EL.� /c Flue vent for water heater or gas
/�j ST ' T Fes- l f.A_/ L l Log fireplace 10.00
l � 1 J/ Log lighter (gas) 10.00
�T)7 ,� P b Po[_ �62s,. 7)1- 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
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: ;-..X.87�� —.y P ��e Clothes dryer (gas)
[ Other:
Address: Q• -9- 5 t.; / �h+4l� MECHANICAL PERMIT .FEES *- .
City/State/ZIP: / TCQ a 17 ty , c y 7Z,7-z Subtotal 2. 3 1 . ) 6
Minimum permit fee ($72.50)
Phone: (.7,51 )Z? ` c,9W Fax: (5 ) 023' 9747 Plan review (25% of permit fee) 5 Pi 13
CCB lic.:. � & State surcharge (8% of permit fee) / g . -
TOTAL PERMIT FEE 3 o 7 . 90
Authorized signature: This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: J 1Jtiir Date : 2 y 0 3 • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building 'PemtitsVMEC- PennitApp.doc 12/03 40 -4617T (I I /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.
•
•
i:\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPE(TION,OIVISION Business Line: (503) 639 -4171 MST
G� r/ BUP
Received Date Requested /6 / / AM " PM BUP
Location / S 75
P Suite *TV M MEC 3 'C OLS 78
Contact Person • Ldit L U Ph ( ) t 7 9 �3' - 7/ PLM
• Contractor 4 Ph ( ) 7e - e 47 SWR
BUILDING Tenant/Owner ELC
Footing
------s
Foundation Access: ELC
Ftg Drain - g ELR
Crawl Drain
Slab Inspectio te s: - -- SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
1
Drywall Nailing
Firewall t ' •� �, WAI
Fire Sprinkler — J.i • w1`�` lb �r�`
Fire Alarm
Susp'd Ceilin. , , ,
Roof 4 4e: /
Other: Final • J4 ,
PASS PART FAIL
PLUMBING i �i �.
Post & Beam I. ►�—
Under Slab I
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS FAIL
CRANK
ost & -earn
Rough -In
G,
_S - •= Dam.e.-
Tip ART FAIL
CAL
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 0 Please call f r reinsp ction RE: 0 Unable t inspect - no access
Fire Supply Line ,
ADA �'
Approach/Sidewalk Date Inspe ,f�
Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL