Permit CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2003 -00690
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/3/03
PARCEL: 2S112DD -00701
SITE ADDRESS: 15852 SW UPPER BOONES FERRYRD BLD.0
SUBDIVISION: OREGON BUS. PARK II 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: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas piping to connect existing unit heater to gas meter. Project Value: $550.00
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 12/3/03 $72.50
[MECPLN] Plan Rev 12/3/03 $18.13
[TAX] 8% State Surchari 12/3/03 $5.80
Phone: Total $96.43
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: 503 453 - 4822 Gas Line
Final Inspection
Reg #: LIC 62196
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 -00
Iss rd By: , • . , i� C L: - Permittee Signature: 0l �',�
Call (50 ;39-4175 by 7:00 P.M. for inspections needed the next bus' ess day
Mechanical Permit Application FOR OFFICE USE ONLY
Received a. , Mechanical
Date/By /e ?5 o 3 Permit No ri 5001 -061 90
Cit of Ti and 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 A,
Post - Review Land Use
I
Internet: www.ci.tigard.or.us � •� Date/By-
Case No I Contact Ju ®See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 — Name/Method 4 Supplemental Information.
' • • TYPE OF WORK : . = COMMERCIAL FEE* SCHEDULE.- USE CHECKLIST _
❑ 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 CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling ❑ Commercial /Industrial Value: $ 2 See Page 2 for Fee Schedule
❑ 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: I SS'5 a S W U R F300A/c'S - ( . Gas heat pump 14 00
Suite #: Bldg. /Apt. #: Duct work 14.00
Hydronic hot water system 14.00
Project Name: I/4 i 7 — S 56e -A 6i..---7 Residential boiler
Cross street/Directions to job site: (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
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10 00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
0 PROPERTY WNER - ' I ID • Other: 10.00
Name: l= � 0 1 /) K �� � Environmental Exhaust & Ventilation
Address: Range hood/other kitchen equipment 10.00
City /State /Zip: Clothes dryer exhaust 10.00
Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
' ❑ APPLICANT . • 0 CONTACT PERSON utility rooms) 6 80
Name: Attic /crawl space fans 10.00
Address: Other: 1 0.00
Fuel Piping
City /State /Zip: ••($5.40 for first 4. $1.00 each additional)
Phone: Fax: Furnace, etc. ••
Gas heat pump ••
E -mail: WalUsuspended/unit heater F ••
CONTRACTOR - Water heater ••
Business Name: Ci /,i'4T (04/77o( Fireplace ••
Address: / &S SC,/ 72_ ' L ` l i9? Z- • Range ••
City/State/Zip: BBQ ••
. y p'G� / G� � •C lothes dryer (gas) ••
Phone:5G7 -y'j4{8ZL Fax: Other. ••
CCB Lic. #: (Z / Y ( Total:
/ Mechanical Permit Fees*
A houe� // (4 ll � �� Subtotal: $ /
Signature /` /,� Date: /2/3/03 Minimum Permit Fee $72.50 $ 7 P • '37D
Plan Review Fee (25% of Permit Fee) $ / 5 • /3
(Please print name) State Surcharge (8% of Permit Fee) $ 5.80
TOTAL PERMIT FEE $ / f n � 3
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\MecPermitApp 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 $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.
$1 0,001.00 to $50,000.00 $231.50 for the first $1 0,000.00 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.
•
•
is \Building \Permit Forms \MecPermitAppPg2 09- 01- 03.doc
•
sc24\
4 rei
r - x
PnD
ck/
•
•
_ • _ _
. • !
•
•
r
E
i d
--u
‘11 173r7 W
PI (9 ... comcic,T3
litsa f--
z _
7.1 g 2, F2
lb U`
1 tA
z v‘ !;...; _k
M,0
•-• Pc' —
o' r , ‘<.t. 3.70
-Tt - N m-12 .
" F 0 M z
it, z
g
Ort -
5 c rN 0
f,:s `4:-
•
nil i
)
m ATE Ci) NT t 16500 SW 72nd Avenue Portland, OR 97224
503-453-4822 FAX: 968-7224
10004 HEATING & AIR CONDITIONING 503-453-HvAc
cm)
DATE: /2 - 3- 65 fiN_T 5 plicE GR_EGfent. aus • Pr....Tg
(-)
sc(RE:
•.co
R.Auuri /14,P INC 15 (APPE: aocAto_....faRgy RD,
_ AP PE
SOB /sg52._
-
SHEET ND: Ai rl&Ro& 97 22_14
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
B;JP
Received Date Requested / - AM PM BU
Location / 5Th - Lippe." 3 o o ✓ , e S• I - j Rd- Suite C.. EC 3 — 000q
Contact Person r e Ph ( ) '+S 4 g��– PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner S gG • �- �� ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: - � SIT
Post & Beam
Shear Anchors k
e a r n, ` s
Ext Sheath/Shear �� '
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
/ 6
Susp'd Ceiling
Roof
Other: �• y�
Final
PASS PART FAIL
PLUMBING �? /
Post & /
/
Under Slab
m , 2 ` E C � / y
Rough -In
Water Service
Sanitary Sewer /)66) � C ( C=7-)
/(
Rain Drains �
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P RT FAIL
c ECHANICAL
t� i eam
Rou h -In
as me
SmoDampers
Fi. -
. - SS PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Q
Approach/Sidewalk Date 4 2' 0 3 /specter Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL