Permit CITY TIGARD MECHANICAL PERMIT
7 .I DEVELOPMENT SERVICES PERMIT #: MEC2004 -00178
6.III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/8/04
PARCEL: 2S113AB -00600
SITE ADDRESS: 16150 SW UPPER BOONES FERRYRD BLDG.
SUBDIVISION: SANNO CREEK ACRE TRACTS ZONING: I -L
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:
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:
> 10000 cfm: GAS OUTLETS:
Remarks: Relocate existing grilles, replace (3) thermostats, and duct work.
VALUATION = $1,000.00
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300-WMI
PORTLAND, OR 97224 [MECH] Permit Fee 4/8/04 $72.50
[TAX] 8% State Surcharl 4/8/04 $5.80
Phone: Total $78.30
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 233
Final Inspection
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 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
Issued By: 412? Permittee Signature
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
• Mechanical Perm i ; l a -1 ` _ I FOR OFFICE USE ONLY
Clty*!lard Received �, Pernut No. ✓
Date /By. 7 7 0 �% ' CZ ,/ N' DO `7 r
13125 SW Hall Blvd., Tigard, OR 9722A 0 2004 Other Permit
Plan Revi w
Phone: 503.639.4171 Fax: 503.598 19 0 /napdiv I ; /'t� Date/By.
Inspection Line: 503.639.4175 CITY OF TIGARD , R J Date Ready /By: lusts El See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Method: Supplemental Information
`
,!; ' s=` °�''' - CMMERCIAL'. ' FEE * CHEDULE':L U
j:; `�'. ,. _* �TYPEUF'iW0 .. .. - -. ,"'` _.. � O- - ... ,
❑ New construction at Addition /alteration/replacement 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, labor, overhead, and profit
1 i "CATEGORY�'OF.!CONSTRUCTION:' _''' Value: $ I 006
i', , . ,, , - ..,.., .. -...n . .. ' ` RESIDENTIAL•EQUIPMENT' /SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist
❑ Multi - family ❑ Master builder ❑ Other: Descnption Qty Ea. Total
"' ` " +' '. '' :t.4 'JOB, :SITE':INFORRMATION SIV- 445"i6 ; ' ° p _ Heating/cooling
Job site address: ( I SC, Su. t, te- l 3 Air conditioning or heat pump
Gt7ti�5 � �F ' (requires site plan showing placement) 14.00
Furnace 100,000 BTU (ducts /vents) 14.00
City/State/ZIP: d `� �- Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: (p 44Ut IQ& t SNilPT3 Gas heat pump 14 00
Cross street/directions to job site: Duct work t 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
;, t: •- iu ., ..
g;`; r` >,.` =,w;a ,ti, 40'ESCRIPTION:1OF"sWORIC•,:.� ',:. r _ E' : r a' # >; ,. Water heater 10.00
p� Gas fireplace 10.00
-
4.t_LO _Arne- i,c_ I sT (P 3 - 6 J g- S Flue vent for water heater or gas
fireplace 10 00
t'PL-Occ-e- C 1 " 5 S Log lighter (gas) 10 00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
`]' °'PROEERTYrUWNEIt °'' : ' ❑<A TENANT'' '" Other
10.00
Name: F Toe,us l Environmental exhaust and ventilation
(5 Range hood /other kitchen
Address:
(5 5s0 $(t.' stczt.t.c( ?Ku) y 4 equipment 10.00
City/State/ZIP:'p e_7L1{ ^,le>, CCL . FTZ.Z.. ]/ Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (5 4'z V. 4-0,1,1=. Fax: ( ) toilet compartments, utility rooms) 6.80
'c,: - , ❑t - r:i',`z:`= i , `} CONTACT ' PERSON` Attic /crawlspace fans 10.00
: " ' "' ' +t ,� � V'u f � "� Other 10.00
Business name: �j►4.11�5 ( a...1 Cr t- 6 Fuel ng 1 i
P�P�
Contact name: $5.40 for first four; $1.00 for each additional
J t...) 1r.' 15.e40/ ....DES '��tee-`{ l .D Furnace, etc.
Address: � ( I `J <j
Gas heat pump
City/ State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E - mail: Range
:; ; .c n r ::� r ri ,:.s ,,.,,, ,.;, h ,= t ; : I f; °a,' , .,:°F. ;,: _,F Barbecue
= �� °�;<�: s ,; �
F,p;,` `CUNTRACTOR",;<a' „- R��' .�.,�;� „ ; „ i,:
Business name: � T � .C- � '� 4 aC t Arms tl' Clothes dryer (gas)
Other:
Address: 97SS s 1 .. - ar.; H
1VIECANICAZ,`PERMITFEES*
City/State/ZIP: e ppyZT- L,p 62- �`1'z'LZ Subtotal ?2. So
^ Minimum permit fee ($72.50)
Phone: (�� ) ZZ,?) - a ((( F ax: (b3 23'8 �'j l 1 +► I Plan review (25% of permit fee)
CCB lic.: -3�ros State surcharge (8% of permit fee) s,
TOTAL PERMIT FEE 7,P, 3
Authorized signature: This permit application expires if a permit is not obtained within 180
A da after it has been accepted as complete.
Print name: - +� � (� �
A . Q , 1't Date:
1 e& , O-(f ' Fee methodology set by Tn- County Building Industry Service Board
i \ Budding \Permits \MzC- PemtitApp doe 12/03 440 -4617T (I I /02 /COM/ WEB)
Mechanical Permit Application - City of Tigard ,
Page 2 - Supplemental Information
Commercial Fee Schedule:
T, OtaI=V,'all ` afi011',_,''` , Permif ;Eee: ;%;_ >Y' ;..A .; .. ,
$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.
is\BuildingWermits \MEC- PermitApp.doc 12/03 2
•
CITY OF TIGARD 24 -Hour
BUILDING Inspections: (503) 639 -4175 MST
INSPECTION DIM ION Business Line: (503) 639 -4171
J1 BUP
Received Date Requested M PM UP
Location ■ V 4.. Iii : a. Suite MEC 4-
Contact Person �L' Ph ( ) 10 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling •
Roof
Other: ■
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
�
Water Service -�
Sanitary Sewer .,.f
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL _
Post & Beam
ough ?I
as ins
Smoke Dampers
41
PART FAIL
CTRICAL
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 Date ( � Inspector pier EXt
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL