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10240 SW NIMBUS AVE L12
• CITY OF TIGAR®
MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00722
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 12/19/03
PARCEL: 1 S134AA-01800
SITE ADDRESS: 10240 SW NIMBUS AVE L-12
SUBDIVISION: SCHOLLS BUSINESS PARK ZONING: I-P
BLOCK: LOT:002 JURISDICTION: TIG
CLASS OF WORK: OTR 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 TYRES 0 - 3 HP: DOMES. INCIN:
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: <s 10000 cfm: GAS OUTLETS:
> 10000 cfrn:
Remarks: Add rooftop unit,weight 287 11,g. Project value: $5,500
Owner: FEES
ROBINSON, CONSTANCE A + Description Date Amount
ROBINSON, LYNN + BELL, KAY ET �MFCH)Permit Fee 12/19/03 - $150.50
BY INSIGNIA COMMERCIAL GROUP
BEAVERTON, OR 97008 {'AX]9%State SurcharE 12/19/03 $12.04
Phone: Total $162.54
Contractor:
HUNTER DAVISSON INC
1800 SW PERSHING
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: 503-234-0477 Mechanical Insp
Duct Inspection
Reg#: LIC 01612 Fina! Inspection
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requir tojol low rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
sued By: r Permittee Signature:
G
Call (503) 39-4175 by 7:00 P.M.for Inspections nes the next business day
Mechanical Permit Application
Received Mecham.-
Date/By- / /� Q !�"-mtil No.
CityCit of Tigard Planning Ap oval Building
Date/9 Permit No
13125 SW Hall Blvd. Plan Review —v Other -
Tigard,Oregon 97223 Date/By Permit No
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land use
Internet: www.ci.tigard.or.us Date/By, Case No..
24-hour Inspection Request: 503-639-4175 Naintact me/Method Jun$.. See Page 1 for
supplemental lisrormation.
TYPE OF WORK _ CONEURCIAL FSE•SCIM01_7m,E-USE CHECKLISV
New construction _ Demolition Mechanical permit fees'are basted on the total value of the work
Addition/alteration/re lacement Other: performed. Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION mechanical materials,equipni9b labor,overhead and profit.
ff2-Family dweli�in Commercial/Industrial Value: S _S f00. See Pate 2 for Fee Schedule
r� ung Multi-Family RnID LEQUIPMUNT/SYST>cMSF1�B�sCHEDL7.EDescrl don a.) Total
Builder Other: — HeadnyLrolla
JOB SPIE INFORM^TION and LOCATION Furnace-add-on air conditioning•' 14.00
Job site address: a W , M'8 Gas heat pump ;4.00
Suite #: /�, Bid ./A t.#: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Cross street/Directions to job site: Residential boilerfor radiator or hdroY nic system 14.00
Unit heaters(fuel,not electric)
in will,in-duct,suspended,etc.) 14.00
Flue/vent(for any of above) 10.00
Subdivision: Lot#: Repair units _ 12.15
- -
Other Frey Ilaaees
Tax ma /parcel #: Water heater10-00
DESCRIMT '-%"i OF WORK. Gas fire lace 10.00
_ W
�( t _1`- Flue vent water heater/gas fir.T ace 10.00
Log It hter as 10.00
_Wood/Pellet stove 10.00
_. Wood fireplace/insert 10.00
Chimney/liner/flue/vent _ , 10.00 _
PROPERTY OWNER . TENAN _ Other: 10,00
Name: C 13 k1C0x1,4gZEaviroantental Exhaust&Ventilation
Range hood/other kitchen equipment 10.00
Address: /tom�{O ��,) /1�/�'l�t)s IL-3 _ Clothes dryer exhaust 10.00
Cit /State/Zip: i p �? Single duct exhaust
Phone: - -c> Fax: (bathrooms,toilet compartments,
APPLICANT CON;fkCT PLR.sON utili rooms_ 6.80
kjne: , e�� Attic/crawl space fans 10.00
-
Address: �� '��� Other: _ _10.00
Fuel Piping
City/State/Zip: • (SS.40for first 1,$i.00 each _
_ _ additional)
F Phones r Furnace,etc. _ ••
Gas heat pump _ ••
N E-mail: Wall/suspended/unit heater _ ••
r CONTRACTOR Water heater _ ••
5 Business Name (e_ 9ya&,) ..'TAv Fireplace ••
m Address: � 0 _S.r. Pf .;af/r.r� B
Cit /State/Zi PJ64 -_9T02 •'
Clothes d er �� ••
Phone: c r Fax: ocher: ••
CCB Lic. #: �/(o/01 Total:
Mechanical Permit Fees*
Authorized Subtotal: S
Signature: __ Date: �00
Minimum Permit Fee 572.50 S _
� - A16 G� _ Plan Review Fec 25%of Permit_Fee S
(Please print name) State Surcharge(8%of Permit.Fee S -
_ TOTAL PE&MIT FEE S ,
Notice: This permit opplicatlon expires If a permit It not obtained within *Fee methodology set by Tri-County Building Industry Service Board.
190 days after It has been accepted as complete. °'Site plan required for exterior A/C units.
i,\Dsts\Permit Forme\htecPerrriitApp.doc 01/03
Mechanical Permit Application -City of Tigard
Page 7 - Sui?plemental 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 each
additional$100.00 or fraction thcreo o rnd
_ includin 55,000.00.
$5,001.00 to$10,000.00 $141.50 for the first$5,. and$1.80 for
each additional$100 or fraction thereof,to
_ and including$ 00.
$10,001.00 to$50,000.00 2.11.50a first$10,000.00 and S i.35 for
ditional$100.00 or fraction thereof,to
an includin $g 50,000.00.
00 to$100
550,001. $77 0 for the first$50,000.00 and S1 25 for
each a itional S 100.00 or fraction thereof,to
and inch in S l0(1 000.00.
$100,001.00 and up $1,396.50 r the first$100,000.000 and
— $1.10 for eac additional S 100.00 or fraction
thereof.
All New Commercial Buildings require 2 sets of plan .
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i�f3uildinglPernit Forms\MecPermitAppPg2 09.01-03.doc
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60JGW4 208/230-1-60 289 131.1 991.1(39.02) 500.1(19.7) 353.1(13.9) 381.0(15.0)
50JS030 208!230 180,2LkV230 3�0 257 130.2 991.1(39.02) 495.3(19.5) 348.0((3.7) 36i.(1(15.0)
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (603)639.4111
sup --
Received Date Requested_ 7— AM -V BUP t
Location — D i D -- 1'f�(/�� —.. Suite / MEC -3— DO 7.a ;t,
Contact Person -- �� 0 _ - Ph(__ .—_) - /SC PLM —
Contractor — _—.__. _ Ph SWR
BUILDING Tonant/Owner _— ---_ _ ELC _
Footing - ELC
Foundation Access:
Ftg Drain ELR —
Crawl Drain
Slab Inspection N ' :C.,Ze SIT
Post&Beam
Shear Anchors --
Ext Sheath/Shear V� _
Int Sheath/Shear -
Framing -- ----- --- -- -
Insulation
Drywall Nailing -- - ----- -- ---
Firewall
Fire Sprinkler -- --
Fire Alarm
Susp'd Ceiling ------ -
Roof
Other:
Final ----------
PASS PART FAIL --- - r
PLUMBING
Post&Beam -
Under Slab
Rough-in
Water Service
Sanitary Sewer
Rain Drains -- ---
Catch Basin/Manhole
Storm Drain — —
Shower Pan
Other:
Final
PAS RT FAIL -- - - -
4CCHANJO _ ---------- - - - -
m -
Rough-In --- --- _ -
IL Gas Line
Spoke Dampers --------- - - --------- ---- - -- —
M- i
rn AS PART FAtr
METRICAL -- —
m Service
Rough-In --- --- - ------
,U UG/Slab
J Low Voltage
Fire Alarm
Final Reins _
PASS PART FAIL � P�on fee of ---------required before next inoper.Non. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for relnspecti,)n RF __ _. Unable to inspert-no access
Fire Supply Line --'7
ADA
�. � �-,
Approach/Sidewalk Bye-------- -�-- �����----- -
aid
Other:
Final — DO NOT REMOVE this Inspection reo*W tf+ m bile slat.
PASS PART FA'L