Permit (173) CITY OF TIGARD MECHANICAL
� 2p.o DEVELOPMENT SERVICES PERM I T
J �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PERM T T # ME C 97 —��.37
DATE ISSUED: 10/29/97
PARCEL: 2S115BA -00101
SITE ADDRESS...: 16200 SW PACIFIC HWY #X
SUBDIVISION • ZONING: C - -G
BLOCK • LOT JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 2
OCCUPANCY GRP..:M VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES . 1 BOILERS /COMPRESSORS HOODS 0
FUEL TYPES 0 -3 HP.....; 0 DOMES. INCIN: 0
:GAS 3 -15 HP • 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP....: 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: N 30 - 50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: M 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS -- -- AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS. : 1
FIJRN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Demolition of office/mezzanine, add demising wall to create 2 tenant
spaces. Separate gas lines & electrical service, separate meters, add restrooms.
Owner: -- - - - -- FEES --
CAPITAL /BIT HOLDINGS TWELVE IN type amount by date recpt
C/O FORUM PROPERTIES PRMT $ 25.00 JSD 10/28/97 97- 300457
8705 SW NIMBUS PLCK $ 6.25 JSD 10/28/97 97- 300457
BEAVERTON OR 97005 5PCT $ 1.25 JSD 10/28/97 97- 300457
Phone #:
Contractor: - - - -- - - - - --
GENERAL SHEET METAL WORKS INC
11231 SE HWY 212 _ - - - - -- - - - --
32.50 TOTAL
CLACKAMAS OR 97015
Phone #:
Reg #..: 000401
REQUIRED INSPECTIONS ----- -_ -_ -_
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Final Inspection
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- 001 -0010 through OAR 952- 001 -0080. You may —
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
11111111M1101110111 Issue By: Permittee Signature: --4
I � 1
++++++++++++++++++++++++++++++++++++++++++++++++ + + ++ ++ + + ++ ++ + + + ++ + + + + + + ++ + ++ +++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + +++ + ++ + ++ + + + + + ++ ++ + + + + + +++ + ++
Plan Ch
CITY OF TIGARD Mechanical Permit Application Recd By ,
13125 SW HALL BLVD. Commercial and Residential / Date Recd r x-17
TIGARD, OR 97223 9 7/ Date to P.E. 4 -q-4'
503 639-4171, x304 i .fl Date to DST q -9 -9 7
t Print or T
( ) q� Permit# M�C9 7 - 0337
Type p�
YP TU Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
f 1044/6 .5 C/4 6 Table IA Mechanical Code QTY PRICE AMT
Job Sheet Address - Suite.' A) Permit Fee -0- -0- 10.00
Address /6200 -AI Mr-ex Amy 4P
Bags 1 y City /State Zip 1.) Furnace to 100,000 BTU 6.00
Y/(1/ y� U ` 7 including ducts & vents
N ame (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner t^4,fit- d /T /ftU2 /"IG re/LL!/d, /cJL including ducts & vents
0 Men') Mailing Address 3.) Floor Furnace 6.00
/*pdt/Jd 810..c..il2 MR1(5 4.A//1b 230 including vent
City/State p Phone 4.) Suspended heater(wall heate 6.00 k
CtiVef 9 P j� ez7 7 or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3
Y4trvr - jrezc
Occupant Mailing Addreu 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT" ,
City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor Na ne.. )ti 11 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to •L/ 1 i i / ii i . jl",.„ 15-30 HP; absorb unit5-1 mil BTU"
issuance Mailing Address _ , 9.) Boiler or comp, heat pump, air cond. 22.50
applicant 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all city/State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor > 50 HP; absorb unit 1.75 mil BTU"
license Oregon const. Cont Board Licit Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
information if e� � d
expired in
COT COT Busrt+esa T etro Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database). -
Architect � /!� Mt"- 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single dud 3.00 G
• Engineer Cny/stat , / Zip Phone q 15.) Ventilation system not included in 4.50
/Ne 5714/' -1 _ e 24-15-a9 appliance permit
Describe work New 0 Addition 0 Afterati n Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential •
Additional Description of work 17.) Domestic incinerators 7.50
,Ae•�al%2r! � o' �/lICLZ /124... / deit40/iMj
_ d i ) ��O /�. �L/ �}� � //� corn( 18.) Commercial or industrial type 30.00
R�`�� - Incinerator
Existing use of �/� 19.) Repair units 4.50'
building or property Y Kei/Wi %AK ,f/t4 '/
20.) Wood stove 4.50
Proposed use of y�� ' 21.) Clothes dryer, etc. 4.50
building or property fee/ Grd�r
22.) Other units 4.50
Type of fuel - oil 0 natural gas 1>p LPG 0 eledri,( 23.) Gas piping one to four outlets I 2.00 Z -
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws. .
Signature of Owner /Agent A Date *SUBTOTAL 2r •
C/Cie )V, 1 //, 5% SURCHARGE / y
Contact Person Name
��/ /� Phone PLAN REVIEW 25% OF SUBTOTAL G Z
jia # / ZZ44/CO TOTAL '
i:klstlrnechpmtdoc (rev 9 *Minimum permit fee is $25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit.
OVER- THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: P i m V L i,, p ,., 4,4 /-,
e z /in ,,, e
A7)2 O 7 /a / r.^q kv4 1I �o co-09474.E �'wo / T 4f17 PA- / I P(fl0J -�c"A
C Fl,, 1P -d(C € f0 a r'of ri ,Jeri 041,12 J
Class of Work: At 1 t Floor Furnace: Evap Coolers:
Type of Use: KaaJ, -, Unit Heaters: Vent Fans:
Occupancy Grp: A/ Vents w/o Appl: Vent Systems:
Stories: in e Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
J / / / / 3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: v < = 10000 cfm: Oth Units:
Gas Pressure: H / L > 10000 cfm: Gas Outlets: Dote f- ,s- Lc'q k
No. Of Units:
Furn < 100k Btu:
Furn > =100k Btu:
NOTES:
$ 2 --- Fee
Gas Line Inspection $ G 2 ) Plan Review
Mechanical Inspection $ 2-C State Surcharge
Cooling Unit Inspection $ Additional Permit Fee
Shaft Inspection $ Additional Plan Review Fee
Hood Inspection $ Inspection Fee
Fire Suppr Inspection $ Miscellaneous Fee
Duct Inspection
Fire Alarm Inspection
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
Fire Alarm Inspection
✓ Final Inspection
:.FOR OF I E USE O ; :. ;>.>:;.;.::.:» . >:: >.::;:::<:.:.,::::;: ::::;.. ; ;; . ...:: ;:: :. »:::;; :::::::;.; > >::;.;:..:.: ; >::.; :; .:.:::.:.:... :. •
TYPE OF. USE OPTIONS (COM; = ; comtnerciats:: CMS; = comnierciaL manufactured: structurej : >: ; : _.; >.:..:
CLASS OF WORK..OPTIONS FOR ALL;PERMITS:(NEW -'new, Af3D = addition ALT. = ACS. =accessory;
FND foundation;. 0TH:.. = ::other DEl = ;demolitio i RER. sepal(: BPS =; fire::protectiort..syrstem NOFE =t1SE 0TN FOR.FENCES: :
`•RETAINtNG :.DETACHED' DECKS::: SIGNS4 : CANOPIES] :::. :: >':
i:\ovrcntr.doc (dst) 8/97
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6/30/99 Activities for Case #: MEC97 -00337
4:43:58 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 9/9/97 DRA OTR DRA 9/9/97
MECC008 Permit created 9/9/97 DRA MEMO DRA 9/9/97 Contractor to be determined.
MECC014 Plan checked /Approved by P.E. 9/9/97 JHF PASS DRA 9/9/97
MECC015 Reviewed Plans Routed to DSTS 9/9/97 JHF PASS - DRA 9/9/97
MECC799 Final Inspection 11/13/97 TLP PASS TLP 11/13/97
MECC705 Gas Line Insp 9/9/97 DRA 9/9/97
MECC706 Mechanical Insp 9/9/97 10/29/97 TLP PASS J'H 10/29/97
MECCO50 (F) Ready to issue - 9/9/97 DRA PASS DRA 9/9/97 Needs to determine contractor -
and verify all licensing.
MECC090 (F) Issue permit 10/29/97 JSD PASS JD 10/29/97
MECC800 Case Finaled 11/13/97 TLP PASS TLP 11/13/97
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