Permit (208) • v\
C ITY OF TIGARD MECHANICAL PERMIT
; DEVELOPMENT SERVICES PERMIT #: MEC2003 -00303
- I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/7/03
PARCEL: 2S115AB -01900
SITE ADDRESS: 16200 SW PACIFIC HWY A
SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C -G
BLOCK: LOT: 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 TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML.INCIN:
MAX INPUT: 200,000 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: 1 <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Adding new roof - top AC unit.
Owner: FEES
BIT HOLDINGS LTD PARTNERSHIP Description Date Amount
BY FORUM PROPERTIES INC [MECH] Permit Fee 6/6/03 $72.50
FIVE CENTERPOINTE DR STE 290
LAKE OSWEGO, OR 97035 [MECPLN] Plan Rev 6/6/03 $5.57
[MECPLN] Addl Pln Rv 7/7/03 $12.55
Phone: [TAX] 8% StateTax 7/7/03 $5.80
Contractor: Total $96.42
MCKINSTRY CO
5400 NE COLUMBIA BLVD
PORTLAND, OR 97218 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 331 - 0234
Heating Unt lnsp
Reg #: LIC 40981 Final 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
• requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
Issued = : • . ' ,,,' -� Permittee Signature: A A J
Ca 03) 6 - • -4175 by 7:00 P.M. for inspections needed the t business day
/6200 SU. PAc/F /C HWy 1 „/�3/er3 &
E - .114= 20 V oo3.
MechanicalPermitApplication OFFICE USE ONLY
EC E V E D Date receivedG. 4 - 03 Permit no.:Th - 003 -CO 1 1
,� "ill City of Tigard II l
- Y g ar Projecdappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Ti an� V Tigard, OR X97
Phone: (503) 639 -4171 b U3
!Ut' Date issued: By:la ' Receipt no.:
Fax: (503) 598-1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval: BUILDING DIVISION Building permit no.: /92.7Zo03 BO /
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family 1111.Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
.JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: I 4320Q 5W ?AC119C I-I,wY Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: ,-• value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 1)402 , OM .
Lot: (Block: I Subdivision. 7/ i *See checklist for important application information and
Project name: 'MAW TOWN hut,, r- . Q fee schedule for residential permit fee.
City /county: -1-1 GP,-(t..0 • I ZIP: °11224 I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE
laa b t -# ( u^) I'-I' Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC: C.:- s
Air handling unit CFM 9
Is existing space heated or conditioned? fzrYes ❑ No Air conditioning (site plan required)
Is existing space insulated?)ff ❑ No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: 1 14 ms - Tam a lip Tons BTU/H
Address: S4ca1 .4 G ti s.ry e,,, gL J 0 Fire /smoke dampers /duct smoke detectors
City: 7, 1%. ,4 4 ., 1 iJ I State: Q2 I ZIP: °IT 2i a Heat pump (site plan required)
Phone: - .. 1 ®234 Fax: 331 ( E -mail: Install replace furnace/burner BTU/H
including ductwork/vent liner ❑ Yes ❑ No
CCB no.: 4098 I Install/replace /relocate heaters - suspended,
City /metro lic. no.: 1 ("'( 9 wall, or floor mounted
Name (please print): )_per,(_ Sac.S>eu+2- Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
Hoods, Type I/ II/res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
Fuel piping and distribution (up to 4 outlets)
City: I State: I ZIP: Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: ZIP: insert - type
Phone: I Fax: I E -mail: Woodstove /pellet stove
Other:
1 Applicant's signature: S LSC3uo../ Dat e : (o/o3 /03 Other:
Name (print):
' Not all jurisdictions accept credit cards. please call jurisdiction for more information.' Permit fee $
Notice: This permit a Minimum fee $ Z S0
0 Visa ❑ MasterCard o
Credit card number: / / expires if a permit is not obtained Plan review (at . $ 18r6 1 1.2... Ex
Expires within 180 days after it has been o a
p State surcharge (8 /o) .... $ if
Name of cardholder as shown on credit card accepted as complete 1 -A TOTAL $
S J
Cardholder signature Amount (� 440 -4617 (6 /00 /COM)
�/ ¢//3 iffiX24"
CITY OF TIGARD 24 -Hour
BUILDING Inspectio J 9 - 4175 ST
INSPECTION DIVISION Business Line: (503) 639 -4171 Z
404 //.3 UP
'/
Received Date Requested 4 3 XIAM PM B
Location /(p 7-0)D /J Suite #' O � I -on A 9/
Suite
Contact Person Ph 90/ — Peri/ PLM Grn
Contractor Ph ( ) SWR
BUILDING Tenant/Owner / / Gt 7% fI ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: � SIT
�
Post & Beam /ivi
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall CS
Fire Sprinkler
Fire Alarm ck_
Susp'd Ceiling
Roof JC— cpk
Other:
Fina
` PART FAIL
:J BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final 111S11!1;111°151116
PA AR FAIL
Post & Beam
Rough -In
Gas Line
Dampers
44 740 PART FAIL
E 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 L Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA 7;-5/d ( " /]
Approach/Sidewalk Date / � f 1 Inspector
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
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