Permit (5) " CITY OF TIGARD MECHANICAL PERMIT
i 4, DEVELOPMENT SERVICES PERMIT #: MEC2002 -00400
F� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6 -4171 DATE ISSUED: 10/28/02
PARCEL: 2 S 103 D D -00400
SITE ADDRESS: 13727 SW PACIFIC HWY 100
SUBDIVISION: ZONING: C -G
I3LOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: Installation of Type I hood and exhaust system. NO FIRE SUPPRESSION SYSTEM
Owner: FEES
WILSON'S TIGARD RETAIL CENTER Description Date Amount
BY BOMCC ESCROW ADMINISTRATION
TX1 -2495 [MECH] Permit Fee 9/10/02 $110.50
DALLAS, TX 75201 [MECH] Permit Fee 9/10/02 $0.00
[TAX] 8% StateTax 9/10/02 $8.84
Phone: [TAX] 8% StateTax 9/10/02 $0.00
Contractor: [MECPLN] Plan Rev 9/10/02 $27.63
[MECPLN] Plan Rev 9/10/02 $0.00
DAN -CO SHEETMETAL + CONST Total $146.97
55695 VIEWCREST PL
WARREN, OR 97053 REQUIRED INSPECTIONS
Phone: Final Inspection
hone: 397 - 4457
Mechanical Insp
Reg #: 110448 Hood Inspection
Duct Inspection
Misc. Inspection
•
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
7
Issu d By: ` i . /..% ` / /, , 1 / Permittee Signature•
�-- Call (503) 39 -4175 by 7:00 P.M. for inspections needed th • n : business day /
fg
Mechanical Permit Application
. Date received: 9 /O D`}- Permit -G6 'N City of Tigard Project/appl. no.: Cara date: -
o Ti and Address: 13125 SW Hall Blvd, Ti ard, OR 9 7223 W
City f 8 g Date issued: B Receipt no.: � O
Phone: (503) 639 -417 /� q`
Fax: (503) 598 -1960 &® OP J 57 Case file no.: Payment type: I'
Land use approval: Ol'� Building permit no.:
TYPE OF PERMIT -gl
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family enant improvement
❑ New construction 0 Addition/alteration/replacement CI Other:
- JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE f
Job address: /3 7,a , r (,J X, 4 _ , C /14.07 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: �Qs�• /5 value of all mechanical materi equipment, labor, overhead, .d
Tax map /tax lot/account no.: profit. Val $ 65 47 . .
Lot: (Block: ISubdivision: *See checklist for important application information and
Project name: ..,r,-2, / , G /0/6 jurisdiction's fee schedule for residential permit fee.
City / county:.7 5 ., , ,d I ZIP: 9 7.,a 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description an c of work on premises: C, 7" AND COMMERICAL/INDUSTRIAL EQUIPMENTSCI g
/ 4 o d Fee (ea.) Total
Est. date of completion /inspection: Description Qty. Res.only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes ❑ No Air handling unit CFM
space insulated? ❑ Yes 0 No Air conditioning rati of existing plan HVAC Is existing system
P Alterati of existing HVAC system
MECHANICAL CONTRACTOR Boilcr /compressors
State boiler permit no.:
Business name: ., ,C2 r ,ti - C p HP Tons BTU /H
Address: , ,PS/7/ 04,0 4gt .i
,e f�vcr r "eV Fire/smoke dampers/duct smoke detectors
City: , ,r7 /lfe,/e,,„<" I State: ode I ZIP: 99as`7 Heat pump (site plan required)
Phone: 3'9 7as`e/S` I Fax: 7p7 6'14 E InstalI/replacefurnace / burner BTU /H
Including ductwork/vent liner O Yes 0 No
CCB no.: / /c. /4/ ' 7X - / 5 0 g Install/replace/relocate heaters -suspended,
City /metro lic. no.: C50 7 ) -' 7) 01 CJ / wall, or floor mounted
Name (please print): 1",,e . r�L�j Vent for appliance other than furnace .
• CONTACT ' efrrgeratron:
ONTACT PERSON
Absorption units BTU/H
Name: Chillers HP
Compressors HP
Address:
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type I/Ores. kitchen/hazmat
hood fire suppression system /•
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC / -
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
rocess piping (schematic required)
Number of outlets
Name: -
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert-type
Phone: I Fax: I E -mail: Woodstove/pelletstove
Other:
Applicant's signature 0 ,; I Date: j /a�� Other: .
Name (print): /�3ir ," -,..el.", z. 4 y '
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ I/o - v
❑ Visa ❑MasterCard Not Th permit application Minimum fee $
/ / expires if a permit is not obtained Plan review (at AS %) $ 7 '
Credit card number. within 180 days after it has been
Name of cardholder as shown on credit card Expires accepted as complete. State surcharge (8%) $
TOTAL $ C 9 7
Cardholder signature Amount 440.4617 (6/00/COM)
i
MECHANICAL PERMIT FEES ,
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: ,. .
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit 6.80
$1.45 for each additional $100.00 or
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond
fraction thereof. footnotes below. Comp
Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit
to 100K BTU 14.00
8% State Surcharge $ 8) 3 -15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9 ) 15-30 HP; absorb 35.00
Required for ALL commercial permits only - unit .5 -1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU
11) >50HP; absorb
unit >1.75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12) Air handling unit to 10,000 CFM 10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) Amount 17.20
Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct
ducts & vents 6.80
Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater s 17) Hood served by mechanical exhaust
Vent not included in appliance 445 10.00
permit 805 18) Domestic incinerators 17.40
Repair units
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101 k to 500k BTU 10.00
15 -30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
mil. BTU 5.40
30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each)
1 -1.75 mil. BTU 1.00
>50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $
>1.75 mil. BTU
Air handling unit to 10,000 cfm / 656 fp57,10 8% State Surcharge $
Ail handling unit >10,000 cfm 1,170 _
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not included in 656
appliance permit
Hood served by mechanical exhaust / 656 v`"r" Other Inspections and Fees:
1 170 1 1. Inspections outside of normal business hours (minimum charge - two hours)
Domestic incinerator $62.50 per hour.
Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge - half hour)
Other unit, including wood stoves, 656 $62.50 pet hour
inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum
• Gas piping 1 - 4 outlets 360 charge -one -half hour) $62.50 per hour •
Each additional outlet 63 *State Contractor Boiler Certification required for units >200k BTU.
TOTAL COMMERCIAL $ **Residential A/C requires site plan showing placement of unit.
VALUATION: / 3/ Z All New Commercial Buildings require 2 sets of plans.
i:\dsts\forms\mech- fees.doc 02/11/02
CITY OF TIGARD 24 -Hour
BUILDR,1G Inspection Line: (503) 639 -4175
INSPECTION DIVI ON' Business Line: (503) 639 -4171 MST
Received Date Requested 4/4 AM PM BUP
Location /3 7 a_ 7 e l Suite l S MEC o2 " 237) a
Contact Person - /A.c.{/ Ph ( ) 59'7 - 37 4 y PLM
Contractor (f Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ' _ ELC
Ftg Drain �� c{i rt U U Lo ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam �jJ
Shear Anchors -, G ' f / SO 4.e S / I 6" ,ft-, ' %-4 ( I
Ext Sheath/Shear /
Int Sheath/Shear
Framing
Insulation
Drywall Nailing •
Firewall # 0 a / UG Lc/ fP
Fire Sprinkler
Fire Alarm f /4 S O C �C /�- /6;71 �L) at
Susp'd Ceiling Roof c / � L � � C -e C 41
Other:
Final : g ( s
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
as ine 4 ;
Smoke Dampe
'PASS 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 [J Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA /
Approach/Sidewalk Date ////70 Z i Inspector / c7 Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL