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Permit (11) C ITY OF TIGARD MECHANICAL PERMIT Awirve DEVELOPMENT SERVICES PERMIT #: MEC2002 -00503 .�� - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/13/02 PARCEL: 2S103DD -00400 SITE ADDRESS: 13727 SW PACIFIC HWY 100 SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M 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: 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: < =10000 cfm: GAS OUTLETS: 3 > 10000 cfm: Remarks: Run new gas line to 2 existing root top units and 1 stub out to kitchen. Owner: FEES WILSON'S TIGARD RETAIL CENTER Description Date Amount BY BOMCC ESCROW ADMINISTRATION TX1 -2495 [MECH] Permit Fee 11/13/02 $72.50 DALLAS, TX 75201 [MECH] Permit Fee 11/13/02 $0.00 [TAX] 8% StateTax 11/13/02 $5.80 Phone: [TAX] 8% StateTax 11/13/02 $0.00 Contractor: Total $78.30 OREGON HEATING +A/C INC PO BOX 397 DUNDEE, OR 97115 REQUIRED INSPECTIONS Phone: 538 -2953 Gas Line Insp Final Inspection Reg #: 125815 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: W _� Permittee Signature: ,Ic Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busin ss day MechanicalPermit Application Date received: /4 -13-D.2_ Permit no.: IYlEG1ixa-6,,:5■71 lip., City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: e..5 I Receipt no.: Phone: (503) 639 - 4171 Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF P 'RMIT ❑ 1 & 2 family dwelling or accessory Q Commercial/industrial 0 Multi - family "Fehant improvement 0 New construction 0 Addition /alteration/replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCIEDULE Job address: 1 ' j -] J 7 SL.,) ?4r ,(p 1 L 1.1 z,A4 Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: 1 Suite no.: J A value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ . Lot: 'Block: 1 Subdivision: *See checklist for important application information and Project name: D r r•e.,- - .oeld jurisdiction's fee schedule for residential permit fee. City /county: ' ZIP: `` IA 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description n¢ location of wprk on rr�r� vu LL / 1.5 'fiV AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE 2- ewe P' 7 'tit 0 1AO�tt \ Fee(ea.) Total Est. date of compl Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air handling unit CFM Is existing space heated or cpnditioned ?� Yes ❑ No Air conditioning (site plan required) Is existing space insulated? Yes 0 No Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: ©Cechy► l` 1 �(4 L--- State boiler permit no.: �_"" �- �. HP Tons BTU/H Address: r(, 37 Fire/smoke dampers/duct smoke detectors City: I:7, J7.t.9/O I State:6i I ZIIiti f I( Heat pump (site plan required) Phone: s25 j s�fit 95;.s I Fax: 1E-mail: Install/replace furnace/burner BTU /H Including ductwork/vent liner 0 Yes O No CCB no.: ..1:0 12„5 /0 -t. --n6 Install/replace/relocate heaters- suspended, City/metro lic. no.: wall, or floor mounted Name (please print): - j A , s )a,.Q,r( Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: ( ` (b %`{- tyk ttr`.Q� Chillers HP , Address: Compressors HP Environmental exhaust and ventilation: City: I State: 'ZIP: Appliance vent Pho • o ) da y,; , , Fax: E -mail: Dryer exhaust OWNER 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 heatin AC -- - ∎ City: I State: I ZIP: Fuel piping and distribution (u to 4 outlets)- Type: LPG NG Oil �o3 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: 1 State: i ZIP: Insert - type Phone: 1 Fax: (E -mail: Woodstove/pellet Other: Applicant's signature: 1 Date: Other. . I Name (print): F Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ J� ❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $ Credit card number: / / expires if a permit is not obtained Plan review (at %) $ Expires within 180 days after it has been Name of cardholder as shown on credit card accepted as complete. State surcharge (8%) .... $ $ TOTAL $ Cardholder signature Amount 430.4617 (6/00/COM) MECHANICAL PERMIT FEES 1 . . 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 17) Hood served by mechanical exhaust Vent not included in appliance 445 10.00 permit 18) Domestic incinerators Repair units 805 17.40 < 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 101k 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 8% State Surcharge $ Air 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 Other Inspections and Fees: 1 170 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 per 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: - All New Commercial Buildings require 2 sets of plans. is \dsts\forms\mech- fees.doc 02/11/02 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 // BUP Received Date Requested /( — I 3 AM PM BUP Location 1„3 7 Z 7 S('c) 74 c l �� j-1 �I Suite /0 0 MEC SD) Contact Person Ph ( ) � l v °/ Z PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain �{ ELR Crawl Drain !J Slab Inspection Notes: SIT Post & Beam Shear Anchors f � ` Ext Sheath/Shear UL/ I Lf8h ! / / &tr � Int Sheath/Shear Framing C-e Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING 1/1/::-.61 Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Z( Rain Drains Basin / Manhole 6 / ...*** 7 Storm Drain Shower Pan Other: Final PASS PART FAIL 'MEGUANICAb os Beam Rough -In Smoke Dampers Fin.. • PART FAIL TRICAL 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 El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date / y Inspector xt Other: Final DO OT REMOVE this inspection record from the job site. PASS PART FAIL