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Permit
ro CITY OF TIGARD MECHANICAL PERMIT 'd el^ DEVELOPMENT SERVICES PERMIT #: MEC2001 -00284 =-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/08/2001 PARCEL: 2S101 AA -06400 SITE ADDRESS: 12323 SW 66TH AVE SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: C -G BLOCK: LOT: 024 JURISDICTION: TIG CLASS OF WORK: ALT 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: 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: 1 GAS OUTLETS: > 10000 cfm: Remarks: HVAC Change out. Owner: FEES TING, ELON + SYLVIA Type By Date Amount Receipt BY WILLIAM R SOUTHARD PRMT CTR 08/08/20C $213.10 2720010000 603 SE VICTORY AVE STE 100 5PCT CTR 08/08/20C $17.05 2720010000 VANCOUVER, WA 98661 Total $230.15 Phone: Contractor: AMERICAN HEATING INC 1339 SE GIDEON STE 1 REQUIRED INSPECTIONS PORTLAND, OR 97202 Mechanical Insp Phone:239 -4600 Cooling Unt Insp Reg #: LIC 33135 Final 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 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct que i to OUNC by calling (503)246 -9,.> 9. / j) Issue By: / 9 .OG/ Permittee Signatur:. sivi )1 Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next( • usiness da - -- Mechanical Permit Applicati®n Datereceiv - • ./7) Permit no.. i[, 0 - 00(y 21 1 i l City of �r Projecdappl. no Expire date: CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR Date issued: M Receipt Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: • Payment type: Land use approval: Building permit no.: T1'PE 01 PERM1a'. ❑ 1 & 2 family dwelling or accessory f"Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ' Addition/alteration /replacement ❑ Other: , JOB Sir LE +INFORMAL ION COMMERCIAL VALUATION SCHEDULE ' Job address: g (A) C , 7 N -Ay Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ 14 2S0 '� . Lot: Block: Subdivision: *See checklist for important application information and Project name: i~t 4C jurisdiction's fee schedule for residential permit fee. City /county: T _ ,bA ZIP: I .: 2; FAMII Y DWELLING' PERMIT FEE SCHEDULE L' Description and loca on of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENT HV.�C C/iAN • 6 , tAT Fee(ea.) Total Est. date of completion/inspection: • ilEV© Description Qty. Res. only Res. only Tenant improvement or change of use: 11' AC: Is existing space heated or conditioned; lSr/es LRNo Air handling nit CFM slB MI �,! Air conditioning (site plan required) - Is existing space insulated? Wes l o Alteration of existing HVAC system _ 1\IECIIANICAL''`CONTR ACTOR Boiler /compressors II■■ State boiler permit no.: •� HP Tons BTU /H Address: _ -A, , ST. Fire /smoke dampers/duct smoke detectors IIM EMIFVE! _.. Ma ZIP: ' ' 7 X0 Heat pump (site plan required) _ Phone: 3 - , • Fax: 0 Install/replacefurnace/burner BTU /H ■ -- Including ductwork/vent liner ❑ Yes ❑ No CCB no.: "� Install/replace/relocate heaters- suspended, ■ -- City/metro lic. no.: o wall, or floor mounted Name (please print): Vent for appliance other than furnace �_ -- CONTACT PERSON efngera on: . " . , Absorption units BTU/H ■ Name: Chillers HP IIIII Address: TW.1111111111MINIONIM Co .ressors HP Environmen exhaust and ventila on: II City: State: ZIP: Appliance vent Phone: Fax: E-mail: Dryer exhaust I O«'1 . Hoods, Type U IUres. kitchen/h azmat __ ■ hood fire suppression system - {L Exhaust fan with single duct (bath fans) - Mailing address: • • , c .A Ved Exhaust system a s art from heating or AC = _ .c State: .A ZIP: Fuel p p : an but ion buon up to 4 out ets) ■ -- - Type: LPG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets NM ENGINEER P rocess schematic aired . o p g( required) Number of outlets Name _ Ot er listed appliance or equipment: ■ - Address: Decorative fireplace City: State: ZIP: Insert - type I= Phone: 1a Ij �� Woodstove/pelietstove M pp g /�.. 1/ M �/./� O Other: er. Applicant's signature. Dat Name (print): .• I= �� Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ Gil 11/ O Visa ❑MasterCard Notice: This permit application Minimum fee $ expires if a permit is not obtained Plan review _ Credit card number: - / (at % w ithin 180 days after it has been ( ) $ Expires y State surcharge (8%) .... $ _/7. Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ / Cardholder signature Amount 440.4617 (6R10/COM) ` MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: 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) Fumace 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 Fumace _ $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 $1.45 for each additional $100.00 or 6.80 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* *" 7) <3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00 8) 3 -15 HP; absorb Value Total unit 100k to 500k BTU _ 25.60 Description: Qty (Ea) Amount 9) 15 -30 HP; absorb Furnace to 100,000 BTU, including 955 unit .5 -1 mil BTU 35.00 ducts & vents 10) 30 -50 HP; absorb Fumace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20 ducts & vents 11) >50HP: absorb - Floor fumace including vent 955 unit >1.75 mil BTU 87.20 Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 13) Air handling unit 10,000 CFM+ permit 17.20 Repair units 805 . 14) Non - portable evaporate cooler < 3 hp; absorb. unit, 955 10.00 to 100k BTU - 15) Vent fan connected to a single duct 3 -15 hp; absorb. unit, 1,700 6.80 101k to 500k BTU - 16) Ventilation system not included in 15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00 mil. BTU 17) Hood served by mechanical exhaust 30 -50 hp; absorb. unit, 3,400 10.00 1 -1.75 mil. BTU 18) Domestic incinerators >50 hp; absorb. unit, 5,725 17.40 >1.75 mil. BTU - 19) Commercial or industrial type incinerator Air handling unit to 10,000 cfm 656 69.95 Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves Non - portable evaporate cooler 656 10.00 Vent fan connected to a single duct 446 21) Gas piping one to four outlets Vent system not included in 656 5.40 appliance permit 22) More than 4 -per outlet (each) Hood served by mechanical exhaust 656 1.00 Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $ Commercial or industrial incinerator 4,590 Other unit, including wood stoves, 656 8% State Surcharge $ inserts, etc. Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $ Each additional outlet 63 Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: , Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum charge -two hours) $72.50 per hour. 2. Inspections for which no fee is specifically indicated (minimum charge -half hour) $72.50 per hour 3. Additional plan review required by changes. additions or revisions to plans (minimum charge-one-half hour) $72.50 per hour * State Contractor Boiler Certification required for units >200k BTU. * "Residential A/C requires site plan showing placement of unit i:kists\forms\mech- fees.doc 10/11/00 f SW 66 Avenue F:TU C V � `Nto� i qo joo Equipment: (NEW) Make: Carrier Model: 48TJD016 Volts: 230 / 3 pH Weight: 1650 LBS. Equipment: (EXISTING) Customer: American Heating, Inc. Make: Carrier Farmers Insurance 1339 SE Gideon Street Model: 50DD016 12323 SW 66 Avenue Portland, OR 97202 Volts: 230 / 3 pH Tigard, OR 9797223 Weight: 2450 LBS. 1 CITY=OF BUILDING INSPECTION DIVISION ST '1-- 1 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 _ BUP Date Requested /1 %' AM PM BLD Location j Z 3 Suite 45 (-1/ 3 j— OD a Pi Contact Person v� � Ph '79,3 ‘2,5 PLM Contractor • Ph SWR BUILDING • _ Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab T Post & Beam Ext Sheath /Shear / Tr.) rv1 .�� Int Sheath /Shear Framing Insulation - . Drywall Nailing Firewall • Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: " Final PASS PART. FAIL PLUMBING - Post & Beam Under Slab Top Out - Water Service Sanitary Sewer Rain Drains Final PASS PAR MECHANI(t L Post & Beam Rough In Gas Line am F�inal - • prsw PART FAIL ELECTRICAL • Service Rough In UG /Slab Low Voltage Fire Alarm Final - PASS PART FAIL • SITE _ • Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access " Fire Supply Line ADA / Approach /Sidewalk Date Inspector Ext3 Other Final PASS PART . FAIL DO NOT REMOVE this inspection record from the job site. - CITY TIGARD BUILDING INSPECTION. DIVISION 'MST 24 -Hour Inspectiv Line: 639 -4175 Business Line: 639 -4171 ' BUP Date Requested — 17 AM PM BLD Location 1 2- 3 Z 3 (a (4--(1 Suite MEC - 0/ — DOZ,Q� Contact Person s Ph '�' - 3 �� � PLM , 2 4 Contractor Ph � � SWR e a` ELC BUILDING eria Owner r �Q_t� Retaining Wall ELR Footing Access. Foundation = ° = - - FPS Ftg Drain Crawl Drain Inspection Now SGN Slab �riiii /n` SIT Post & Beam - —1 Ext Sheath /Shear / 2111/`;.' . %anti / i _' 1 Int Sheath /Shear Framing Insulation . Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final /� i / v � Pd /j s izz Ii e!/) c PASS PART FAIL / ` •mil Y U PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Pos1`R am Gas Line . ' ' FAIL ELECT Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ • required before next inspection. Pay at City Hall 3125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection. RE: [ ] U e to inspect - no access ADA fn //� Approach /Sidewalk Date I V Ins Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.