Permit CITY TIGARD MECHANICAL PERMIT
��; DEVELOPMENT SERVICES PERMIT #: MEC2002 -00548
,.� I ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/28/03
Jr // PARCEL: 2S101AA -08700
'I►2
SITE ADDRESS: 585 S 68TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 029 JURISDICTION: TIG
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 4
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 2 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: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: 4 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: 4
> 10000 cfm:
Remarks: Mechanical work for new office building.
Owner: FEES
ROTH, J T JR + THERESA Description Date Amount
12600 SW 72ND AVE, STE 200 [MECH] Permit Fee 3/28/03 $87.70
TIGARD, OR 97223 [MECPLN] Plan Rev 3/28/03 $21.93
[TAX] 8% StateTax 3/28/03 $7.02
Phone: Total $116.65
Contractor:
ABODE HEATING AND A/C
6151 SE HACIENDA STREET
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 649 -2440 Gas Line Insp
Mechanical Insp
Reg #: LIC 76115 Fire Damper Insp
S.D. Shut -down inspection
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 -00
Issue By. ), 19 # Permittee Signature.
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bu ess day
• '5-21-0 C9 - c.,
. -er M echanical Permit Application
City R E QE I V Date received: a g Q� - Permit no.: WEeko�Mergg
�.,. , Y Ci! of Tigard
X 1,1 __� ty g Project/appl. no.: 're date:
City ofTigard Address: 13125 SW Hall Blvd %).11. uC
rd 3
Date issued: By I Receiptno.:
Phone: (503) 639 -4171 pent) ,`
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval: -DBfV Building permit no.:
TYPE OF P
❑ 1 & 2 family dwelling or accessory Ti Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COi\INIERCIAL VALUATION SCHEDULE
Job address: 1 , VZ ! . J, 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 $ •
Lot://-)y-3 - Block: Subdivision: N A *See checklist for important application information and
Project name: aw AO j of _ jurisdiction's fee schedule for residential permit fee.
• , r tfigv:ernall ZIP: `% 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPM ENT SCI IEDULE
N. . i#71' LiYL JL e Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res.only Res. only
Tenant improvement or change of use: VAC: ■ --
Is existing space heated or conditioned? 0 Yes 0 No Air c unit CFM
Air conditioning (site plan required) -
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
A7ECIIANICAL CONTRACTOR State ,■■
State boiler permit no.:
Business name:
go I n N 4- 4 2 • D ai HP Tons BTU/H
Address: , 15 / 5E . , L! 7 .�• • • .57 Fire /smoke dampers/duct smoke detectors MI
lEIZTRAMMEI State: 1>re_ lEal Heat pump (site plan required)
Phone: ' _89 7 Fax:a SP_79 /i E -mail: Install/replacefurnace/burner BTU /H III
Including ductwork/vent liner 0 Yes ❑ No
CCB no.: 6 Instal l /replace/relocateheaters- suspended, ■ --
City/metro lic. no.: wall, or floor mounted
E 1 nT 1m- krY�USit(� r .r" Vent for as, liance other than furnace NM
CONTACT PERSON e � gelation:
Absorption units BTU/H II
IMI
` aa Chillers HP
Address: .. , i Com.ressors HP =
E j J -.. i vironmental exhaust and ventilation: ■
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
O■1T`ER Hoods, Type U II/res. kitchen/hazmat ■__
hood fire suppression system
Name: -T; illy �'� • • 0,_ _. c • Exhaust fan with single duct (bath fans) -
.
Mailing address: 260 a AY0 p zoc5 Exhaust system a. art from heating or AC I
ue p g an .l nhut on up to 4 outlets ■ --
Stater! ZIP: � l �'Z23 Type: LPG NG Oil
Phone: 4 -263'7 Fax: - -D2S E -mail: Fuel s i . ing each additional over 4 outlets UM
ENGINEER rocesspp i g (schematicrequired) = ==
Number of outlets
122
0 er - . app lance or equipment: ■ --
Address: • 5"5 17 ,. _ kt Decorative fireplace
En L J ZIP: 72/6 Insert - type i=
Phone: _ S - 9� S E -mail: Woodstove/pelletstove .
Other: =
Applicant's signature: 7no _ Date: Other _
Name (print): r - —�
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
(] Visa O 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%) .... $
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $
Cardholder signature Amount 440 -4617 (6/00/COM)
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 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 Comp Pump Cond
fraction thereof. footnotes below. p
Minimum Permit Fee $72.50 SUBTOTAL: 7) <3HP; absorb unit
$ to 100K BTU 14.00
8% State Surcharge $ 8) 3 -15 HP; absorb
unit 100k to 500k BTU 25.60
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 VALUATIONSIPER 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
Fumace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Fumace > 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
to 100k BTU 19) Commercial or industrial type incinerator
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: $
>1.1. 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:
Domestic incinerator 1,170 1 Inspections outside of normal business hours (minimum charge -two hours)
$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.
i:\dsts\forms\mech- fees.doc 02/11/02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503).639 -4175
INSPECTION DIVISION -- Business Line: (503) 639 -4171 MST
1 BUP
1
Received . D-.� \ \ Date Requested ((Vac AM - PM BUP
Location Suite tr Z- -00 514
Contact Person Ph ( ) PLM
Contractor 4 3 Ph ( ) f b -06 0a SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear � j 7 (� _ e f
Framing ' �l
Insulation
Drywall Nailing S,n 0/4Ce
Firewall ,t C4' I S
Fire Sprinkler 1 d
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
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
Cr! C HMW
eam
Rough -In
Gas Line
s ke Dampers
ar PART FAIL
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 ❑ Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA p /)//6h.)3 Inspector "'‘ Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL