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Permit ~' a CITY OF TIGARD MECHANICAL PERMIT t�, DEVELOPMENT SERVICES PERMIT #: MEC2000 -00487 "I I 1 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/14/00 PARCEL: 1 S 136AA -02000 SITE ADDRESS: 10340 SW 69TH AVE SUBDIVISION: FUR VALLEY ZONING: R -4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: GAS 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: 1 AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 2 > 10000 cfm: Remarks: Replace Furnace Owner: FEES DAVID GLASGOW Type By Date Amount Receipt 10340 SW 69TH PRMT CTR 12/14/00 $72.50 2720000000 TIGARD, OR 97223 5PCT CTR 12/14/00 $5.80 2720000000 Total $78.30 Phone: Contractor: TRI COUNTY TEMP CONTROL 13150 S. CLACKAMAS RIVER DR OREGON CITY, OR 97045 REQUIRED INSPECTIONS Gas Line Insp Phone: 503 - 557 -2220 Mechanical lnsp Reg #: LIC 72623 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 questions to OUNC by calling (503)246-9189. Issue By: i �Q /yr] Permittee Signature: adopt Call ( 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Date received: Pe o.2 OW -O a e.,„,,elovit, City of ><gar Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Bi,rlfl 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Ei���� -- Fax: (503) 598 -1960 1 ZQpq Case file no.: Payment type: Land use approval Building permit no.: • e EtBY • • TYPE OF PERMIT ifl & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION • COMMERCIAL VALUATION SCHEDULE . Job address: /Q34/0 .S'ZJ i - n Q7,,2.3 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 $ . Lot: 'Block: ISubdivision: *See checklist for important application information and Project name:ja /v 61QS60p.t.) jurisdiction's fee schedule for residential permit fee. City /county: 7/s47 v I ZIP: Q 7.2_23 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Descrirpti� and of work on premises: - AND` COMMERICAL /INDUSTRIAL SCIIEDULE �,CP /44$ ✓!oa C/e Fee(ea) Total Est. dale of completion/inspection: /2 - /%'- O Description Qty. Res.only Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned ?,Yes ❑ No Air handling unit CFM Air conditioning (site plan required) Is existing space insulated? ► • es ❑ No Alteration of existing HVAC system i1 CONTRACTOR Boiler /compressors %-j A /�_ State boiler permit no.: Business name: C "tit t/!7Z> Tlrs� / OJ'lTl1D / HP Tons BTU /H Address: 3/. SD S.' (1 /.40.4'd,',4,` gC�,rGg,s /�/ a _. Fire /smoke dampers/duct smoke detectors City: � pyt C ,y'(� Mate: 6 el ZIP: 070/5" , Heat pump (site plan required) Phone _6� 7�?O I Fax _0Q9/C) I E -mail: InstalUreplace furnace /burner c O Includin rork/vent liner Yes BTU /H ❑ No �, CCB no.: =4...1_7 7 Install/replace/relocateheaters- suspended, City /metro lic. no.: //I /' wall, or floor mounted Name (please print):: qp & . Vent for ap I liance other than furnace CONTACT PERSON Refrigeration: _.- Absorption units BTU/H Name: f+�i4.�! Chillers HP Compressors HP Address: Environmental exhaust and ventilation: City: I State: ' Appliance vent Phone: Fax: E -mail: Dryer exhaust Hoods, Type U II/res. kitchen/hazmat hood fire suppression system Name: MOW -t &,fritci. 4I,QSAD /0 Exhaust fan with single duct (bath fans) Mailing � - Exhaust system apart from heating or AC Fue pip g an d ton (up to 4 out ets 1e:jjFax:E-rnj : Fuel piping each additional over 4 outlets Process piping (schematic required) Number of outlets . Name: Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert-type Phone: 1 Fax: 1 E -mail: Woodstove/pelletstove Other: Applicant's signature: I Date: Other: Name (print): Not all jurisdictions accept credit cards, please call jurisdiction for more infonnation. Permit fee $ Z2: ❑ Visa ❑MasterCard Notice: This permit application Minimum fee $ / expires if a permit is not obtained Plan review (at %) $ Credit card number: Expires w ithin 180 days after it has been p State surcharge (8 %) .... $ �� Name of cardholder as shown on credit card accepted as complete. TOTAL $ 'g,-_e) Cardholder signature Amount 440 -4617 (6/00/COM) Commercial Schedule 1 &2 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE Description Fumace to 100,000 BTU . Table 1A Mechanical Code Qty Price Total ducts & vents 955 1) Fumace to BTU including ducts & 0 vents g including duds & vents 14.00 ,/ Furnace > 100,000 BTU 2) Fumace 100,000 BTU+ /7 4 including ducts & vents ( 17.40 1 including ducts &vents 1,170 3) Floor Furnace • • including vent 14.00 floor fumace 4) Suspended heater, wall heater including vent 955 or floor mounted heater 14.00 suspended heater, wall heater 5) Vent not included in appliance permit 6.80 or floor mounted heater 955 6) Repair units 12.15 Check all that apply: 'Boiler Heat Air Vent not included in appliance permit 445 For items 7 -10, see or Pump Cond Qty Price Total Repair units 805 footnotes 1,2 Comp P 7) <3HP; absorb unit to < 3 hp; absorb.unit 100K BTU 14.00 8) 3 -15 HP; absorb unit to 100k BTU 955 100k to 500k BTU 25.60 3 -15 hp; absorb.unit unit 5 mil BTU 35.00 - 101k to 500k BTU 1700 10) 30 -50 HP; absorb unit 1-1.75 mil RT11 52.20 15-30 hp; • absorb.unit 11) >50HP; absorb unit >1.75 mil BTU 87.20 501k to 1 mil. BTU 2310 12) Air handling unit l0 10,000 CFM 30 -50 hp; absorb.unit 1000 13) Air handling unit 10,000 CFM+ 1 -1.75 mil. BTU 3400 17.20 • > 50 hp; absorb.unit 10.00 Non potable evaporate cooler 1000 > 1.75 mil. BTU 5725 15) Vent fan connected to a single dud 6.80 Air handling unit to 10,000 cfm 656 16) Ventilation system not included in appliance permit 10.00 Air handling unit > 10,000 cfm 1170 17) Hood served by mechanical exhaust Non-portable evaporate coller 656 10.00 Non - P P 18) Domestic incinerators vent fan connected to a single duct 446 17.40 19) Commercial or industrial type incinerator Vent syst. not included in appliance permit 656 69.95 Hood served by mechanical exhaust 656 20) Other units inducting wood stoves 10.00 Domestic incinerator 1170 21) Gas piping one to four outlets 5.40 Commercial or industral incinerator 4590 22) More than 4-per outlet (each) 1.00 Other unit, including wood stoves, inserts, etc. 656 Minimum Permit Fee $72.50 SUBTOTAL aglow - Gas piping 1-4 outlets 360 8% SURCHARGE wag ENS Each additional outlet 63 PLAN 25% OF SUBTOTAL : °a -v Required for ALL commercial permits only .' yam_ ^ r_;.. TOTAL MI MI Other Inspections and Fees: 1. Inspections outside of normal business lours (minimum charge -two hours) 572.50 Per hour 2. Inspections for which no fee is specifically indicated (minimum charge -half hour) _. _s72.50 per four Total Valuation Fee 3. Additional plan review required by changes.. additions or revisions to plans (minimum charge-one-half hour) 872.50 per hour •State Contractor Boiler Certification required $1.00 to $5,000.00 Minimum $72.50 "Residential me requires site pan shaving placement of unit $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, • to and including $10,000.00 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for each additional $100.00 or fraction thereof, to andincluding $25,000.00 $25,001.00 to $50,000.00 ' $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to and including $50,000.00 $50,000.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction • thereof CITY OF TIGARD BUILDING INSPECTION DIVISION -. MST 24 -Hour Inspettion1 ine: 639 -4175 Business Line: 639 -4171 BUP Date Requested /Zi t I AM PM BLD Location 1 b 3 ScA) GI +4 Suite MEC 'Caro — (9.94[10 Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear 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 P SS PART FAIL ost & • eam Rough In Gas Line 0 Smo - ampers F PART FAIL • CTRICAL 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 Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date /2/14/ f Inspector D/ 41%. Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour InspetionLine: 639 -4175 Business Line: 39 -4171 &Mr // / Date Requested / . Z ��/ ) AM PM BLD Location /03 qv ,5 tv Suite —.1 124 2. Gc.) aJ Contact Person Ph S0 - f57 -ZZ& PLM Contractor Ph SWR /� BUILDING Tenant/Owner /� I "GI 3-C C4 (( C t,� v ■► ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina Sheath /Shear G �! /1/1 _ /�/� Lori Framing �j (� �J OU O Insulation O � . l' _ Drywall Nailing � `�,✓� % Firewall Fire Sprinkler Fire Alarm W /; S (-49 Susp'd Ceiling �Jw�� --- ✓✓lll���II l Roof Misc: 511."\--Q n 4 / l ,, 6 V V 'H lJ�` `� PA Final SS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL d {A CH ANIC Post & Beam gpu In as Li Smo e_ Dampers m PART 42 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 ( a b /C. Inspector 3 (7 Approach /Sidewalk Date \ 11% S l Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.