Permit C ITY OF TIGARD MECHANICAL PERMIT
°'. ;I DEVELOPMENT SERVICES PERMIT #: MEC2003 -00079
er�l A I DATE ISSUED: 2/26/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S125DB-12000
SITE ADDRESS: 09425 SW 74TH AVE
SUBDIVISION: PP1990 -008 ZONING: R -4.5
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: REP FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 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: 1
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Replace existing gas furnace and duct work to entire house.
Owner: FEES
KRAMER, TIM J + RUTH M Description Date Amount
9425 SW 74TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 2/26/03 $72.50
[TAX] 8% StateTax 2/26/03 $5.80
Phone: Total $78.30
Contractor:
WATTS HEATING & COOLING INC
18108 SE RIVER RD
MILWAUKIE, OR 97267 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Mechanical Insp
Reg #: LIC 134602 Heating Unt Insp
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
I sued By: I �� !� ■ /' Permittee Si (,(�
Call (503 9 -4175 by 7:00 P.M. for inspections needed the next business day
O A° eC�1 5; t1 �1 Permit Application Received 03 Mecha F ' FOR;OFFICE USE ONLY
Date/By: Mechanical
C
City f Ta and Planning Approval Building
y g Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
: Case No.:
Internet: www.ci.tigard.or.us 'N��illjl� 1 V h.� I ( Date/By Contact Juris.: ' ® See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name /Method: /7 Supplemental Information.
.T`M ;NW.04Y4EW..,WORK ' T ...,. .: 10
:). „, { COMMERCIAL` FEEtiSCHED,ME USECCAEKLIST.. , '
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition /alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
Mgilift ii CATEGORY ,QF CONSTRUCTION e t : �
mechanical materials, equipment, labor, overhead and profit.
12F & 2- Family dwelling ❑ Commercial /Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family :2'RESIDENTIAtiEQUIPM ENT /SYSTEMsiELE* SCHEDCJLE ;
Description 1 Qty Fee(ea.) ] Total
❑ Master Builder ❑ Other: Heating/Cooling
ii P„ ,JOB SIT.E'INFORIVIATIONfand'1LOC T:IfJN ,::-: Fumace - add - on air conditioning ** i 14.00 /4
Job site address: y'/ '6 g-s) 7ei / O � Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work / 14.00
Proje Name: Hydronic hot water system 14.00
1 Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
L ot #: Repair units 12.15
Subdivision: ' OtheriFuel Appliances _ _
• Tax map /parcel #: Water heater 10.00
iM l riESCRI'PTiION =OF WORK , "p : 4W i 10.00
� ,w �, - � ; . Gas fir eplace
/1
/
to l c S4 il ly -t r/(7 "tic r • Flue vent (water heater /gas fireplace) 10.00
l l C � r - 7. I og lighter (gas) 10.00
C �(,'�.�
i Wood hter stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
i __ _ a�„I ,, 'TE°NANzlei .•.,.. t'' Other: 10.00
, �PROPER�ThY OWNERS
• Environmental ":Exhaust; &Weutit
Name. 7'j M .$ 16,.1-• I, 14vr.4.-vrt."--Vs Range hood/other kitchen equipment 10.00
Address: q wL 5 s, W, 7 g t_ Av e- Clothes dryer exhaust / 10.00 / a d
City /State /Zip: T y ,/ (91
( � 9 7 th Single duct exhaust
Phone SO3 2.y6, / yL 7 , / Fax (bathrooms, toilet compartments,
. PLICANfT . a .. a!„n �� It CONTACT;PERSOStV ;dry:' utility rooms) 6.80
Name: e� / .$--- III.. t,&yc6Ivwa 17W-- Attic /crawl space fans 10.00
Other: 10.00
Address: 30,5 ci . Pci,liv.blc,..d, Q{, - -. ' - FuelTiping , .
City /State /Zip: Cve- V It. 9703 (. * *($5.40 for first 4, $1.00 ea/ cp additional)
Phone: 3 - (, 6( - e e (Fax: b�3 - (, -9 H � g Furnace, etc. ** 5 .10 '��
Gas heat um
// tt / pump _
Email CMG' 1 0, IIeo.j14i y�.vte�& t/ /t/P 1,03, Wall/suspended/unit heater *
., ,, ,,,CONTRA +TOR ,:> S.". Mir A - .- Water heater I
Business Name: le Al f EANI Nsf. Fireplace **
**
Range
A ddress: N i t s� - z4ee -ci RsQ **
City/State/Zit ;' V ltG Clothes d ryer (gas)
Phone: . ij� jj;�jW _ Other: **
Yaw Total:
CCB Lic. i I q Mechanical Permif+:F.ees*
Authorized I ;,. Subtal: $ `7 • k S
Signature: ` ' - �,F Date: L Minimum Permit Fee $7 $
t/ � ��� / �( �� Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ 5. $s)
TOTAL PERMIT FEE $ —7 g . 5e)
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsis\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information '1
Commercial Fee Schedule:
Total Valuation ` Permt�Fee
$1.00 to $5,000.00 Minimum fee $72.50
$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 and including
$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.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
Assumed Valuations Per: Appliance t., ::,
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit f 445
•
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
1Olk to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU •
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1 -4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
is \Dsts\Permit Forms\MecPermitAppPg2.doc 01/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Lini: 1503) 639 -4171 MST
BUP
Received Date Requested� AM BUP
Location 9"c2 J 5 7' h t Suite tfao ^ Oa) 7 9
Contact Person Ph ( s°3 ) 793 0 9 76 ®3 - coo 6y
Contractor 5 7 Ph ( ) SWR
BUILDING Tenant/Owner • ELC 0200 040 0 9�
Footing
Foundation ELC
Ftg Drain Access:
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors 53 C7- 9t�
Ext Sheath/Shear /
Int Sheath/Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PA T FAIL
P MBING
Pos &imam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Alga_
•ART FAIL
N .M ANIC
Pol�z = - -
Rough-In
Gas Line
Sni ke Dampers
inal�
PART FAIL
LECTRICAL
Rough -In
UG /Slab
Low Voltage
Fire Alarm
41 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA 3 Approach /Sidewalk Date �� d Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
•