Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2002 -00423
e DATE ISSUED: 10/22/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DB -00600
SITE ADDRESS: 15205 SW 74TH AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 014 JURISDICTION: TIG
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: GAS OUTLETS:
> 10000 cfm:
Remarks: Adding (2) furnaces upstairs, (1) a/c to office and (2) unit heaters.
Owner: FEES
DENNY MEYER Description Date Amount
7340 SW LANDMARK LANE [MECH] Permit Fee 10/22/02 $86.18
TIGARD, OR 97223 [MECH] Permit Fee 10/22/02 $0.00
[MECPLN] Plan Rev 10/22/02 $21.54
Phone: 503- 620 -2086 [MECPLN] Plan Rev 10/22/02 $0.00
[TAX] 8% StateTax 10/22/02 $6.89
Contractor: [TAX] 8% StateTax 10/22/02 $0.00
(additional fees not shown here)
LAY'S HVAC
2850 NW 29TH Total $200.79
PORTLAND, OR 97210 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 227
Mechanical Insp
Reg #: 00064064 Mechanical Insp
Mechanical Insp
Mechanical 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
Issued By: '://A Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed th next business day
6 W 6 Z
"" Mechanical Permit Application'
—
CD
Date received: 9 A7 pa, Permit no.: *A, 4 ,, -de V
. , A I� City ®f Tigard Project/appl. no.: A Exp - date:
C' of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 ' ��
Phone: (503) 639 -4171 Date issued: B .� Receipt no.: N
Fax: (503) 598 -1960 Case file no.:e9 1 , „ „ , /I , Payment type:
Land use approval: Building permit no.:
' ,. ''' TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory 2'Commercial/industrial ❑ Multi- family ❑ Tenant improvement
at New construction ❑ Addition/alteration/replacement ❑ Other:
SITE °` ., t” COMMERCIAL 'SCIHEDULE�
�.^ ° r , /`;' ITE INFORMATION� v � . , r�� � "; :.
. ,.. J OB,S
Job address: g • s S , Indicate equipment P ment q I ui 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 $ / Y00 C
Lot: Block: Subdivision: *See checklist for important application information and
Project name: /A • e . N 0
jurisdiction's fee schedule for residential permit fee.
City /county: ' , L MEM ZIP: 9 7 2 23 ?•= &',I, FAMILY DWELLING PERMIT FEE t
Description and •cation of work on premises: A COMMERIAL/INDUSTRIAL EQUIPMENTSCHEDULE,
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only `lb
Tenant improvement or change of use: HVAC: n --
Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM p
g P Air conditioning (site plan required) MI
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system I
' #�' i *Yi p,. s;+ r i ,. StateboileCer
I mit
"4, F ?a. < 9,' MECHANICAI:,,CONTRACTOR E ' Boiler/compressors
name: // ,/ State boiler permit no.:
LA V i C HP Tons BTU /H II
Address: ' ;; (,J r • L o b Fire /smoke dampers /duct smoke detectors —
tMI ►'1, State:0 ZIP: • 2 9 Heat pump (site plan required) Mil
Phone: , earIMEM E -mail: Install/replacefurnace /burner BTU /H ■ -
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: 4pq0 Install /replace /relocate heater's- suspended, of
^ --
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace -
- Refrigeration: ���
s h • _ `.� CONTACT;PERSON n,«
1 1. 1 ,';'..c,, , ' �, • , ,4 ;it-
,� , . -- + Absorption units BTU /H
IIMINEMMINIMINIMINIMMII
Chillers HP -
Compressors HP =I
4 / F Address: , -. i ( Environmental exhaust and ventilation: ■--
riM State: ZIP: Appliance vent
Phone: (p2/4 q 3 'j E -mail Dryer exhaust _
(., 4 Y, e . . - s .. �V VN ER . • . ti' -. ; > , Hoods, Type I/ II/res. kitchen/hazmat ■
ril __
hood fire suppression system
. ,, Exhaust fan with single duct (bath fans) -
Mailing address: • L,�,q • Exhaust system apart from heating or AC —
State: ZIP: Fuel piping and distrib ion (up to 4 outlets) III -
• L 72 Z Type: LPG V NG Oil
Phone: Fax E -mail: Fuel piping each additional over 4 outlets MI
'' ENGINEER - . ' Process piping (schematic required) =
Number of outlets
Name: Other listed apphance or equipment: ■ -
Address: Decorative fireplace
City: State: ZIP: Insert - type
MI
Phone: Fax: E-mail: Woodstove/pelletstove _
Other: M
Applicant's
�
signature: ` • �,� • i ;� „ „� � Date: • Erma Other:
Name (print): t, - --
• Pei - mit fee $
Not all jurisdictions accept credit cards, please call jurisdiction for more information. -
Notice: This permit application Minimum fee $ 9(. le
❑ Visa 0 MasterCard expires if a permit is not obtained
Credit card number: / / Plan review (at %) $ 2., l i $
Expires within 180 days after it has been State ( surcharge 8%
accepted as complete. g ) ”" $ tit. .
a cce
Name of cardholder as shown on credit card p TOTAL $ ` L4 . lot
•
Cardholder signature Amount 440 -4617 (6/00 /COM)
MECHANICAL PERMIT FEES " ;
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
"TOTAL VALUATION :..''PERM,IT F , ' ,.` ",' Descnptlon : " . " -` Price Total .
$1.00 to $5,000.00 Minimum fee $72.50 Table1A;Mechanical °Code. 2- ,. A PtY-. (EP): ;flint • z„
$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
$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 Boiled Heat A
$1.20 for each additional $100.00 or For,items 7 -1 =see or Pump Cond
fraction thereof. fot ot
oes bel Comp, `
°" 7) <3HP; absorb unit
Minimum Permit Fee $72.50 SUBTOTAL: $ 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
- -, NO
PE << .._ 12) Air handling unit to 10,000 CFM
,ems 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 n 1,170
340 15) Vent fan connected to a single duct
ducts & vents a 6.80
_ Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 1 n lb appliance permit 10.00
floor mounted heater 1 "� 17) Hood served by mechanical exhaust
Vent not included in appliance 445 10.00
permit 805 18) Domestic incinerators
_ Repair units 17.40
< 3 hp; absorb. unit, 955 C� 19) Commercial or industrial type incinerator
to 100k BTU I `�� 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101 k 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: ,, P } .
>1.75 mil. BTU ' #;;
Air handling unit to 10,000 cfm 656 8% State Surcharge Y '' $
Air handling unit >10,000 cfm 1,170 ,
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446 ( ,33 5 TOTAL RESIDENTIAL PERMIT FEE: $
Vent system not included in 656
appliance permit
Hood served by mechanical exhaust 656 Other Inspections and Fees:
1 Inspections outside of normal business hours (minimum charge - two hours)
Domestic incinerator _ 1,170 $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 / 360 340 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 5 f 6sd
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (� 3) 639 -4175 MST
• INSPECTION DIVISION Business Line:,' 'fl \ 639 -4171
l 1 BUP
Received Date Requested / / r AM% PM BUP
Location / C? O 5 7'7 i Suite MEC -co V .3
Contact Person Ph (2 ) �o ) — (43 PLM
Contractor Ph_L. ) _ SWR
BUILDING Tenant/Owner it� gr�'3 J ELC
Footing (/
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT •
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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
P. - • R AIL
ECHANIC
- -am
'ough In
Gas Line
Smoke Dampers
- -411111 120 PART FAIL
RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line r
ADA �°�
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL