Permit - CITY OF TIGARD MECHANICAL PERMIT
Fo DEVELOPMENT SERVICES PERMIT #: MEC2001-00337
111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/29/01
PARCEL: 2S112DC -01400
SITE ADDRESS: 15865 SW 74TH AVE 110
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2
OCCUPANCY GRP: B 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: M 50 + HP: CLO DRYERS:
FURN <100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: 3 <= 10000 cfm: 1 GAS OUTLETS: 1
> 10000 cfm:
Remarks: Commercial TI. Installation of 3 HVAC systems and 3 fans.
Owner: FEES
PACIFIC AMERICAN PROPERTY EXCH Type By Date Amount Receipt
PACIFIC SANTA FE CORP PLCK CTR 10/29/01 $20.03 2720010000
17700 SW UPPER BOONES FERRY RD PRMT CTR 10/29/01 $80.10 2720010000
PORTLAND, OR 97224 5PCT CTR 10/29/01 $6.41 2720010000
Phone: Total $106.54
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Gas Line Insp
Phone:453 -4822 Mechanical Insp
Reg #: LIC 62196 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 -0010 through OAR
952 - 001 -0080. You may obtain copies of these rules or direct estions to OUNC by calling
(tiM17dR -Q 1 R ^ -.. (Div)
Issue By: ' /" Permittee Signature: I (Div' - 0."74
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
(0-1C-0 f (p 0
r - Mechanical Permit Application a;
C-7- � 2,5 0 / Permitno.�eC ZOO Gyd3 �.
- „.�i�. Cit of Tigard Date received: P roject/appl.no.: Expire date:
Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: j4
CitygfTigard Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type: �,
Land use approval: Building permit no.: ,
0
rtF TYPE OF PERMIT K
❑ 1 & 2 family dwelling or accessory Commercial /industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: �T
1 ` ?t v , • .: I ..a, . Y,,. "'.,:r: -” ,,,m : !• 1 1' . 1 t'.� l I ‘,' _ f I UL .a ,;''
r a .
Job address j5R 5 7 y +.b 1 1 Q 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 $ 18 i O00. O0 .
Lot: IBlock: I Subdivision: *See checklist for important application information and
Project name: 6RA Ad 7n 1-9aS jurisdiction's fee schedule for residential permit fee.
City /county: T; y H KC( ZIP: 9 (4 r 1 & 2 FAMILY;,,DWELLING,PERMIT FEE,SCHEDULE {,�; "t.'
Description and location of work on premises: Tn5 tta l l �3) H VAC. AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE
59.0fmS + (RnS Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Airconditng unit CFM
Is existing space heated or conditioned? Q Yes ❑ No
Air conditioning (site plan required)
Is existing space insulated? ❑ Yes 0 No . Alteration of existing HVAC system
,N t d:� 4: Boiler /compressors
MECHANICALOIITRACTOR
State boiler permit no.:
Business name: C I i m A-I e Co n i o I HP Tons BTU /H
Address: 16S no SW 72 A VC Fire /smoke dampers /duct smoke detectors
City: r e g.. i nth I State: pQ I ZIP: c1 - y Heat pump (site plan required)
Phone: U 53 - i{ I a 2 I Fax: /63 _ -a2y 1 E -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: 62 lci 6 Install/replace /relocate heaters- suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): 1) fte,2Qn U Q,1--son Vent for appliance other than furnace
'," CONTACT ,PERSON , , , Refri
t` � Absorpt un BTU /H
Name: Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OVVI�IER " Hoods, Type I/ II /res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER • Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: ZIP: Insert - type
Phone: n 'Fax: J E -mail: Woodstove /pellet stove
Other:
Applicant's signature: i j)j , V.). 1 . Date: ' / zs / of Other:
Name (print): (') o a e_,Q l�l . U K f-'o r. • -
1 Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ C !
0 Visa 0 MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained $ :? ,Q ;3'
Credit card number: / / Plan review (at �S %)
Expires within 180 days after it has been State surcharge (8 %) .... $ . -lo /' 5A.(
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $ -:0 •S c'
Cardholder signature Amount 440 -4617 (6/00 /COM)
/A
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
'TOTALsVALUATION: PERM IT; FEE: , ' ''. Descrlption , '` Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table,1A.Mechariical Code •. .... . : -Pty,', , .(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 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: , `Boiler Heat' Air - .
$1.20 for each additional $100.00 or For item 7- 11,;see or Pump . =Cond r -
fraction thereof. footnotes belo■., obit)'*'
7) <3HP;absorb unit
Minimum Permit Fee $72.50 SUBTOTAL: $ anAi to 100K BTU 14.00
-cc! 8) 3 -15 HP; absorb
8% State Surcharge $ unit 100k to 500k BTU 25.60
e 9) 1530 HP; absorb
25% Plan Review Fee (of subtotal) $ ,1 unit .5 -1 mil BTU 35.00
Required for ALL commercial permits only, 10) 30 -50 HP; absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1 - 1.75 mil BTU 52.20
4:4A4=9"" 11) >50HP: absorb
(� unit >1.75 mil BTU 87.20
(0 1 12) Air handling unit to 10,000 CFM
ASSUMED VA LUATIONS PER APPLIANCE:;' . 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 . 1,170 15) Vent fan connected to a single duct
ducts & vents / 6.80
Floor furnace including vent 955 16) Ventilation system riot 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 applicance 445 10.00
permit 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU 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: , f ' :r ,' $
>1.75 mil. BTU
Air handling unit to 10,000 cfm I 656 8% State Surcharge x $
Air handling unit >10,000 cfm 1,170 , >° 1 f ,, ,
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: ' : $
Vent fan connected to a single duct '2 446 C
Vent system not included in 656
appliance permit Other Inspections and Fees:
Hood served by mechanical exhaust 656 1. Inspections outside of normal business hours (minimum charge -two hours)
Domestic incinerator 1,170 $72.50 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 $72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimun
inserts, etc.
charge - one - half hour) $72.50 per hour
Gas piping 1 outlets I 360
Each additional outlet 63 `State Contractor Boiler Certification required for units >200k BTU.
"''Residential A/C requires site plan showing placement of unit.
TOTAL COMMERCIAL ,..,,,,;,.: f , $ ,
VALUATION: •
• is \dsts \forms\mech- fees.doc 08/06/01 ��`�
1
- CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
"24=1ibur Inspection Line: 63 75 Business Line: 639 -4
BUP
Date Requested � � AM PM BLD
r
Location / Suite 06' MEC / Z.>11337
Contact Person Ph ` S 3 Y PLM
Contractor Ph SWR
BUILDING Tenant/Owner F - % ,�� 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
PASS PART FAIL
MECHANICAL ,�J''/ ^{/�, . /z,i (@
/
Post & Beam " `� /
v
Smoke Dampers
Fil-
Cat 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 ( ((J �� Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.