Permit •
•
CITY TIGARD MECHANICAL PERMIT
I�
DEVELOPMENT SERVICES PERMIT #: MEC2002 -00488
� � 'll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/4/02
PARCEL: 2S 1128A -03100
SITE ADDRESS: 14080 SW 80TH CT
SUBDIVISION: WAVERLY MEADOWS ZONING: R -7
BLOCK: LOT: 023 JURISDICTION: TIG
CLASS OF WORK: ALT 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:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Install approximately 40' gas pipe and 1 outlet for insert.
Owner: FEES
HIGGONS, LINDA H Description Date Amount
14080 SW 80TH CT
TIGARD, OR 97224 [TAX] 8% StateTax 11/4/02 $5.80
[TAX] 8% StateTax 11/4/02 $0.00
[MECH] Permit Fee 11/4/02 $72.50
Phone: [MECH] Permit Fee 11/4/02 $0.00
Contractor: Total $78.30
JAY'S GAS PIPING
PO BOX 393
BEAVERCREEK, OR 97004 REQUIRED INSPECTIONS
Phone: 503 632 - 8623 Gas Line Insp
Final Inspection
Reg #: 119836
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
•
1 .400,
Issued By: �( � la /ice ��r C� ___ Permittee Signature/
Call (503) 639 -4175 by 7:00 P.M. for inspections needed e next business day
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�-- " "1VlechanicalPermit Application
Date received: // -4 -o J-- Permit no.: 01 E2-03000 _ 2 0 0
A „:,i6 i I�
,,.� I •• City of Tigard Project/appl. no.: Expire date:
I City i Address: 13125 SW Hall Blvd, Tigard, OR 97223 �r
rY f Tigard Date issued: Bye Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
E
.TYPE OFP RMIT ;
g 1 & 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: No ! O S . 0 f- ' . 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 $ 4 .
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: Z ' 1..& 2'FAMILY DWELLING. PERMIT FEE SCHEDULE
De ription3nd location of work on p emises: ' ' o / AND . COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE
do ; re♦ c, r- r lJ � A` , 4 _
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC: ■--
Is existing space heated or conditioned? ❑ Yes CI No Air handling unit CFM
Air conditioning (site plan required) _
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system _
j'MECHANICAL CONTRACTOR ; Boiler/compressors bII
State boiler permit no.:
Business name: .___7 .7 o S ----/ t. HP Tons BTU /H
I Address: v - 6,r , , • Fire /smoke dampers /duct smoke detectors _
1 131 r ZIP: -) 0 0 Heat pump (site plan required) _
PhoneM /1M Fax: E - mail: Install/replace BTU /H II
Including ductwork /vent liner ❑ Yes ❑ No
CCB no.: 0// " 3 InstalUreplace/relocate heaters - suspended, ■--
City /metro lic. no.: ,5 ” wall, or floor mounted
Name (please print): Vent for appliance other than furnace M
' CONTACT 'PERON
Refrigeration: ■
�'' Abso units BTU /H
Name: Chillers HP _
Address: Compressors HP _
Environmental exhaust and ventilation: ■--
City: State: ZIP: Appliance nce vent
Phone: Fax: E-mail: Dryer exhaust
ME
_ , 0 OWNER ■ • : Hoods, Type 1/ II/'es. kit a hazmat
hood fire suppression system ■_
Name: ,L t h d G ,' i O itJ 5 Exhaust fan with single duct (bath fans) -
Mailing address: / o ; • S , 0/ - e. Exhaust system apart from heating or AC _
State: (, R ZIP: T7 Fuel piping and dist • 1 ution (up ti • . utlets) FA
Type: LPG 1 - NG Oil
Phone 01 5" g0'/ ,.Fax: E - mail: Fuel piping each additional over 4 Cutlets 1.11
- ' ENGINEER , Process piping (schematic required) =
Number of outlets
Name: Other hsted apphance or equipment: ■ -
Address: Decorative fireplace
City: State: ZIP: Insert - type M—
Phone: Fax: E Woodstove/pellet stove -
Other: MI
Applicant's signature: Date: Other:
Name (print): -
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ 7 ..
❑ Visa ❑MasterCard Not Th permit application Minimum fee $
expires if a permit is not obtained Plan review at _ %) $
Credit card number: Expires within 180 days after it has been
p accepted complete. State surcharge (8 %) .... $ 6
Name of cardholder as shown on credit card as d p TOTAL $
Cardholder signature Amount 440 -4617 (6/00 /COM)
MECHANICAL PERMIT FEES'
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
'.TOTALiVALUATIQN PERMITRFEE. a ,. , ; . ._ Description q Pnce • Total
$1.00 to $5,000.00 Minimum fee $72.50 Table lA MechanlCal 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 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 all t Boile H „ Air 17
$1.20 for each additional $100.00 or For items 7 i see '''',, um
Pp, Cond ,,
fraction thereof fo b O1 pz , .
,", % k14;e , . a•, '' p. 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 . 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
^ ASSU att TIQNS PR, APPLIANC .11t14 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
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 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 19) Commercial or industrial type incinerator
to 100k BTU 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: $
>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:
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 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.
nE.
VALUATION: . »'. , ..a All New Commercial Buildings require 2 sets of plans.
is \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
� I W.- BUP
Received l Date Requested AM PM BUP
Location / Y 0 s D go c" Suite -0 0 4
Contact Person Ph ( ) S 9 g 06 `-(4 PLM
Contractor Ph ( Cell) S 7 7 2- Z '2-5SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
-
Slab iInsp ChOh1 No 5° IT
Post & Beam i�.O Q�J�
Shear Anchors `
7 Sheath /Shear L7 /d ` b ' , p
, ' `
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof 1
3\
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 P RT FAIL
ANICA
0
Rou h -In 40
as Line
mo a Dampers
ASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final j 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 D /Cr-L./
AAoac /Sidewalk Date , l Inspector _ ` " v" " ` Ext
PP
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF,TI3ARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 1 ( AM OWS PM B •
7 b �+ p p�
Location f 0 Do ��' �%%� Suite o d O
Contact Person • P Ph ( ) S 7 7 - zs PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: 4.40 i 6 / SIT
Post & Beam
Shear Anchors 3--/--),c1---/-f—
" ) -- f-
Ext Sheath /Shear - �
Int Sheath /Shear •
Framing ''`�� _ / /s., _ A
Insulation ` r
Drywall Nailing i4
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rou • h -In
(eintrab
Smoke Dampers
Final
PASS PART 40
ELECTRICAL Service
Rough -In n✓"
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 LJ Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA 1
Approach /Sidewalk Date I / Inspector Ext
Other:
Final DO NOT R EMOVE this inspection record from the job site.
PASS PART FAIL