Permit C ITY OF TIGARD MECHANICAL PERMIT
a ri DEVELOPMENT SERVICES PERMIT #: MEC2001 -00103
'� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/2/01
PARCEL: 2S 112CB -16000
SITE ADDRESS: 15301 SW 84TH AVE
SUBDIVISION: HAMPTON COURT ZONING: R -7
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 1 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: Installation of a/c unit. Placement of a/c unit must comply with standard setbacks.
Owner: FEES
RENEA BERGER Type By Date Amount Receipt
15301 SW 84TH AVE PRMT CTR 4/2/01 $72.50 2720010000
TIGARD, OR 97224 PLCK CTR 4/2/01 $5.80 2720010000
Total $78.30
Phone: 624 -2308
Contractor:
SPECIALTY HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 620 -5643 Final Inspection
Reg #: LIC 66578
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 (50. 4. • 189.
Issue B , , 4.4 � . a,62/7/624 . Permittee Signature: V 11/4/ L dl 112,! J
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
_
A , Mechanical Permit Application
Date received:. 6 �
� Permit no.: ca / .. Q7�e1
""Z g A
C . of Ti and
ty g Project/appl -no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
• Fax: (503) 598 - 1960 Case file no.: ' Payment type: ,
Land use approval: Building permit no.: •
TYPE OF PERMIT '
Arl & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction ,Addition/alteration/replacement - 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE P
Job address: /530 f $S (V 8' , 4 L' 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: I Subdivision: *See checklist for important application information and . •
Project name: 4/Ai C.,t/ jurisdiction's fee schedule for residential permit fee.
City/county: elej ,, c e „ 514 ZIP: • 7 adg / , 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: , 7 aril AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE •
. 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? J� tio
Yes 0 No Air handling unit -
Air conditioning (site plan required) red)
• Is existing space insulated? tees 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors • State boiler permit no.: •
Business name 4 IF G c ! • . l n 1?G ' HP Tons BTU/H '
Address: Cl S c cS(c:) -; a7 ' • S t" I Fire/smoke dampers/duct smoke detectors ' •
City: - fie/044e I State: o -I ZIP: q 7o1 • 9. 3 Heat pump (site plan required)
Phonel,3 p - 7/ E- mail:. Install/replacefurnace/burner BTU /H
Including ductwork/vent.liner O Yes O No •
CCB no.: . t,4.5 7 8-' ' Install/replace/relocateheaters- suspended,
- City /metro lic. no.: ! b 96, wall, or floor mounted
Name (please print): • ,, r r , • -t--$ €JS ' Vent for- appliance other than furnace
CONTACT PERSON Refrigeration: _
Absorption units BTU/H -
- Name: A. 11.VL e " N 1 h 4 e !� Chillers HP -
Address: $c.8 S (.J• e( S' Compressors HP •
q Environmental exhaust and ventilation:
City: 71 d _ - I Sta e:Qg. I ZIP: ei 7,1.a-2 Appliance vent
Phone5v3 Gao $ E'Fax:598eo'1I ' E- mail: " -Dryer exhaust
OWNER Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system ,
Name: ' 124424.-- C I •Q/ - Exhaust fan with single duct (bath fans)
Mailing address: I 5130 /. S - 4 o Exhaust system apart from heating or AC
City: 0A Li I State: O !Q I ZIP: ? 72_;.2- 1� Fuel piping and distribution (up to 4 outlets)
f� Type: _LPG NG Oil ,
Phone: - g303 Fax: E - mail: - Fuel piping each additional over 4 outlets
Process piping (schematic required) •
Name: Number of outlets , .
Other listed appliance or equipment:
Address: - • Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: I Fax: E - mail: Woodstove/pelletstove "
Other:
Applicant's signature' , J Dater 4 11c2/6 1 ' Other: '
Name (print): Site v .; rylath P.I.S - , ^^ 7�
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ 7Ar 5C.
O Visa ❑.MasterCard Notice: This permit application Minimum fee $
/ / expires if a perm i s not obtained plan review (a[ — %) $
Credit card number: Expires w ithin 180 days after it has been $U
a State surcharge (8 %) .... $ 5%
Name of cardholder as shown on credit card , $ • accepted as complete. TOTAL $ 7 g• 30
• 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 /A Mechanical Code Qty Price Total
including ducts & 955 1) Furnace to 100.000 vents g including ducts 6 vents 14.00
Furnace > 100,000 BTU 2) Furnace 100,000 BTU+
including ducts 8. vents 17.40
including ducts & vents 1,170 3) Floor Furnace
floor furnace 4) vent 14.00
4) Suspended healer, 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 Qly Price Total
Repair units 805 footnotes 1,2 Comp -
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 9) 15-30 HP; absorb
unit .5-1 mil BTU 35.00
101k to 500k BTU 1700 10) 30-50 HP; absorb
unit 1 -1.75 mil BTU 52.20
15-30 hp; absorb.unit 11) >501-IP; absorb unit >1.75 mil BTU r
87.20
501k to 1 mil. BTU 2310
12) Air handling and to 10.000 CFM
30 -50 hp; absorb.unit 10.00
• 13) Air handling unit 10,000 CFM*
1 -1.75 mil. BTU 3400 17.20
> 50 hp; absorb.unit 14) Non - portable evaporate cooler 1000
> 1.75 mil. BTU 5725 15) Vent fan connected to a single duct
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 colter 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 including wood stoves 10.00
Domestic incinerator 1 170 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 gen Ems -
Gas piping 1-4 outlets 360 8% SURCHARGE l
Each additional outlet 63 . PLAN REVIEW 25% OF SUBTOTAL <:
Required for ALL commercial permits only
TOTAL ,MMESE
Other Inspections and Fees:
I. Inspections outside of normal business hours (minimum charge-Mc hours)
$72.50 per hour
2. Inspections for whidr no lee is specifically indicated (minimum charge -half hour)
$12.50 per hour
Total Valuation Fee 3. Additional plan review required by changes. additions or revisions to plans (minimum
charge-one -half hour) 572.50 per hour
'Slate Contractor Bader Certification required
$1.00 to $5,000.00 Minimum $72.50 -Residential A/C requites site plan showing 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 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
$50,000.00 and up $742.00 for the first $50,000.00 and $1.20
for each additional $100.00 or fraction
thereof
MS Ia4�J)
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
l Date Requested / AM PM _ BLD •
Location /6 s4 4 Suite MEC 26n r - 00 1 03
•
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 A
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service -
Sanitary Sewer -
Rain Drains
Final.
PASS FAIL
,IFANI
• . /:trstirEleam V
Rough In
Gas Line • . V
Smoke Dampers
ma -
PART FAIL
CTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fin
ART FAIL. _
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 /
Other Date //9'77/ Inspector Ext
Final
• PASS . PART .FAIL DO NOT REMOVE this inspection record from the job site.. .