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Permit CITY TIGARD MECHANICAL PERMIT fl` DEVELOPMENT SERVICES PERMIT #: Y 1' i I 4/4/01 1 -00112 Ail. SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 4/4/01 PARCEL: 1 S135DC -07200 SITE ADDRESS: 11600 SW 91ST AVE SUBDIVISION: CHARBEN ZONING: R - 4.5 BLOCK: LOT: 005 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: DOMES. INCIN: OIL 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Replace oil furnace with like kind. Owner: FEES BELL, CARROLL M + FLORENCE P Type By Date Amount Receipt 11600 SW 91ST AVE PRMT CTR 4/4/01 $72.50 2720010000 TIGARD, OR 97223 5PCT CTR 4/4/01 $5.80 2720010000 Total $78.30 Phone: Contractor: SPECIALTY HEATING & COOLING 9528 SW TIGARD ST TIGARD, OR 97223 REQUIRED INSPECTIONS Heating 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 ermit will expire if work is not started within 180 days of issuance, or if work is suspended for m e than 180 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. Yo may obtain copie's of these les or direct questions to OUNC by calling (503)246 -9189. Is a By: _._,,j ;'rift ____ . i • Permittee • Signature: „ > 74./...4 ,p�2, Call (503) 9 -4175 b 7:00 P.M. for inspections needed the next business day by p Y Mechanical Permit Application - .. A Date received: f 0/ Permit no.: t if.49 -199/ 40 //€2 , � j �,I j, �•� �, City of Tigard /- Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 7 ') 23 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 jtQ Case file no.: Payment type: Land use approval: Building permit no.: . TYPE OF PERMIT . J 1T & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction gAddition /alteration/replacement U Other: JOB SITE; INFORMATION . . - .COMMERCIAL VALUATION SCHEDULE . • . . y Indicate equipment quantities in boxes below. Indicate the dollar • value of all mechanical materials, equipment, labor, overhead, profit. Value $ . Ii i • ck: Subdivision: *See checklist for important application information and Project ` . jurisdiction's fee schedule for residential permit fee. City /county: ir?a (, A_ S ZIP: R -2, 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE - De cription and � l / o 7 c ca at ' ion of work on premises: *40/ete o % AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE st. date of completion/inspection: Description Qty. Res. only :. only Tenant improvement or change of use: HVAC: Air handling unit CFM Is existing space heated or conditioned? 'Wes ❑ No Air conditioning (site plan required) Is existing space insulated ?Al'es ❑ No Alteration of existing HVAC system MECHANICAL CONTRACTOR. Boiler /compressors i State boiler permit no.: I ■ Business named f)p�jyr� L� U • I. C/ ¢ # • / !�� n HP Tons BTU /H Address: C./ cS ai 7 - ya ► e sr / Fire /smoke dampers/duct smoke detectors Mil City: T'ai O I State:[} £j ZIP: q7,....3 Heat pump (site plan required) Phone , ,5 £4/.5 Fax 59f , 9 /r E -mail: InstalUreplacefurnace/burner6, e 3 BTU /H .ia' Including ductwork/vent liner Yes U No CCB no.: 4,4 ,5 7 a- Install/replace/relocateheaters- suspended, City /metro lic. no.: / z, 96, wall, or floor mounted • Name (please print): • s /`i'1IA,e • -t-ff -t-f elS Vent for appliance other than furnace • CONTACT PERSON - Refrigeration: Absorption units BTU/H Name: K4_ Lee /v in 'le re Chillers HP Address: 7,5 9- 8 , S(.-(.) . a s % --/ -1 ' Compressors HP City: T el I q 7 ��-; Environmental exhaust and ventilation: 111 - Ci (,� Sta e :Q . ZIP: Appliance vent Phone 3 Ga0 S( Fax: 59NC71/S E-mail: Dryer exhaust Type :- OWNER Hoodsoods, , Type U II/res. kitchen /hazmat • hood fire suppression system Name: ( Exhaust fan with single duct (bath fans) Mailing ep (S(.4) C i t S r Exhaust system apart from heating or AC Ci t y : - �ddress: / CO Fuel piping and distribution (up to 4 outlets) City: / ♦ GP (State:0 l ZIP: q 7,„z, , Type: LPG NG x Oil Phone: , ••-• 1 • Fax: E -mail: Fuel piping each additional over 4 outlets i �� ENGINEER Process piping (schematic required) Number of outlets Other listed appliance or equipment: Address: Decorative fireplace Insert - type Phone: Woodstove/pelletstove • Other: signature: 1 /.i,ii AA ' ' - 4.4 Other: Name (print): 4-7"l:( `.-e_ 2 N A A/'A/' _ Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ / "37 Visa ❑MasterCard Notice: This permit application Minimum fee $ _ ex if a permit is not obtained 30 Credit card number: / 1 Plan review (at To) $ Expires within 180 days after it has been $ State surcharge (8 %) .. Name of cardholder as shown on credit card accepted as complete. TOTAL $ -5 $ Cardholder signature Amount 110 1617 (6 /00 /COM) • Commercial Schedule • 1&2 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE , - Description Furnace to 100,000 BTU Table 1A Mechanical Code Qty Price Total including ducts & vents 955 1) Furnace to ducts & 0 BTU g including duds vents 14.00 Furnace > 100,000 BTU 2) Furnace 100,000 BTU+ including ducts & vents 17 40 including ducts & vents 1,170 - 3) Floor Furnace including vent 14 00 floor furnace 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 i Check all that apply: 'Boiler Heat Air. Vent not included in appliance permit 445 For items 7 -10, see or Pump Cond Qty 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) >5OHP; absorb unit >1.75 mil BTU 87.20 501k to 1 mil. BTU 2310 12) Air handling unit 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 10-00 - 5725 15 Vent fan connected to a sin duct > 1.75 mil. BTU 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 10.00 Non - portable evaporate roller 656 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 WORM -- Gas piping 1-4 outlets 360 8% SURCHARGE Mae ECM Each additional outlet 63 X 1r_ ? � PLAN REVIEW 25 % OF SUBTOTAL °. . i= . . _ Required for ALL commercial permits only = - .'r - : - . TOTAL ,"3?- tiM Other Inspections and Fees: 1. Inspections outside or normal business hours (minimum charge -two hours) $72.50 per hour 2. Inspections for which no lee is specifically indicated (minimum charge-half hour) $72.50 per hour Total Valuation Fee 1 Additional plan review required by changes, additions or revisions to plans (minimum charge-one-half hour) $72.50 per hour 'State Contractor Boiler Certification required $ 1 .00 to $5,000.00 Minimum $72.50 "Residential A/C requires 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 CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested 44`4( AM PM BLD Location //'' Se- 7/ 3 Suite MEC Z� ' / - r� U / / Z— Contact Person Ph L Z � f e/ 3 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 J Framing ' / Le .e � --- t 0 ?Z 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 ECHANIC': Post & Beam Rough In Gas Line S e Dampers Final PART FAIL ELECTRICAL' • Service Rough In . UG /Slab Low Voltage Fire Alarm .. Final PASS PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line (- ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date Y — // — U/ Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. V F.. BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By I Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation _ Post/beam structural Shear walls /anchors _ ELR - Restricted Energy Permit Roof nailing Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry/Reinforcement Framing MFG Structure set -up MEC - Mechanical Permit Insulation 4 Inspection Description Date Passed By Drywall nailing Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final _ Smoke detector Fireproofing Lab Final _ Mechanical final 4- -1 I - 01 Structural observation Final inspection PLM - Plumbing Permit Inspection Description Date Passed By BUP - Fire Protection S ystem Permit Plumbing underslab E Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post /beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer - 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin/Manhole J SWR - Sewer Permit Engineered soils - -4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP PLM SWR ELC, ELR, MEC SIT PERMITS C ITY OF TIGARD MECHANICAL PERMIT A DEVELOPMENT SERVICES PERMIT #: MEC2001 -00112 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/4/01 PARCEL: 1 S135DC -07200 SITE ADDRESS: 11600 SW 91ST AVE SUBDIVISION: CHARBEN ZONING: R -4.5 BLOCK: LOT: 005 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: DOMES. INCIN: OIL 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: 1 AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Replace oil furnace with like kind. Owner: FEES BELL, CARROLL M + FLORENCE P Type By Date Amount Receipt 11600 SW 91ST AVE PRMT CTR 4/4/01 $72.50 2720010000 TIGARD, OR 97223 5PCT CTR 4/4/01 $5.80 2720010000 Total $78.30 Phone: Contractor: SPECIALTY HEATING & COOLING X 9528 SW TIGARD ST TIGARD, OR 97223 REQUIRED INSPECTIONS ( 141% Heating Unt Insp Phone: 620 -5643 Final Inspection Reg #: LIC 66578 aloe 115 0 I This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 0 Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This ermit will expire if work is not started within 180 days of issuance, or if work is suspended for m a than 180 -days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Util' y Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0080. Yo may obtain copies of thes- les or direct questions to OUNC by calling (503)246 -9189. Is e By: / i ;� �� / . Permittee Signature:XJ ,_QA,i . tGCLA Call (503)`• 9-4175 by 7:00 P.M. for inspections needed the next business day