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Permit A - CITY OF TIGARD MECHANICAL PERMIT 1 DEVELOPMENT SERVICES PERMIT #: MEC2001 -00028 r 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01/23/2001 PARCEL: 2S 114AD -03900 SITE ADDRESS: 16641 SW 90TH PL SUBDIVISION: WAVERLY ESTATES ZONING: R -12 BLOCK: LOT: 038 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: 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: 1 FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installation of residential NC unit. Unit cannot be placed within the required setbacks. Owner: FEES HASS, DELBERT R Type By Date Amount Receipt 16641 SW 90TH PL PRMT CTR 01/23/20( $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 01/23/20( $5.80 2720010000 Total $78.30 Phone: Contractor: FIRST CALL HEATING & COOLING 1650 NE LOMBARD PORTLAND, OR 97211 -4798 REQUIRED INSPECTIONS Final Inspection Phone: 231 -3311 • Reg #: LIC 102030 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 cop of these rules or direct questions to OUNC by calling (503)246 -9189. _I Issue By: 40 i - Permittee Signature: / Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day - Mechanical Permit Application - Date received: / Z3 a/ Permit no.://eeZ00-6;002 , irks � - y► :'_) . City of Tigard 4 �� - �� Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tiga�� ,,k7R 97 Phone: (503) 639 -4171 R• sc: Date issued: B y'.. / Receipt no.: Fax: (503) 598 -1960 \, Case file no.: Payment type: Land use approval: ,,,,"\ .. � Building permit no.: O - . • . TYPE OF PERMIT . ' X v '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: / �, 4"/ e t a' g(:) h i1 ( 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 $ . Lot: (Block: I Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: 'T u , . / C � I ZIP: ''/ 7 2 2 L/ =2_E01ILY D 3'E.LLIN -PFRI IT-4Y-- - HED_I�LF_ ... • Description and location of work on premises: 1/7 51--x. t / AND COMMERICAL/INDUSTRIAL EQ ' - /7 L _ Fee(ea.) Total Est. date of completion /inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air handling unit CFM Is existing space heated or conditioned? ❑ .Yes ❑ No Air conditioning (site plan required) ( ii-I, Is existing space insulated? O Yes ❑ No Alteration of existing HVAC system ' MECHANICAL CONTRACTOR Boiler /compressors Business name: - - /(.// /-{�°a .4f y �� CO / l,r C • State boiler permit no.: HP Tons BTU/H Address: /6 c //g y l 1( e ( Fire /smoke dampers/duct smoke detectors _ City: ./ , /` ( C, I State /,'_1 ZIP: q 7Zi / Heat pump (site plan required) Fax: E-mail: Install/replace furnace/burner BTU /H Phone: ia7 - Li-7 I'�5l �S� I Including ductwork/vent liner ❑ Yes ❑ No CCB no.: )0_,I63 v Install/replace/relocate heaters - suspended, City /metro lic. no.: Lk, g Q . wall, or floor mounted Name (please print): ,/ tax p!$ f eW-/P-75 Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units 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 OWNER Hoods, Type I/ Il/res. kitchen/hazmat . '- t - - —° _ - --r_" -° . hood fire suppression system Name: �-i' / AZ-4_ 5_5 Exhaust fan with single duct'(bath fans) it o !�/ Mailing address: /(„ y/ 5 /p / _ Exhaust system apart from heating or AC Stae ZIP: Fuel piping and distribution (up to 4 outlets) City: 7--/ � �- ✓'� I t �'e� 722 Type: LPG NG Oil Phone: 4,, , ' -. e. A F __axe— E -mail: Fuel piping each additional over 4 outlets _ ENGINEER 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: I E -mail: Woodstove/pellet stove Other: Applicant's signature,. 4 _,-, Date: / /Gj-c2 / Other: Name (print): ',.Z //C/Qr4 5�� 5 Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ ❑ Visa ❑MasterCard Notice: This permit application Minimum fee $ 1 1,5 Credit card number: / / expires if a permit is not obtained Plan review (at %) $ Expires within 180 days after it has been State surcharge (8%) a v Name of cardholder as shown on credit card accepted as complete. g ( ) $ ° 1 R • )cam Cardholder signature Amount • 440 -4617 (6 /00 /COM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total Table 1A Mechanical Code Qty (Ea) Amt $1.00 to $5,000.00 Minimum fee $72.50 1) Furnace to 100,000 BTU $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and including ducts & vents 14,00 $1.52 for each additional $100.00 or 2) Furnace 100,000 BTU+ fraction thereof, to and including including ducts & vents 17.40 $10,000.00. Floor Furnace $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) including vent 14.00 $1.54 for each additional $100.00 or fraction thereof, to and including 4) Suspended heater, wall heater $25,000.00. or floor mounted heater 14 $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. 4i 12 15 $50,001.00 and up $742.00 for the first $50,000.00 and Check allythat ~apply . Boiler � _ Heat Air - +' $1.20 for each - additional $100.00 or For it 7 11, see or Pump, ,, C o ed '� • fract there fo P 2 , Corn ,....._. '7 :V.3 R,:, - �. _-. 7) <3HP;absorb unit to 100K BTU 14.00 ASSUMED VALU PER APPLIANCE: 8) 3 15 HP; absorb Value Total unit 100k to 500k BTU 25.60 Description: Qty (Ea) Amount 9) 15 -30 HP; absorb Furnace to 100,000 BTU, including 955 unit .5 -1 mil BTU 35.00 ducts & vents 10) 30 -50 HP; absorb Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20 ducts & vents 11) >50HP: absorb Floor furnace including vent 955 unit >1.75 mil BTU 87.20 Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 13) Air handling unit 10,000 CFM+ permit 17 Repair units 805 14) Non - portable evaporate cooler .. < 3 hp; absorb. unit, 955 10.00 to 100k BTU 15) Vent fan connected to a single duct • 3 -15 hp; absorb. unit, 1,700 • 6.80 101k to.500k BTU 16) Ventilation system not included in 15 -30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00 mil. BTU 17) Hood served by mechanical exhaust 30 -50 hp; absorb. unit, 3,400 10.00 1 -1.75 mil. BTU ..... 18) Domestic incinerators >50 hp; absorb. unit, 5,725 17.40 >1.75 mil. BTU 19) Commercial or industrial type incinerator Air handling unit to 10,000 cfm 656 69.95 Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves Non - portable evaporate cooler 656 10.00 Vent fan connected to a single duct 446 21) Gas piping one to four outlets Vent system not included in 656 5.40 appliance permit 22) More than 4 -per outlet (each) Hood served by mechanical exhaust 656 1.00 Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: r >. ' ° - :'; $ Commercial or industrial incinerator 4,590 ' � ',;k , : .: ' Other unit, including wood stoves, 656 8% State Surcharge - ". - - -, $ inserts, etc. ' _ Gas piping 1 -4 outlets 360 • 25% Plan Review Fee (of subtotal) ;>, ,< ± '`.:- � $ Each additional outlet 63 ',,i:7 a Required for ALL commercial permits only �,, . TOTAL COMMERCIAL : $ TOTAL RESIDENTIAL PERMIT FEE: y = ` ? ° : $ VALUATION: ,',1?: Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum charge -two hours) ,$72.50 per hour. 2. Inspections for which no fee is specifically indicated (minimum charge -half hour) $72.50 per hour 3. 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 for units >200k BTU. `"Residential A/C requires site plan showing placement of unit. is \dsts \forms \meth- fees.doc 10/11/00 _ L Ali e4. rum f t,,,. �.. cam m < CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP Date Requested ( AM PM �� • BLD Location / C(l 5k) ,a 67( ! 2, Suite ,f MEC V o% 00 0_Z Y Contact Person Ph 2 4/ 9 s` PLM Contractor ' E7ec_ / Ph SWR BUILDING Tenant/Owner ELC & /' w °J J 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 ART FAIL CHAN Post & Beam Rough In � Gas Line Smoke Dampers 4 II PASS PART FAIL ELECTRICA Service Rough In UG /Slab Al ^, v Low Voltage LJ F' a Alarm Fin 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 Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date 2/S/ Inspector — �/ Ext Final PASS. PART . FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By 4 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 'I Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry/Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit . Insulation Drywall nailing 4 Inspection Description Date Passed By 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 1- `9 - a Structural observation Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP — Fire Protection System Permit Plumbing underslab 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 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 Aillb CITY OF TIGARD MECHANICAL PERMIT ,L�l,fI t DEVELOPMENT SERVICES PERMIT #: MEC2001 -00028 DATE ISSUED: 01/23/2001 ,�- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114AD -03900 SITE ADDRESS: 16641 SW 90TH PL SUBDIVISION: WAVERLY ESTATES ZONING: R -12 BLOCK: LOT: 038 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: 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: 1 FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installation of residential A/C unit. Unit cannot be placed within the required setbacks. Owner: FEES HASS, DELBERT R Type By Date Amount Receipt 16641 SW 90TH PL PRMT CTR 01/23/20C $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 01/23/20C $5.80 2720010000 Total $78.30 Phone: Contractor: FIRST CALL HEATING & COOLING 1650 NE LOMBARD PORTLAND, OR 97211 -4798 REQUIRED INSPECTIONS Final Inspection Phone: 231 -3311 Reg #: LIC 102030 at lir g This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. I Specialty Codes and all other applicable laws. All work will be done in accordance with approved Il lb 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 copi- of these rules or direct questions to OUNC by calling (503)246 -9189. 3 11) Issue By: 4 — % 0 - - Permittee Signature: • , ,OL./C'.9-r7a�t/ -,,,'t_€ Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day