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Permit CITY TIGARD MECHANICAL PERMIT A-44I DEVELOPMENT SERVICES PERMIT #: MEC2002 -00352 � 13125 SW Hall Blvd., Tigard, O 97223 (503) 639 -4171 DATE ISSUED: 8/15/02 PARCEL: 2S111 CA -14200 SITE ADDRESS: 15025 SW 98TH AVE SUBDIVISION: ALDERBROOK FARM ZONING: R -3.5 BLOCK: LOT: 008 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 OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Install approx. 20 If gas line and 1 gas outlet. Owner: FEES ONNIS, DORIS A/ROBERTO Type By Date Amount Receipt 15025 SW 98TH AVE PRMT CTR 8/15/02 $72.50 2720020000 TIGARD, OR 97223 5PCT CTR 8/15/02 $5.80 2720020000 Total $78.30 Phone: Contractor: LAY'S CONSTRUCTION 7400 SE MILWAUKIE BLVD. PORTLAND, OR 97202 REQUIRED INSPECTIONS Gas Line Insp Phone: 503 - 233 -4989 Mechanical Insp Reg #: 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 questio s to OU by calling (Rf \94R -Q 1 • !."` Issue By: lir "� Permittee Signature: /4,0 Call (503) 639 -4175 by 7:00 P.M. for inspections nek / ed the next business day Mechanical Permit Application FOR OFFICE USE ONLY Received , / Mechanical Date/B : 8, 10 0 Permit No. U _ _..d,. - /I 5 City of Tigard T Planning Approval est Form Date /S Building Permit 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date /B : Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post- Review Land Use �Mru+ AA Date /B : Case No.: Internet: www.ci.tigard.or.us �JJ n i Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Method: Su lemental Information. TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work ❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit. 1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule ❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE Description I Qty I Fee(ea.) I Total ❑ Master Builder ❑ Other: Heating/Cooling JOB SITE INFORMATION and LOC� IO I Furnace - add -on air conditioning 14.00 Job site address: ,e6:3 5�9 , Z' ' Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 Project Name: /. Hydronic hot water system 14.00 1 Residential boiler Cross street/Directions to job site: (for radiator or hydronic system) 14.00 Unit heaters (fuel, not electric) _6 jd (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) 10.00 �i Repair units 12.15 Subdivision: r A Lot #: Other Fuel Appliances Tax map /parcel #: Water heater 10.00 : DESCRIPTION OF WORK .. , ,. , _ '•, '' Gas fireplace _ 10.00 F • „ _2_,,:- N lki, a A AAA Flue vent (water heater /gas fireplace) 10.00 I Log lighter (gas) 10.00 Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 ❑ PROPE TY OWNER ❑ TENANT Other: 10.00 Name: ,� Environmental Exhaust Ventilation � �� << Range hoo kitchen equipment 10.00 Address: 45—(3126—SE” ��r� Clothes dryer exhaust 10.00 City /State /Zip: O `L- Single duct exhaust Phone: 9- Fax: (bathrooms, toilet compartments, ❑ APPLICAliT ❑ CONTACT PERSON utility rooms) 6.80 Name: Attic /crawl space fans 10.00 Other: 10.00 Address: Fuel Piping City /State /Zip: ($5.40 for first 4, $1.00 each additional) ** Furnace, etc. ** Phone: Fax: Gas heat pump ** E -mail: Wall /suspended/unit heater ** CONTRACTOR ** heater Business Name: 4 5 C,,�� . iZ_Gfrcv, Fireplace ** / f � O ,/ Range Address: ` BBQ ** City /State /Zip: z� G� r �� Clothes dryer (gas) ** Phone:23 , F ax: ? —7t79 Other: ** CCB Lic. #: ' % /c f 7' -0 ( Total: f Total: Mechanical Permit Fees* Subtotal: $ Authorized / Permit Fee $72.50 $ Signature: 1 _ Date: Plan Review Fee (25% of Permit Fee) $ State Surcharge (8% of Permit Fee) $ TOTAL PERMIT FEE $ (Please print name) Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 $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. $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Assumed Valuations Per Appliance: Value Total Description: Qty (Ea) Amount Furnace to 100,000 BTU, including 955 ducts & vents Furnace> 100,000 BTU including ducts 1,170 & vents Floor furnace including vent 955 Suspended heater, wall heater or floor 955 mounted heater Vent not included in appliance permit 445 Repair units 805 < 3 hp; absorb. unit, 955 to 100k BTU 3 -15 hp; absorb. unit, 1,700 101k to 500k BTU 15 -30 hp; absorb. unit, 501k to 1 mil. 2,310 BTU 30 -50 hp; absorb. unit, 3,400 1 -1.75 mil. BTU >50 hp; absorb. unit, 5,725 >1.75 mil. BTU Air handling unit to 10,000 cfm 656 Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 Vent fan connected to a single duct 446 Vent system not included in appliance 656 permit Hood served by mechanical exhaust 656 Domestic incinerator 1,170 Commercial or industrial incinerator 4,590 Other unit, including wood stoves, 656 inserts, etc. Gas piping 1-4 outlets 360 Each additional outlet 63 TOTAL COMMERCIAL $ VALUATION: CITY OF TIGARD 24 -Hour BUILDING • Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST ,, • BUP 2 ,5 7 S Received Date Requested 12-3 4 AM PM BUP • Location f S 0 ?S F 6v-v- Suite MEC r2 — ob. -� Contact Person Ph ( ) ° S 0 5 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear r u ation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fina CO) ART FAIL P ' ' BING Post & Beam /., Under Slab Rough -In f,. Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole / 777' Storm Drain Shower Pan Other: Final P o FAIL ECHANIC P . =eam S` - Dampers t SS PART FAIL ELECTRICAL Service Rough -In 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 Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date G /' 3G ? Inspector / Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 -i MST BUP Received Date Requested - < 1 AM PM BUP — e 3 3 Location /5 a a 5 / a Suite MEC 0 r 60 3 S0 7 — Contact Person Ph ( ) PLM Contractor Ph ( ) 233 SWR Tena t/: (2 y . c� 2� Z —Op 3c59 Footing 13 �! — 5315 — () Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof -■11011111111.16Y. / Other: oral PART FAIL P U MBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PAS$ PAETT FAIL CISECHANICALD Post & Beam Rough -In Gas Line Si oke Dampers FAIL Service Rough -In UG/Slab Low Voltage Fir= larm : 41e - 1 PART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SI ❑ Please call for reinspection RE: 0 Unable to inspect — no access F Fire Supply Line /// Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL