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Permit CITY OF TIGARD MECHANICAL PERMIT ; .I DEVELOPMENT SERVICES PERMIT #: MEC2001 -00289 °° n 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/13/01 PARCEL: 2S114BB -08300 SITE ADDRESS: 16358 SW 104TH AVE SUBDIVISION: SWANSONS GLEN ZONING: R -12 BLOCK: LOT: 024 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: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Installation of new a/c unit. Owner: FEES ARMSTRONG, RICHARD K AND FRANC Type By Date Amount Receipt 16358 SW 104TH AVE PRMT CTR 8/13/01 $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 8/13/01 $5.80 2720010000 Total $78.30 Phone: Contractor: SPECIALTY HEATING & COOLING 9528 SW TIGARD ST TIGARD, OR 97223 REQUIRED INSPECTIONS Cooling Unt lnsp 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 952-00-1-001G through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by cal ' g (503)246 -9189. I Is ue By: '` , 4 , _ 4 . , I Permittee Signature: )C,1},/,Z ig, 1/4 ) 1/ 7 6 -at✓Q.(-4.) Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day ill'o Mechanical Permit Application Date received: c -' '-' Permit no.: i' lrC' i / - Gc , / .A4-. , ,.� � � City of Tigard 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 X 1 & 2 family dwelling or accessory CI Commercial/industrial CI Multi - family CI Tenant improvement ❑ New construction Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: r6 35 ir C l ot/ - Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ . Lot: Zock: J Subdivision: *See checklist for important application information and Project name: 3'Nt.r01"✓1 jurisdiction's fee schedule for residential permit fee. City /county:7741na cr /A.Sly VlZIP: Q Jed- // 1 & 2 FAMILY DWELLING PERMIT 3 SCHEDULE Description an location of work on premises: GM,Q.II AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE Fee(ea.) Total Est. date of completion/inspection: IS 7 /Cot Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned ?,Yes O No Air handling unit CFM space insulated? Yes ❑ No Air conditioning (site plan required) Is existing P Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors State boiler permit no.: Business name‘� 04L 4. 4 * ! y 7 l?G HP Tons BTU/H Address: Cl 6 �" vt-J 71 Lam) • S' / Fire /smokedampers/duct smoke detectors City: 1T322/) qt vp i State: 0 £.l ZIP: q 7;1 9.3 Heat pump (site plan required) E -m ail: Install/replace furnace/burner BTU /H Phone�lp3(P�p6k‘/ Faxs9fs p 7/ Including ductwork/vent liner ❑ Yes ❑ No CCB no.: 4,4.5 7 Install/replace/relocate heaters-suspended, City /metro lic. no.: f k 96 wall, or floor mounted Name (please print): , /-pyi,4 4 (6+1 Zis° Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU /H Name: KA_ -'µ Lie N f n 'le je. Chillers HP Address: q.S�- $' S(-c.) 7/A '' S Compressors HP r aA el I Environmental exhaust and ventilation: Cit y: Stae l 4' 7o L a e:G ZIP: Apppplia iance e vent vent Phone'3 6„2(2 -6 ' Fax: 59g0118' E - mail: Dryer exhaust OWNER Hoods, Type I/ II/res. kitchen/hazmat ,�r hood fire suppression system Name: 4 / a ' / ; { 'y 1 1 ( i'Y'7# Exhaust fan with single duct (bath fans) Mailing address: /6i B$ ¥'' _ sal I oq for/ Exhaust system apart from heating or AC State: ZIP: q Fuel piping and distribution (up to 4 outlets) City: l � l 7a� Type: LPG NG O Phone: Er-- /( 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: ZIP: Insert - type Phone: ax: I, E-mail: Woodstove/pellet stove e�� Other: Applicant's signal re• q team 4/4.4414.1, 4.1. Date: •/AVOI Other. Name (print): A ee W CS'K /A/*Cf 5C Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ �� ❑ Visa 0 MasterCard Notice: This permit application Minimum fee $ Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $ Expires within 180 days after it has been a cce red as comp lete. State surcharge (8 %) .... $ '7 /. C L j f 2 Name of cardholder as shown on credit card p p TOTAL $ ( V W , , Cardholder signature Amount 440-4617 (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 _ induding ducts & 955 1) Furnace to 100,000 BTU g including ducts & 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 heater, 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 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 unit .5-1 milBTU 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) >50HP; 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 10.00 Non - portable evaporate cooler 10 > 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 10.00 Non - portable evaporate toiler 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 gregions. Gas piping 1-4 outlets 360 8% SURCHARGE isga i Each additional outlet 63 PLAN REVIEW 25 % OF SUBTOTAL Required for ALL commercial permits only TOTAL sinosin Other Inspections and Fees: I. Inspections outside of normal business hours (minimum charge -two hours) $72.50 per hour 2. Inspections for which no Tee is specifically indicated (minimum charge -half hour) $72.50 per hour Total Valuation Fee 3. Additional plan review required by changes. additions or revisions to plans (minimum chargeahe -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 ' • c o 6 4 ") _ C z Lt ".1& • CJTY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested ! 5 AM PM BLD / Location 6 3 �J % / ` 9� ' Suite MEC J G l Ge a--g'/ Contact Person Ph G, 2-6 -S ' PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: l — FO 4- 1( q 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 PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers ma PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final 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 Y 16 — v( t Ext Inspector x Other Date p Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit J Inspection Description Date Passed By ,f 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 J 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 j Structural observation Mechanical final cs - / - = 0/ fl'rA Fireproofing Lab Final Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP — Fire Protection System Permit Plumbing underslab 4 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 is \dsts \ forms \InspRecordBUP.doc 04 /17/01 I CITY TIGARD MECHANICAL PERMIT r ' DEVELOPMENT SERVICES PERMIT #: MEC2001 -00289 �� I � I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/13/01 PARCEL: 2S 114BB -08300 SITE ADDRESS: 16358 SW 104TH AVE SUBDIVISION: SWANSONS GLEN ZONING: R -12 BLOCK: LOT: 024 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 new a/c unit. Owner: FEES ARMSTRONG, RICHARD K AND FRANC Type By Date Amount Receipt 16358 SW 104TH AVE PRMT CTR 8/13/01 $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 8/13/01 $5.80 2720010000 Total $78.30 Phone: Contractor: SPECIALTY HEATING & COOLING 9528 SW TIGARD ST g TIGARD, OR 97223 REQUIRED INSPECTIONS Cooling Unt Insp Phone: 620 -5643 Final Inspection Reg #: LIC 66578 li g 0 1 Ore. S This permit is issued subject to the regulations contained in the Tigard Municipal of Or Specialty cipal Code, a pe iy Codes° and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work() 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 -0 1 -00 fhraugkOAR 952 - 001 - 0080. You may obtain copies of these rules or direct questions to OUNC by cal ' g (503)246 -9189. )17/ Is u e By: 4,i , `A,__, I Permittee Signature: x j.tui I ) f f , Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day