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Permit - CITY OF TIGARD - MECHANICAL PERMIT ,,� 1 -` DEVELOPMENT SERVICES PERMIT #: MEC2001 -00215 ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/15/01 PARCEL: 2S110DA -08700 SITE ADDRESS: 15125 SW 107TH TERR SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5 BLOCK: LOT: 048 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: 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: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: Remarks: Install exterior NC unit. Unit must not be placed within the required setback. Owner: FEES CONNIE LEE Type By Date Amount Receipt 15125 SW 107TH TERR PRMT CTR 6/15/01 $72.50 2720010000 5PCT CTR 6/15/01 $5.80 2720010000 Total $78.30 Phone: Contractor: TRI TECH HEATING 6603 NE 137TH AVE VANCOUVER, WA 98682 REQUIRED INSPECTIONS Mechanical Insp Phone: 360- 891 -2002 Final Inspection Reg #: LIC 101873 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 rule • direct q -stions to OUNC by calling (503)246 -9189. Issue By: Permittee Signature Call (503) 639 4175 by 7:00 P.M. for inspections needed t usiness day A . Mechanical Permit Application ryyy ��/ Date received: t0 -/ 61-,01 PeArAtT7f4"gop / -oo t 2_ /s '' ,, i° City of Tigard Project/appl. no.: Expire date: City ofTigard 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 n I & 2 family dwelling or accessory U Commercial/industrial ❑ Multi- family ❑ Tenant improvement 0 New construction U Addition/alteration /replacement 0 Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: // /2; s) /62 T / r 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: ISubdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMEN'TSCHEDULE 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? U Yes 0 No Air handling unit CFM g p Air conditioning (site plan required) Is existing space insulated? 0 Yes U No Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: � /� �Z'.6' State boile permit no.: � HP _4__ Tons BTU /H Address: ej , ,.• / 5/ �,,L/L Fire /smokedampers/duct smoke detectors City: / j,ae I State:l.4ht _I ZIP: .7 ,, g2 -- Heat pump (site plan required) Phone:? 89.L2oa2-1 Fax: 9 - 5 , 7 _,,, I E -mail: Install/replace furnace/burner BTU /H Including ductwork/vent liner ❑ Yes ❑ No CCB no.: /12/8 Install /replace /relocate heaters - suspended, City /metro lic. no.: wall, or floor mounted Name (please print): Q AMP ,,, Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU /H Name: / Chillers HP Address: j;#,YgComyressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER Hoods, Type 1/ II/res. kitchen/hazmat hood fire suppression system Name: ( 1) VI n t'- l Exhaust fan with single duct (bath fans) Mailing address: /52 74— 5 / D7 e Exhaust system apart from heating or AC City: �fr p I State: ZIP: 9 767�-z-i Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: I S . ter I ZIP: Insert - type Phone: , I l~ . E -mail: Woodstove/pellet stove Other: _ Applicant's sign. ur•. 1 ,rAir , Date: , — � Other: Name (print): - jILO J ' 'Not all jurisdictions accept credit cards, please call jurisdiction for more information Permit fee $ Cl Visa ❑ MasterCard Notice: This permit application Minimum fee $ 72- ' _ expires if a permit is not obtained Plan review (at % Credit card number: E Expires 180 d after it has been ( %) $ p State surcharge (8%) .... $ Name of cardholder as shown on credit card accepted as complete. S TOTAL $ Cardholder signature Amount , 440 - 4617 (6A0/COM) MECHANICAL PERMIT FEES 4 COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: • TOTAL VALUATION: FEE: Description: Price Total $1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU including ducts & vents 14.00 $1.52 for each additional $100.00 or 2) Furnace 100,000 BTU+ fraction thereof, to and including $10,000.00. including ducts & vents 17.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace $1.54 for each additional $100.00 or including vent 14.00 fraction thereof, to and including 4) Suspended heater, wall heater $25,000.00. or floor mounted heater 14.00 $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. 12.15 $50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond fraction thereof. footnotes below. Comp* ** 7) <3HP;absorb unit to 100K BTU 14.00 ASSUMED VALUATIONS 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 17.20 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 ill 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: S '2 1-- Commercial or industrial incinerator 4,590 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 Required for ALL commercial permits only TOTAL COMMERCIAL $ Q% TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: f 7 O 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\mech- fees.doc 10/11/00 !| ,:1z/ ::, /4 : ]:: :r ^ 590-8391 RTMCU F4i /' ` 1 || | ` / / . . . _ ^ | _'_--- • / | / / ' �|�^~ \� / / ' \ | � li J' | � / !~ ' -� 2L1 ' ! - 0 ^ � !-- -------- p•••-• 1 |/ i ./ _ \ �� ^� i� | - K+~�/ | \y +~~ / ' .. ./"/ I | . � ' / ` | ' I ` | ' i . . /- ) 0:1 '4- ��e* /| -' .| |' , \ \ � / '| 1 / | , , | / | i | / ` ° - __-_--_ ~-~___ . / / ' ) � r 'T � / L/ / Tc_11/ 1 ' ' 1,„ { . / i / V' / [ L , , ��/ �i - � . . / | | '| || r 1i 1 i ' /" | / / | | . ` ' . " ! |� | U / -- CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested AM PM BLD Location /57 �.S / 7 `" 17,(2.42., Suite MEC 6 / 2/5 Contact Person s e A i , J Ph 35 PLM Contractor Ph • SWR BUILDING Tenant/ elf)/ 4/1,440' ELC Retaining Wall ELR Footing Foundation Ftg Drain SGN Crawl Drain I nspec 'on Notes: Slab J SIT Post & Beam Ext Sheath /Shear ;.. � j 0 - / d o Int Sheath /Shear �.�� Framing 4 __+ , Insulation � // Drywall Nailing 6L6Cr/Zi "" (4t IAA /L l 4G // 74 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 Sm. e Dampers • PART FAIL LECTRICAL 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 Other Date - / 7 c l Inspector E 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- 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 Structural observation Mechanical final - / 7_0 / 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 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 CITY TIGARD MECHANICAL PERMIT fir l;' DEVELOPMENT SERVICES PERMIT #: MEC2001 - 00215 ..�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/15/01 PARCEL: 2S 110DA -08700 SITE ADDRESS: 15125 SW 107TH TERR SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5 BLOCK: LOT: 048 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: 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: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: Remarks: Install exterior A/C unit. Unit must not be placed within the required setback. Owner: FEES CONNIE LEE Type By Date Amount Receipt 15125 SW 107TH TERR PRMT CTR 6/15/01 $72.50 2720010000 5PCT CTR 6/15/01 $5.80 2720010000 Phone: Total $78.30 Contractor: TRI TECH HEATING 6603 NE 137TH AVE VANCOUVER, WA 98682 REQUIRED INSPECTIONS Mechanical Insp Phone: 360 - 891 -2002 Final Inspection Reg #: LIC 101873 0 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 0 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 rule • direct q -stions to OUNC by calling (503)246 -9189. Issue By: I Permittee Signature" ��/ / - / Call (503) 639 -4175 by 7:00 P.M. for inspections needed t e nex • usiness day