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Permit f~ CITY OF TIGARD MECHANICAL PERMIT A.00 DEVELOPMENT SERVICES PERMIT #: MEC2003 -00088 All -1 it DATE ISSUED: 3/6/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110AB-03100 SITE ADDRESS: 14305 SW 114TH AVE SUBDIVISION: COLE'S ACRES ZONING: R -2 BLOCK: LOT: 015 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: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Install exterior AC unit. Cannot be placed in required setbacks. Gas furnace. Owner: FEES BURNETTE, DAVID G + THERESA ANN Description Date Amount 14305 SW 114TH AVE TIGARD, OR 97224 [MECH] Permit Fee 3/6/03 $72.50 [TAX] 8% StateTax 3/6/03 $5.80 Phone: Total $78.30 Contractor: TODD A. CHRISTENSEN 4040 SUSSEX SST WEST LINN, OR 97068 -3724 REQUIRED INSPECTIONS Phone: 503 Heating Unt Insp Cooling Unt lnsp Reg #: LIC 104394 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 ' OAR 952 - 001 -00 Issued By: Permittee Signature: A _, / V r Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Permit Application FOR OFFICE USE ONLY Mechanical Per pp Received Mechanical � Date/By: 3 --' -rri' -- Permit No.: n1Z - 3 LC/v 00 Planning Approval Building City of Tigard Date/By: No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use m ��"NP �' j� Contact Case No.: Internet: www.ci.tigard.or.us .' I Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 `-"" Name/Method: Supplemental 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 an LOCATION Furnace - add - on air conditioning ** 14.00 /i/30 Job site address: INFORMATION Gas heat pump 14.00 Suite #: Bid . /Apt'#: Duct work _ 14.00 Project Name: M9 /)/ Gle?/�� Hydronic hot water system 14.00 Residential boiler Cross street/Directions to job site: (for radiator or hydronic system) 14.00 Unit heaters (fuel, not electric) �� //,2( (in wall, in-duct, suspended, etc.) 14.00 , ,Pre-- Flue /vent (for any of above) 10.00 Subdivision: Lot #: Repair units 12.15 Other Fuel Appliances Tax map /parcel #: Water heater 10.00 lIVE RIPTION OF WO t Gas fireplace 10.00 /9 c C d l / iyt-- ' 4/ siL Flue vent (water heater /gas fireplace) 10.00 .447W- _ / Log lighter (gas) 10.00 Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 r -, - Other: 10.00 N ° , �� . Environmental Exhaust & Ventilation l/L � Range hood/other kitchen equipment 10.00 Address: ,/ _y� �� ::::;st 10.00 — Phone: i - - "J...s Fax: (bathrooms, toilet compartments, IS APPLICAN CONTACT PE * ` ' utility rooms) 6.80 Name: Attic /crawl space fans 10.00 Other: 10.00 Address: C/ . IG i J' Fuel Piping City /State /Zip: � `{/ * *($5.40 for first 4, $1.00 each additional) Phone: Fax: - F etc. ** Gas heat pump ** E -mail: Wall /suspended/unit heater ** ` CO TRA"C a R Water heater ** Business Name: .,,1, 1 Fireplace ** Address: 9. rq _ -.),c - Range ** BBQ ** City /State /Zip: '-/ li+" " €::`'/e._ ' Clothes dryer (gas) ** Phoneme d3 -37 , ax: Other: ** CCB Lic. #: Af it % Total: Authorized // �j .../V Mechanical Permit Fees* �i�� Subtotal: $ . (-2) Signature: !�� _ �� - ! 0 — Minimum Permit Fee $72.50 $ 1° ®/� G�� Plan Review Fee (25% of Permit Fee) $ !/� (Please print name) State Surcharge (8% of Permit Fee) $ 6_10 TOTAL PERMIT FEE $ -7 30 Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total t'atiattou; Pere tt ee $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 ValuationsPer 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: '` •, �'" is \Dsts \Permit Forms \MecPermitAppPg2.doc 01/03 I �' s /U l� ` J,_ yp L r ` I l O� 7/-7 < // `t l z(3 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested L(-3 AM t/ PM BUP Location / { .2 5 1 f 1 '�`' Suite MEC 3 - d FY Contact Person Ph ( ) 3/3 — 22g PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Crawl Drain Slab I nspection Notes. SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling / ".7/7if/.. Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Sm.. - Dampers PART FAIL CTRICAL 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 El Please call or rei pection RE: 0 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final D I NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour s BUILDING Inspection Line: (503) 639 -4175 INSPECTIO DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 3 7 AM PM BUP Location ` 4-13 // Suite 3 — OOO s s Contact Person 7 Ph ( ) 3t3-4/ Z 2- & PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: (1� S � SIT Post & Beam Shear Anchors ,lC■ 7 , /'r v� _ - p' • Ext Sheath/Shear � Int Sheath/Shear Framing Insulation ti Drywall Nailing Firewall --- Fire Sprinkler Fire Alarm Susp'd Ceiling � � , p Roof �4 Ln/‘ ` Other: Final PASS PART FAIL PLUMBING 12 4 • - c � A Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P CS T FAIL MECHAN C 'OS earn ough -I Gas ine Smoke Dampers Final t d i r A i PASS Li b" ELECT • „„�.- } 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: Unable to inspect — no access Fire Supply Line ADA Date 1/ 7 / 3 In actor L ^� Ext Approach /Sidewalk p Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL