Permit � •' GG
' ' � f+ CITY OF TIGARD MECHANICAL PERMIT
1 ` DEVELOPMENT SERVICES PERMIT #: MEC2002 -00321
II 13125 SW Ha Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/24/02
PARCEL: 2 S 104AB -09700
SITE ADDRESS: 12367 SW 131ST AVE
SUBDIVISION: MORNING HILL NO. 6 ZONING: R -4.5
BLOCK: LOT: 126 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: 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:
>
GAS OUTLETS:
10000 cfm:
Remarks: Replace gas furnace and add AC. Cannot be placed in the required setbacks.
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Owner: FEES
DRUMMOND, GARY J + GLADYS T Type By Date Amount Receipt
12367 SW 131ST AVE PRMT CTR 7/24/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 7/24/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
ABODE HEATING AND A/C
6151 SE HACIENDA STREET
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 649 -2440 Heating Unt Insp
Reg #: LIC 0076115 Cooling Unt Insp
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 q •ons • OUNC by calling
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Issue By: / Permittee Signature:) iro ,
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Call (503) 639 -4175 by 7:00 P.M. for inspections ne: -d:�� • ; . /'. usiness day
Mechanical Permit Application
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Datereceived:7A ,./. Permit no.: yvi , o _ - oo
1 i City of Tigard
:_„ � g Project/appl. no.: Expire date:
City of Tigard Address 13125 SW Hall : • i' ard OR 97223 Date issued: By: .. Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 - 1960 Te Case file no.: Payment type:
Land use approval: Building permit no.:
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TYPE OF RMIT'
❑ I & 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: ,. 1 i A (V,L' 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 $ .2 y‘o `----- .
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: 1 & 2 FAMILY `DW PERMIT FEE SCHEDULE ,
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENT SCHEDULE
F . _ i " o'rvr _.... An 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) M
Is existing space insulated? ❑ Yes Cl No Alteration of existing HVAC system -
44 + MECHANICAL CONTRACTOR Boiler/compressors b ■■
State boiler permit it no.:
Business name: ,v 0 I HP Tons BTU /H
Address: /1 — «, _ t " et t . Fire /smoke dampers/duct smoke detectors -
ZIP: ? 7 /2 Heat pump (site plan required) -
Phone:� Aceir ��j Fax: r- -- E-mail;___--- Install/replace furnace /burner BTU /H n --
Including ductwork /vent liner ❑ Yes ❑ No
CCB no.: / /S` InstalUreplace /relocate heaters — suspended, �--
City/metro lic. no.: _ 5 wall, or floor mounted
Name (please print): J .a,,e. Vent for appliance other than furnace ME
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~'� CONTACT PERSON ' ". Refrigeration: ■
',.;.'6.,._;`.._:‘; / •• Absorption units BTU /H
Name: j ( - f �, ems• Chillers HP ME
Address: ' .. — . a ' -.1---- Compressors HP -
Environmental exhaust and ventilation: ■ --
<rj State: ®I. ZIP 4 iV Appliance vent
Phone: 4 /.S °/ j Fax:-.---- Email:. Dryer exhaust -
•- ; -• .- • { s a• . OWN f :.� • Hoods, Type I/ IUres. kitchenlhazmat ■_—
hood fire suppression system
Name: Get ) ad J. t ' Exhaust fan with single duct (bath fans) -__
Mailing address: / Exhaust system apart from heating or AC _
• ZIP: `� 7 �Z� Fuel piping and distribution (up to 4 outlets) Ill -
rte, Type: LPG NG Oil
Phone: :p . • eLc.1 e Fax E -maalc Fuel piping each additional over 4 outlets -
ENGINEER ` Process piping (schematic required) NM
Name: Number of outlets in
Other listed appliance or equipment: 111 -
Address: Decorative fireplace
City: State: ZIP: Insert —type. -
Phone: FEHMEMIM E-mail:
Woodstove/pellet stove —
Other: ME
Applicant's signature: /%�� G� � Date.�f Other:
Name (print): .' -rte IN
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fcc $ a JV
❑ Visa ❑ 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 State surcharge (8 %) .... $ S 9
Name of cardholder as shown on credit card accepted as complete. TOTAL $ g• -36
$ Cardholder signature Amount 440-4617 (6/00 /COM)
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MECHANICAL PERMIT FEES 1 �� V
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COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
,TO ;TION. , ;. De sc n pfl on , Price ,:' .
w. , PERMIT FEE � . ��° ,.� ��� .. -_ : # w �. . :�
$1.00 to $5,000.00 Minimum fee $72.50 i Table 1AkMechanlcaltcode .._ _.. . -
. . . QtY (Ea).f., -Amt 'd
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$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 thatF°apply Boiler x Heat n Air 1'
or um Cond
$1.20 for each additional $100.00 or For l4ems7 see p P, ,,
fraction thereof. '4foot bel Comp ' , , _ .
1 ,, - 1 ° .. y ' ' "-
�� "ate s 7) <3HP; absorb unit
Minimum Permit Fee $72.50 SUBTOTAL: $ to 100K BTU 14.00
8% State Surcharge $ 8) 3-15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9) 15 -30 HP; absorb 35.00
Required for ALL commercial permits only unit .5 -1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU
. 11) >50HP; absorb
unit >1.75 mil BTU 87.20
.•ASSU.MED UALUATIONSPER APPLIANCE t 3 4 ' 12) Air handling unit to 10,000 CFM 10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) , Amount _ 17._20 •
Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents _ 10.00
Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct
ducts & vents - 6.80
Floor furnace including vent 955 - 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater 17) Hood served by mechanical exhaust
Vent not included in appliance 445 10.00
permit - 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU _ 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101kto500kBTU - 10.00
15 -30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
mil. BTU _ 5.40
30-50 hp; absorb. unit, 3,400 _ _ -
22) More than 4 =per outlet (each)
1 -1.75 mil. BTU 1.00
>50 hp; absorb. unit, 5,725 - Minimum Permit Fee $72.50 SUBTOTAL: ` :r41 ''' ; :ci
>1.75 mil. BTU t`` '
Air handling unit to 10,000 cfm 656 1 ,, , : , : 7 'f''''' $
0 ,1 $
Air handling unit >10,000 cfm 1,170
8 /o State Surcharge , ..,,. , t .; " ,
Non - portable evaporate cooler 656
TOTAL RESIDENTIAL PERMIT FEE: ` -' •, -,, $
Vent fan connected to a single duct 446 ' .1,` �i',: ,, _!-4
Vent system not included in 656' ',.."„• "
appliance permit
Hood served by mechanical exhaust 656 Other Inspections and Fees:
1,170 1. Inspections outside of normal business hours (minimum charge - two hours)
Domestic incinerator $62.50 per hour.
Commercial Or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge - half hour)
Other unit, including wood stoves, 656 $62.50 per hour
inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum
Gas piping 1 - 4 outlets 360 charge -one -half hour) $62.50 per hour
Each additional outlet 63
- * State Contractor Boiler Certification required for units >200k BTU.
$ * * Residential A/C requires site plan showing placement of unit.
TOTAL COMMERCIAL -v'
-, � z.:; -:
VALUATION: _,
;. All New Commercial Buildings require 2 sets of plans.
is \dsts \formslmech- fees.doc 02/11/02 •
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested a d AM PM BUP
Location / 3 Suite MEC _ . — v7i 3 Z (
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 5 D Lk) ELC
Footing V '
Foundation ELC
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 6
Other:
Final •
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PASS PART FAIL
PLUMBING
0 1)
Post & Beam
Under Slab -
Rough -In
Water Service "
L .
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P FAIL
ECHA�C,�
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PART FAIL
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 Li Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Date / a /` Ins P actor 7 ° Ext
Approach/Sidewalk
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 MST r ` #
INSPECTION DIVISION Business Line: (503) 639 -4171
l BUP
Received Date Requested 3I l' �- AM PM BUP
Location /D 3 C / 3f 1 t f r t Suite MEC (2.: > Z
Contact Person Ph ( ) PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner ■4 . .& ='L! ALL _ - ELC
Footing . I c o — S a 4 7 / D
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain O
Slab Inspection Notes: � • D - 3 3 0 SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing d "f - / iL . .0
Insulation
Drywall Nailing -mil s Aiz%}
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
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
Smoke Dampers
Final
PASS R FAIL
ELECTRI L
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 �l /1
Approach /Sidewalk D G o In s pector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL