Permit i/
CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2003 -00337
�:IIi 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/19/03
PARCEL: 2S 109AB -09300
SITE ADDRESS: 14226 SW 132ND TERR
SUBDIVISION: RAVEN RIDGE ZONING: R -7
BLOCK: LOT: 022 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: DOMES. INCIN:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Extend ducts and grilles to finish basement.
Owner: FEES
MARC MOORE Description Date Amount
14226 SW 132ND TERR
TIGARD, OR 97224 [MECH] Permit Fee 6/19/03 $72.50
[TAX] 8% StateTax 6/19/03 $5.80
Phone: Total $78.30
Contractor:
RITE -WAY HEATING + A/C INC
PO BOX 1815
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Duct Inspection
Final Inspection
Reg #: LIC 00071242
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 -00
I
Issue By: � ,!zaiLL. A _ 1 ' Permittee Signature: •
Call (503) •39 -4175 by 7:00 P.M. for inspections needed the next business day
•
Mechanical Permit Application / OFFICE USE ONLY
Received // Mechanical , /
Y
Date/By: / 9 03 Permit No.: // f e a 0 0 3 - . 0 0 3 5 7
Cit o f Ti and Planning Approval Building
Y g Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By; • Permit No.:
Phone: 503- 639 -4171 Fax: 503-598-1960 Land Use
Internet: www.ci.ti ard.or.us
g _ �� d'l +la Co Case No.:
Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
�:�, :,� �..�,,��� . acv � -�- �,; :��•,� , a -
gralk.�. tai TAI'PE°tOF WORK . LVP- - !:' -,_ ° - ._ ,: fix' $, COMIYIEg7C4 EEE* SCHEOUa5110SE,CHECiOIST ?.
❑ w 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
tf : CATEGORYuOF CONSTRUUCTION 4 »«•- mechanical materials, equipment, labor, overhead and profit.
1 & 2- Family dwelling ❑ Commercial /Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building El Multi- Family °" SIDENT1AIsEQUIMFNT /SYSTEMS FEE SCHEDULE
El Master Builder ❑ Other: oh 1
Description Qty Fee(ea.) Total
JOBANITK conditioning** .. , *! s; _ .. L
® _ INF,ORMA�TION and4I�OC�A�'ION°��_ .`�,' "�,� Furnace - add air 14.00
Job site address: /40.26 54) ( 4 7err- Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name: HOOr'e RPSiG(e/1ll�i Hydronic hot water system 14.00
Residential
Cross street/Directions to job site: (for radiator boiler
(for or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) • 10.00
Subdivision: Lot #: Repair units 12.15
Tax map /parcel #:
F::-.4.,, : :: _" -, , t 0ihei-4Euei ":Appli -',.e _;. -,, : . .
Water heater 10.00
, i °' iNDES.CRIPTION"OF W.ORIZ4 ;; ° .. ,,,, , I :I Gas fireplace 10.00
P fl ki J / y Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
1 � Wood/Pellet stove 10.00
t X Te.o - c e-TS y P Z S Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
PRQ .Y.VAM n;„ ,,, { TENANT ' - `M Other: 10.00
V` `` W �` iEnvironmental EihiuitiBci =Ve iilati
iiiiiV a
Name: ' ` ' `.,-� _
Address: Range hood/other kitchen equipment 10.00
City /State /Zip: Clothes dryer exhaust 10.00
Single duct exhaust
Ph e Fax (bathrooms, toilet compartments,
A PRLtewty- i 'Mtie • tCQN,VACTTPERSON M utility rooms) 6.80
Name: i cie a c, foe_ ( art`s e Attic/crawl space fans 10.00
Address: &Igo SL() ett S 1n _ dl . Other: 10.00
City /State /Zip: 7?- and 0� 9 7ZZ3 * *($5.40 for 4, $1.00 each additional)
Phone: ‘--E/3) 3o 7 —7 /t 1 Fax: 3) .s'7 x'777 Furnace, etc. **
Gas heat pump **
E -mail: Wall/suspended/unit heater **
Asa ; VS;Mn 'ECONTRACT®RZ. w. ..., ,,, _ .- ' ,,: 1 Water heater **
Business Name: R; - gefet'1" ` Fireplace **
Address: e®, o , !$ ** - Range
BBQ **
City /State /Zip: yt/( hero / og 97123 Clothes dryer (gas) **
Phone: 503)13 _ 3 / 6 / Fax: ,t-o3) 693 - 6238 Other: **
CCB Lic. #: 7/. Z d-I 9.'6 (p ti Total:
uthor. ' ;' • _ ". .Meehan elif Fees* -. -- ''' .
ignature: I. �� , Date (7 ( Subtotal: $
�� w Minimum Permit Fee $72.50 $ 79, . 5 U
r S .LC• Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $ -. qU
TOTAL PERMIT FEE $ - g . 50
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.
is \Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule: -
$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 $100.00 or
fraction thereof.
, As:§pinpcf:Valugtmn$TOAPPli40e;M;:
Value Total
Description: Qty (Ea) Amount
Fumace to 100,000 BTU, including 955
ducts & vents
Fumace > 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:
i:\Dsts\Permit Forms \MecPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested t i?'" 01 AM PM BUP
Location I 22, 3;--)14S — 77 - Ai Suite `3 66 337
Contact Person Ph ( ) 3 6- 7/(7 A ar 3 - 00 d--7
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 00 370
Footing ELC
Foundation Access: �- /
Ftg Drain
Crawl Drain / e' 3 — Q C / ` l
`"� �l > �-'t
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
Other:
Final
PASS RT FAIL
UMBIN
Post & Beam
_ Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
O ther::
'ART FAIL
NI L
-- -m
Rough-In
Gas Line
Smoke Dampers
Ina
(0 PART FAIL
RI Q
Service
Rough -In
UG /Slab
`Cow Volte f'
Fire
iL.
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S ❑ Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line.
ADA 9/2 7/0 3
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL