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Permit :r C ITY OF TIGARD MECHANICAL PERMIT *0'x, DEVELOPMENT SERVICES PERMIT #: MEC2003 -00450 C' I I 13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/31/03 PARCEL: 2S 103AC -01700 SITE ADDRESS: 11180 SW FONNER ST SUBDIVISION: ZONING: R -4.5 BLOCK: LOT: 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: 0 VENT SYSTEMS: 1 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: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Extend exhaust duct over range. Owner: FEES SCHULTHEIS, ERIC D + Description Date Amount 11180 SW FONNER ST TIGARD, OR 97223 [MECH] Permit Fee 7/31/03 $72.50 [TAX] 8% StateTax 7/31/03 $5.80 Phone: 503 - 620 - 1605 Total $78.30 Contractor: OWNER REQUIRED INSPECTIONS Phone: Mechanical Insp Duct Inspection Reg #: 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 -00 Issued By: Permittee Signature: ,k 471 % °12,,(1/7//i.._ Call (503) 639 -4175 by 7 :00 P.M. for inspections needed the nex business day Mechaiacal Permit Application FOR OFFICE USE ONLY • -• . -. ' Received ��ee rrnn Mechanical ® Date/By/ 3) - Q t) 1'j Permit No.� D3• CV `,tr �� Planning Approval Building City of Tigard ��� Date/By: Permit No.: 13125 SW Hall Blvd. J ' 1 , Plan Review Other Tigard, Oregon 97223 Date/By: PermitNo.• Phone: 503- 639 -4171 Fax: 503-598-1960 ,--N Post Land Use / u �, .G B Date/By Case No.: Internet: www.ci.tigard.or.us (■ ��11 ' 1ISIOt a Contact Juns : ' ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 F j ` � • ..- " 'i- Name/Method ' I (L) Supplemental Information. k. , ,'. . 66:66. k'lWrt "OF' WORjM :. 7 '° ,giVf _ ' - i,- * :— CbMMERcf./a4FEE Oc EDULE = USE ;CAEGKLIST :% ?4 ❑ 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 14 ., :.,e CATEGORY'OF CONS MT* ON a i As' `, '4 .' mechanical materials, equipment, labor, overhead and profit. W1 & 2- Family dwelling ❑ Commercial /Industrial value: $ See Page 2 for Fee Schedule ; ;; RESIDENTIAL EQUIPMENT /SYSTE1VIStFEVISCHEDUL 0,: Accessory Building 111 Multi Family Description I Qty Fee(ea.) Total ❑ Master Builder ❑ Other: , ' : , , , , , ; Heating/cooniig ;_ . ,:. ;-;,;:,,,:= -, `` i OB ° SITE 4 INEORM TIONsand `LOCATION : 66 a66 Furnace - add -on air conditioning ** 14.00 Job site address: ( (( v O S LA) 7ry1 ruy) Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 Project Name: Hydronic hot water system 14.00 Residential boiler Cross street/Directions to job site: (or radiator or hydronic system) 14.00 / l ■O — W ( /i � r � , , y9 _ �� Unit heaters (fuel, not electric) I / (�� (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) 10.00 Lot #: Repair units 12.15 Subdivision: r .Oth ;Applianc - ,.. -, ,441!::..a'::', . Tax map /parcel #: Water heater 10.00 tr:,W'�„*:;DESCRIP€TI®N °'OF WORK '° =aid :�=�,_ -6 666 4°:166 Gas fireplace 10.00 jnJ to . i f,� p iJ 1 ( J- . Flue vent (water heater /gas fireplace) 10.00 ` .)4(1-7 Log lighter (gas) 10.00 Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 `, P,- ROPERTYK O. ° ; / rf.° i- ,J:14! Other: 10.00 WNE12.'.� °• ° ,:P °. �T >;�• Name: £t l ✓ 4 /t i L, e (o i (- / 1L( ( l - j44.1 '�- ' `"`t: En`- v` iionmentahEztiiusi " &lientilationl` A, ',, Range hood/other kitchen equipment i 10.00 Address: j / / ao cW,rc,eil Clothes dryer exhaust 10.00 City /State /Zip: T a r( o, Z -zi Single duct exhaust Phone: SO 3 - eo - 2,c1, (, 01" Fax: (bathrooms, toilet compartments, , PPLIC :ANT ir:'': "•; ':;` ` -1 D .CONTACT.PERSON;; '', •;_ utility rooms) 6.80 Name: (-08 :0 eil Tc__0 (,(,( 'I[I,?S Attic /crawl space fans 10.00 Other: 10.00 Add ress: . ..1 ,.. '°:'.,- Fuel Pipin r. `::. , g,- 7, -A , , , City /State /Zip: � j ' V L" -'' I * *($5.40 for first 4, $1.00 each additional) Furnace, etc. ** Phone: Fa Gas heat pump ** E-mail: Wall /suspended/unit heater ** iP. 7:3 *; = = . " 70:0NT$A "CT Ai; Ti,...--, libtriA Water heater ** Business Name: 0 Lejvk Fireplace ** Address: Range ** BBQ ** City /State /Zip: Clothes dryer (gas) ** Phone: Fax: Other: ** CCB Lie. #: Total: . , -. , _ - - Mechanical '�Peemit *$ " ":° -z. f Authorized j� / 3 i u Subtotal: $ Signature: fi Date: 1 Minimum Permit Fee $72.50 $ 7,. '-; ) (ol , C. , errt 5e ud ', 6( j• Plan Review Fee (25% of Permit Fee) $ (Please print name) State Surcharge (8% of Permit Fee) $ 6.. g TOTAL PERMIT FEE $ 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: $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 Valuations fPer . ppliance 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 I 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: PA 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 10' Date Request d ( AM PM BUP Location /7(5 1c�� -- Suite MEC 3-004/5 Contact Person .�'C�G� Ph ( ) 624 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing 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 c Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 4 ` 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 PAS PART FAIL ANI L Post & Beam Rough -In Gas Line Smoke Dampers PART FAIL ` RICAL 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 reinspe• ion RE: - Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date G Inspecto • 481b _ Ext Other: Final DO NOT REMOVE this inspection recor , from ob site. PASS PART FAIL @..9© 0 @ VG ®9 B @J c- a - I1v1.11 BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST gg BUP Received Date Requested �l '. -S AM PM — BUP Location / r I Ed -.St - Suite Iirra 3 —0 d 4 2 1 5 - 0 Contact Person Ph ( ) LM ' 2 d ' ; - T - 7 Contractor Ph ( ) SWR BUILDING Tenant/Owner ?` cf -- jc, 0.5 -0 C/ 61 Footing Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors ExtSheath/Shear _-___._ ..___ .._ ________ __________ _.__ ______________ .- ...___.._____ .___________ Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler ! ` -/ S 4 g ` / �. ` -,, K Cc ' (/ Fire Alarm Susp'd Ceiling Roof ie� Other: i � � G6� _ / �` S % � � / , Final PASS—PART FAIL CUMBIf�'9) 1 (-- /)r 7-11X5 7 C ' , X[1 f✓ a / Post & Beam Under Slab , In„-{' C' /� q J r-=--(:, r-=--(:, 4– ice Pp../p-'4 � / Sanitary Sewer Rain Drains Catch Basin / Manhole C7 // 1Jc /— lC Storm Drain ' Shower Pan 4 0 , 1 : - T FAIL P u h -In t// Bea v� A ' y Gas me �J' \ f Smoke Dampers , f 4�` - PART FAIL ? ��� , l f j CT' ( Servic- ' • Ci 4 f `�," - �vP!is 'y' J� 7 i. \ i o 1 ' ') ry A larm% `' v t"� ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. gi •T FAIL S ❑ Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line L 5� /� ADA Approach /Sidewalk Date ` , hhSpeeto l xt Other: Final ®,I. N 1 T REMOVE tIge hmpect oa lrec© flf"' the 2;,,h site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503)'639 -4i75 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP I Received Date Requested 'a AM PM 1 BUP Location / / ( 86 -2 Suite Contact Person Ph ( ) V LM 1--- c2 d .;77_ Contractor Ph ( ) SWR � BUILDING Tenant/Owner a 6 L{-- i ( 05 op -3 - c / G 0 7 l Footing 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 -l�P/S he 9 // V 2 /l Ccp ( 7 Fire Sprinkler Fire Alarm '� Susp'd Ceiling /� Roof EL o /' `f 5 % Ct t7 (j v , . Other: Final PASS T FAIL .UMBI$ „ F /- TL / 5 _ r(' , v /-1 Post & ffeam Under Slab - In e `, �(UUU / " 0 / y /�C? 2 Water ervic l Sanitary Sewer Rain Drains Catch Basin / Manhole c7 // Lev fie.- /C ..: Storm Drain Shower Pan Oth- : N ilk • ' T FAIL '"'L P • Beam 11 c� Q, -k / u h -In - P , ,�-� Gas ine y f Smoke Dampers /I/ 4 ,'/Ader Y C° 'S ti PART FAIL # (; - Servic - ti U.T 4 i • oltage � 6 - Alarm "� � 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. T"- -T FAIL S I t , ❑ Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA � j r Approach /Sidewalk Date ✓ I z,57 J� Inspector - Ext Other: • Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL