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Permit
CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2001 -00147 :4441111 DEVELOPMENT SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/7/01 PARCEL: 2S111 CB -01708 SITE ADDRESS: 10260 SW HOODVIEW DR SUBDIVISION: HOOD VIEW ZONING: R - 3.5 BLOCK: LOT: 007 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: GAS 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: 1 Remarks: Gas fireplace insert Owner: • FEES JOE SHACK Type By Date Amount Receipt 10260 SW HOODVIEW DR PRMT CTR 5/7/01 $72.50 2720010000 TIGARD, OR 97223 5PCT CTR 5/7/01 $5.80 2720010000 Total $78.30 Phone: 503 - 224 - 2755 Contractor: PACIFIC GAS WORKS PO BOX 30646 PORTLAND, OR 97294 REQUIRED INSPECTIONS Gas Line Insp Phone: 503 - 317 -5573 Mechanical Insp Reg #: LIC 136391 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 questions to OUNC • callin. )246 -9189. Issue By: Permittee Si gnat Call (`503) 639 -4175 by 7:00 P.M. for inspectionsAKIed the next business day '•Mechanical Permit Application Date received: S 7 - 1 Permit no a00/ / `f7 ,,�j; ,-..� �, City of Tigard Project/appl. no.: Expire date: City of Tigard 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 _& 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 :A5d?e /�/ ,.4 �j / ./.9/0,.. 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: I Subdivision: *See checklist for important application information and Project name: 4 3lock: ,� jurisdiction's fee schedule for residential permit fee. City / county: 7, �� �'3� ZIP: 9'70. 27 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description andr.'ocation of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE 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? CI Yes ❑ No Air handling unit CFM space insulated? ❑ Yes ❑ No Air conditioning rati fxi existing HVAC C system Is existing P Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: 7 Z/' /E�c State boiler permit no.: AF, C S HP Tons BTU /H Address: X j 1-`", Fire/smoke dampers /duct smoke detectors City: �y?" I Stal ZIP: 7.;:?Q9.- Heat pump (site plan required) Phon : � - 1-`m ax: 1E-mail: Install/replace furnace/burner BTU /H Including ductwork/vent liner ❑ Yes ❑ No CCB no.: /g6 3 ? " Install/replace/relocate heaters- suspended, City /metro lic. no.: wall, or floor mounted Name (please print): er -.C/,,, :""f"—T---- Vent for appliance other than furnace CONTACT PERSON ' elrigeration. Absorption units BTU/H Name: 541P7 , Chillers HP Address: /0 © /Ap,2 .�� Compressors HP Environmental exhaust and ventilation: City: 7 7,0 I State: ZIP: -'7. Appliance vent Phone: 6 07 Fax: E -mail: Dryer exhaust - OWNER Hoods, Type U II/res. kitchen/hazmat hood fire suppression system Name: �e,f= .X/ .e Exhaust fan with single duct (bath fans) Mailing address: Exhaust system apart from heating or AC City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets) Type: LPG sr NG Oil / Phone: Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Name: Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert - type l Phone: 1 Fax: 1 E -mail: Woodstove/pellet stove Other: Applicant's si_• . I Date : 5_7 -C7 ( Other: Name (.: 'Not all juri - • - ept cr edit cards, please call jurisdiction for more.information Permit fee $ 7 5 ❑ Visa • asterCard 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 %) .... $ Jam, gv Name of cardholder as shown on credit card accepted as complete. TOTAL $ _ - 7 ? Cardholder signature Amount , 440-4617 (6/00 /COM) • MECHANICAL PERMIT FEES ( 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+ $10,000.00. fraction thereof, to and including 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 ' gall that apply :.. , ,'Boiler . Heat Air .: $1.20 for each additional $100.00 or - For'iterns 7- 11,see or'. _ Pumps 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 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 Air handling unit to 10,000 cfm 656 19) Commercial or industrial type incinerator 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: ' $ Commercial or industrial incinerator 4,590 , s Other unit, including wood stoves, 656 8% State Surcharge , , , , ' • 'f -; $ inserts, etc. Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) ' , "., $ Each additional outlet fi Required for ALL commercial permits only TOTAL COMMERCIAL $ . TOTAL RESIDENTIAL PERMIT FEE: ^ $ VALUATION: 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. * A/C requires site plan showing placement of unit. is \dsts \forms\mech - fees.doc 10/11/00 . -G P . CITY OF TIGARD BUILDING INSPECTION DIVISION "' • =- 24 -Hour Inspection Line: 639 -4175 Business Line: 639 =4171 MST BUP Date Requested 5— 8 AM PM BLD Location / b 2 6 # 17v- Suite MEC -Sot-60 /4' 7 Contact Person Ph ` 6 7--/ �r� PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation - Drywall Nailing 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 - Post & Beam - Rough In Co y f;r� Gas Line ,� PP p �� Smoke Dampers p" 4 u fin- • • C .a PART FAIL ELECTRICAL 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 5 - 7 - 8 Inspector . , Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.