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Permit
CITY OF TIGARD MECHANICAL PERMIT Ail DEVELOPMENT SERVICES DATES U 02/23/2001 0066 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134AA 00900 SITE ADDRESS: 11344 SW IRONWOOD LP SUBDIVISION: ENGLEWOOD ZONING: R -4.5 BLOCK: LOT: 016 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: DOMES. INCIN: LPG 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: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 0 Remarks: Install gas furnace. Owner: FEES BREWER, WILLIAM W AND Type By Date Amount Receipt NANCY L PRMT CTR 02/23/20C $72.50 2720010000 11344 SW IRONWOOD LOOP 5PCT CTR 02/23/200 $5.80 2720010000 TIGARD, OR 97223 Total $78.30 Phone: Contractor: JACOBS HEATING +A/C 4474 SE MILWAUKIE AVE PORTLAND, OR 97202 REQUIRED INSPECTIONS Heating Unt Insp Phone: 503 - 234 -7331 Final Inspection Reg #: LIC 1441 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 by calling (503)246 -9189. Issue By: `, j Permittee Signature: (3Ei_E- C. 503 •39 -4175 by 7:00 P.M. for inspections needed the next business day ... , Mechanical Permit Application Date received: ` . 111 0 1 Permit no:: V a 4 4 111., • I � City of Tigard b Project/appl. no.: Expire date: City ofT inIE�� less: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: 2I rL3 D ( B Receipt no.: Phone: (503) 639 -4171 `-. / Fa- : 6 503) 598 -1960 k I " Case file no.: Pa enttype: r FEB 1 Land use approval: Building permit no.: .., t,rtt I nPMEI ( T YPE OF PERMIT 1 & 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 L. L.1 S w .J26Yt zc_)CX +/ Lyo . 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: IBlock: (Subdivision: *See checklist for important application information and Project name: f f f /i a-1- { r e.c.c,)e r jurisdiction's fee schedule for residential permit fee. City /county: j ,„..., I ZIP: 9 74 ' Description and 1 ation of work on premises: -) AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE 1A/Sr)14L -L. G' 45 l'LI ✓rt1 etc ^v Fee(ea.) Total Est. date of completion/inspection: - Description Qty. Res. only Res. only Tenant improvementor change of use: HVAC: Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM space insulated? ❑ Yes ❑ No Air conditioning rati fxi existing plan required) Is existing P Alterati of existi HVAC system . _ ,' MECHANICAL CONTRACTOR Boiler /compressors Business name: -nq coa S ,,V State boiler permit no.: HP Tons BTU /H Address: 2/4/ 24/ S F 4/1 f 1 w G f Fire /smoke dampers /duct smoke detectors City: j a _ fr-( 0;,,,,, p} . I State: 01e- I ZIP: 9 7a [ Z • Heat pump (site plan required) Phone: o ? 1 -/- '233/ I Fax: 2/ `�a5"�''E - mail: Install/replace BTU /H / )y 0 Including ductwork/vent liner ❑ Yes ❑ No CCB no.: ) .4/ di / Y. , InstalUreplace /relocate heaters- suspended, City /metro lic. no.: /a ( wall, or floor mounted Name (please print): SR //e2 E sly r9 Vent for appliance other than furnace CONTACT5PERSON Refrigeration: __ Absorption units BTU/H Name: 3H /%Q e y , SW4 Chillers HP Address: v Compressors HP — Environmental exhaust and ventilation: City: „ I State: I ZIP: Appliance vent Phone: 5-1 Fax: E -mail: Dryer exhaust OWNER Hoods, Type U 11/res. kitchen/hazmat hood fire suppression system Name: Lc) 1 II 1 - --N — I F, r e.. .ue r Exhaust fan with single duct (bath fans) Mailing address: ) 3 c../ L/ s L o 'r' tp- G uccej ,A, t o . Exhaust system apart from heating or AC Fuel piping and distribution (up to 4 outlets) City: T C t A I State: ALI ZIP: 9 70 a�� _ _ (J Type: LPG NG Oil Phone:$ Q / 9 ? Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: • I State: I ZIP: Insert - type Phone: I Fax: I E -mail: Woodstove/pelletstove Other: Applicant's signature: Date: Other: Name (print): . . . _ -. ” _... . Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ ❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $ 7ez/ S- Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $ Expires within 180 days after it has been 5- ir_ Name of cardholder as shown on credit card accepted as complete. State surcharge (8 %) .... $ $ TOTAL $ 7 8- 3�? 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+ . fraction thereof, to and including - 17.40 - $10,000.00. including ducts & vents $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 that,apply:' . Boiler . Heat , Air $1.20 for each additional $100.00 or Foritemsn7- 1.1;.see° or ,Pump . -'Cond , fraction thereof. footnotes below.: • ' Comp • 7) <3HP;absorb unit to 100K BTU 14.00 - ASSUMED VALUATIONS PER APPLIANCE: - I 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 19) Commercial or industrial type incinerator Air handling unit to 10,000 cfm 656 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 hermit - -- . 22) Mere 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 Other unit, including wood stoves, 656 8% State Surcharge $ inserts, etc. Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) - ' "` ' $ Each additional outlet 63 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. ** Residential A/C requires site plan showing placement of unit. is \dsts \forms\mech- fees.doc 10/11/00 C1TY OF TIGARD BUILDING INSPECTION DIVISION / ' u 5 MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 3- / Z- AM PM B LD Location //3 ( 54, 2-L - - - Suite Contact Person A/ c7 SAO / 9 1 5 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 �/�a ,t.e�' �F C1 /Z < T �u r 2 , �e 4c , a 2. .AA-b: / © 77¢3 Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL Post & Beam Under Slab Top Out • Water Service Sanitary Sewer • Rain Drains Final PASS PART FAIL lost & Beam Rough In Gas Line yvn Smoke Damp rs Final SL ART FAIL ELECTRICALS ;,,, Service Rough In . UG /Slab Low Voltage Fire Alarm Final PASS. PART FAIL 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 - y- /2- de Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from job site.