Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2001 -00228
- 13125 SW Hall Blvd., Tigard, OR 97223 (50 639 -4171 DATE ISSUED: 6/22/01
PARCEL: 2S1 12 D B -00300
SITE ADDRESS: 07257 SW KABLE LN 300
SUBDIVISION: SOUTHERN PACIFIC TIGARD IND. ZONING: I -L
BLOCK: LOT: 005 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B 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: 2 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 2 OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 2
Remarks: Install (2) new NC units and relocate existing duct work
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 6/22/01 $160.55 2720010000
PORTLAND, OR 97224 PLCK CTR 6/22/01 $40.14 2720010000
5PCT CTR 6/22/01 $12.84 2720010000
Phone: Total $213.53
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON
STE 1 REQUIRED INSPECTIONS
PORTLAND, OR 97202
Gas Line Insp
Phone: 239 -4600 Mechanical Insp
Reg #: LIC 33135 Duct Inspection
S.D. Shut -down inspection
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 by calling (503)246 -9189.
Issue By: Permittee Signature: " f"--
lSiv
Ca 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
D``/v
Mechanical Permit Application
Date received: (p —, / --Q i Permi .. ejeI —aAZZg
A .
A,L :,•� �� City of Ti
Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Paymenttype:
ti.• �Clu,i �
Land use approval: Building perml� o.: — J Z
TYPE OF PERMIT
Cl 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: 72 g7 S(„J ' j 1 1_,,, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: ( Suite no.: 300 00 value of all mec ical materialsequipment, labor, overhead,
profit. Value $ �S C aw,
Tax map /tax lot/account no.: , '
Lot: IBlock: I Subdivision: *See checklist for important application information and
Project name: - 1-,-,.„ Cj cr, jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: .1",..s .II (A) AND COMMERICAL /INDUSTRIAL.EQUIPMENTSCHEDULE
v.eo„1 iP,- /L. v..:.i 4 rr.loc eY avt,ll^,otl< Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
space heated or conditioned? W'Yes ❑ N Air handling unit CFM
Is existing p Air conditioning (site plan required)
Is existing space insulated? "Yes ❑ No Alteration of existing HVAC system
MECHANICAL CONTRACTOR ' Boiler /compressors
Business name: ( un et :c e t} .. c Ak r.A State boiler permit no.:
HP Tons BTU /H
Address: a S S (, i _t_a - Fire /smoke dampers /duct smoke detectors
City: Ao t- kc„.. e I State:UQ I ZIP: 17 g..cia Heat pump (site plan required)
Phone: a3..- 4,(D00 I Fax: alik- 7o't( E -mail: InstalUreplacefurnace/burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: j 313 Install/replace/relocate heaters — suspended,
City /metro lic. no.: lt'i wall, or floor mounted
Name (please print): 2 t ;,., Sl,.e c.• Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: l . s r�,n S�ec� Chillers HP
Compressors HP
Address: t33 q S E (,t.0.
Cit y: Poz` \� I �� I ZIP: Environmental exhaust and ventilation:
aA State: : A liancevent
Phone: Fax: E - mail: Dryer exhaust
OWNER Hoods, Type I/ II/res. kitchen/hazmat
hood fire suppression system
Name: Y r ,c_ I c c34 Exhaust fan with single duct (bath fans)
Mailing p 1<.W 5 ,,,, S op Exhaust system apart from heating or AC
g address: ��i 3S(� 5� S . Fuel piping and distribution (up to 4 outlets)
City: Q 0 t`M. c . e., State: IZI Type: LPG NG Oil
Phone: Cia. 4- ',`30 e Fax: 111.-110 t E - mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: • I State: I ZIP: Insert — type
• - . - •: I Fax: I E -mail: Woodstovc/pellet stove
Other: _
, Applic : nt's signature. 0. „ I Date: — Other:
- - -- l y
Name 1• riot): p ic • A_
all j sdictions ac t credit cards, please call jurisdiction for more information Permit fee $ r _ 0 - S
ptC
❑Visa ❑MasterCard Notice: "This permit application Minimum fee $
Credit card number: / / e xp i re s if a permit is not obtained 0.
Plan review (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ 1 •
Name of cardholder as shown on credit card accepted as complete.
. $ TOTAL $
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
$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
4 $1.54 for each additional $100.00 or including vent
4) 14.00
' Qj fraction thereof, to and including 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,that.apply;; Boiler . _ -Heat'' - .Air .
$1.20 for each additional $100.00 or , For items`7 -11 see < or • , - F•ump, Cond
fraction thereof. footnotes.below. , {, •r ' 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 19) Commercial or industrial type incinerator r
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 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 . '�`'•
Other unit, including wood stoves, 656 8% State Surcharge A;'Y_ -; ' :' $
inserts, etc. . _, -
Gas piping 1-4 outlets a 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only :,,, --
TOTAL COMMERCIAL " ` • $ . TOTAL RESIDENTIAL PERMIT FEE: - - n ¢'-. $
VALUATION: _
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
tt4 ytt. /7 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
1 * 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 .