Permit r I CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00377
All DATE ISSUED: 7/3/03
13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135DD-00800
SITE ADDRESS: 11847 SW PACIFIC HWY
SUBDIVISION: HOFFARBER TRACTS NO.2 ZONING: C -G
BLOCK: LOT: 022 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2
OCCUPANCY GRP: A3 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: 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:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of (2) vent fans in bathrooms.
Owner: FEES
SANOKEE Description Date Amount
375 NW GILMAN BLVD STE C -203
ISSAQUAH, WA 98027 [MECH] Permit Fee 7/3/03 $72.50
[TAX] 8% StateTax 7/3/03 $5.80
Phone: 425 391 - 0570 Total $78.30
Contractor:
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£A d-
REQUIRED INSPECTIONS
Phone: Mechanical lnsp
Final Inspection
Reg #:
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
Iss ed By: , A / Permittee Signature:
- Call (50 639 -4175 by 7:00 P.M. for inspections neede the next business day
Mechanical Permit Application FOR OFFICE USE ONLY
p Received O Z Mechanical v im„ ^,�2_ 377
�'� DDate/By: ✓ Permit No.: / l u-C7 , ✓ /
City of Tigard Planning App oval Building
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 /�a�u si � Post - Review Land Use
Internet: www.ci.tigard.or.us ■ U el I � Date/By: Case No.:
Contact Juris.: ® See Page 2 for
^
24 -hour Inspection Request: 503- 639 - 4175 " ' Name/Method: Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ 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
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling ® Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi - Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description 1 Qty 1 Fee(ea.) 1 Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: (\ S4 SW ?ACs i io Ttvrf` � Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
ft AU, m.39 µw111 Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
4. Flue /vent (for any of above) 10.00
H oc i pl r e r T g cI5I L ot # : °�.' Re units 12.15
Subdivision: Other Fuel Appliances
Tax map /parcel #: IS 1_1,5 DD — 0 0T0O Water heater 10.00
�+
DESCRIPTION OF WORK Gas fireplace 10.00
E ` M S} FANS iN c•GO ntS Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
❑ PROPERTY OWNER I 0 TENANT Other: 10.00
Name: neA'1rTJtitJ �7C t' Environmental Exhaust & Ventilation
S Range hood/other kitchen equipment 10.00
Address: I OS 7 S W kcArrrc.. -6.0 Clothes dryer exhaust 10.00
City /State /Zip: T gAr j o4Z q7 Single duct exhaust
Phone: X03 - Jji 3 Fax: (bathrooms, toilet compartments, nn
[� APPLICANT ❑ CONTACT PERSON utility rooms) v---- 6.80
Name: G.ej Sktes Attic /crawl space fans 10.00
Other: 10.00
Address: Fuel Piping
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Furnace, etc. **
Phone: Fax: Gas heat pump **
E -mail: Wall/suspended/unit heater **
CONTRACTOR Water heater **
Business Name: - 4—A..)
Fireplace **
Address: BBQ **
City/State /Zip: Clothes dryer (gas) **
Phone: Fax: Other: **
CCB Lic. #: Total: ,
Mechanical Permit Fees* •
Authorized ^ Subtotal: $
Signature: �� Date: /-1-03 Subtotal:
Permit Fee $72.50 $ "2 9. 450
Greve sL l le S Plan Review Fee (25% of Permit Fee) $
T (Please print name) State Surcharge (8% of Permit Fee) $ 5 a V)
TOTAL PERMIT FEE $ 7 8 , `'I 0
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.
iADsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
ti •
Commercial Fee Schedule: -
Total Valuation: Permit Fee:
$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 Per Appliance: .; ,,1 ..��
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955 1' '
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents • 4 I} • - f
Floor furnace including vent 955
Suspended heater, wall heater or floor 955 • ; J;
mounted heater
•
Vent not included in appliance permit 445 •,. • 4 11'/: • ] • ' ` + t 't • • •
t .
Repair units 805 '•'� _ ; ;.:• •
< 3 hp; absorb. unit, 955
to 100k BTU • ; •
3 -l5 hp; absorb. unit, 1,700 s.' • ..•i p.: '3; •
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 # • o
Air handling unit to 10,000 cfm 656 ; r•
Air handling unit >10,000 cfm 1,170 • i • '
N on - portable evaporate cooler 656 i • ? ' ,t , t ,+ •
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:
•
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i:\DstsPPermit Forms\MecPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION :+ Business Line: (503) 639'4171 MST p
BUP :7) —DdaO 7
Received Date Requested 74 I AM PM BUP
Location /( � 'T Suite MEC 3 - 0° 3 77
Contact Person .�i►1� Ph ( ) 4N3 363(- PLM
Con Ph ( ) SWR
ILDI Tenant/Owner K ELC
° ELC
Foundation 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
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Ana
S PART FAIL
PL MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P' • :T FAIL
� �'t: cam
Rough -In
Gas Line
. Smoke Dampers
na7
. PART FAIL
7 RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay - C' II, 13125 SW Hall Blvd.
PASS PART FAIL
Please call for reinspection RE: =;;_ e to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7/
i/ O 3 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL