Permit CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2002 -00150
„� � DEVELOPMENT H BMEN9 Tigard, ) 639 -4171 DATE ISSUED: 4/16/02
PARCEL: 1 S135DD -05000
SITE ADDRESS: 11981 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: UNK 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Replace existing oil furnace with new gas furnace
Owner: FEES
DREW ADVANCED AUTOMOTIVE Type By Date Amount Receipt
11981 SW PACIFIC HWY 5PCT CTR 4/16/02 $5.80 2720020000
TIGARD, OR 97223 PRMT CTR 4/16/02 $72.50 2720020000
Total $78.30
Phone: 503 - 635 -4786
Contractor:
COLUMBIA HEATING + COOLING INC
8900 SW BURNHAM
TIGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 624 -2704 Mechanical Insp
Reg #: LIC 76359 Final Inspection
PLM 34 -175
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- 1 -0080. YokJ may obt -in copies of these rules or direct questions to OUNC by calling
(gin. 19AR -U 1 RA
•
Iss e By: , �j : ;I� _/ i _ � Permittee Signature:��_ �.
— Call (503) • 94175 by 7:00 P.M. for inspections needed the next business day Of
•
( Mechanical Permit Application
Date received: v 1 6 el 9-- Permitno.: -x /30
=x,,V1J1 City of Tigard Project/appl.no.: ' edate:
City ojTigard Addre�: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: I Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF P 'RMIT
❑ 1 & 2 family dwelling or accessory Commercial/industrial 0 Multi - family ❑ Tenant improvement
❑ New construction ' Addition/alteration /replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: //98/ 5 (,) pa _ I Pc Hwy 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 $ 2 .
Lot: (Block: ISubdivision: *See checklist for important application information and
Project name: jurisdiction's fec schedule for residential permit fee.
City /county: -77, -, rd I ZIP: 97 z 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and !location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE
((Q I Cori , .(r v\ Ca r 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? ❑ Yes 0 No Air handling unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
NI Ed IAN I CAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: Col (A w,blA a+i 4- Cool■ v, c-\ HP Tons BTU /H
Address: X3900 SvO ?li. r in VIA h^- p Fire/smoke dampers/duct smoke detectors
City: `T 0 ra k I State: OA. I ZIP: 9 7 22. 3 Heat pump site plan required)
Phone: tag - z U I Fax: _ E - mail: Install/ place furnbe /burner foouvBTU /H r
Including ductwork/vent liner i(Yes 0 No 1
CCB no.: 7(o3S c ) Install/replace/relocate heaters - suspended,
City /metro lic. no.: 12 2 wall, or floor mounted
Name (please print): M i Choc I I-101 c h cr Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
ff Absorption units BTU/H
Name: l) -k/,l T lJOV�j 'Ie (fi Chillers HP
Address: I/ I Comyressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: (o2tI - 27(4 Fax: E -mail: Dryer exhaust
OWNER Hoods, Type 1/I1/res. kitchen/hazmat
/� hood fire suppression system
Name: Kt. LA) p-+ �(/Ay ccG{ 4,4 ,t, o- v P Exhaust fan with single duct (bath fans)
Mailing address: 11 9 e 1 5E Pet c, -Fi C- i- w Exhaust system apart from heating or AC
Y Fuel piping and distribution (up to 4 outlets) I
City: a col I State: 0►2 I ZIP: 9 7 2,23 Type: LPG NG Oil
Phone: ;5 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: ( ) , 1E-mail: Woodstove/pellet stove
Other:
Applicant's signature: . I Date: /p /,3,,,'/ e i ce:
Name (print): �,�. 7) / 1 1 .
Not all jurisdictiaas accept credit cards, Please Call jurisdicuoa for more information.'
Mini t fee $ �� Jv
O Visa ❑ MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at % ) $
Credit card number: Exp' (
Expires 180 days after it has been 5 . gU
Name of cardholder as shown on credit card accepted as complete. State Surcharge (8 %) .... $
. $ TOTAL $ 7 k . 5
Cardholder signature Amount 440 -4617 (6&00/COM)
%
•
MECHANICAL PERMIT FEES
COMMERCIAL FEE 'SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code OtY (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 indudin' 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
$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 all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond
fraction thereof. footnotes below. Com
Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit
to 100K BTU 14.00
8% State Surcharge $ 8) 3 -15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb 35.00
Required for ALL commercial permits only unit . 1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU
11) >50HP; absorb
unit >1.75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12) Air handling unit to 10,000 CFM 10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) Amount 17.20
Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct
ducts & vents 6.80
Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater 17) Hood served by mechanical exhaust
Vent not included in applicance 445 10.00
permit 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101 k to 500k BTU 10.00
15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
mil. BTU 5.40
30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each)
1 -1.75 mil. BTU 1.00
>50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656 8% State Surcharge $
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not included in 656
appliance permit
Hood served by mechanical exhaust 656 Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge - two hours)
Domestic incinerator 1,170 $62.50 per hour.
Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge - half hour)
Other unit, including wood stoves, 656 • $82.50 per hour
inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum
Gas piping 1 - 4 outlets 360 charge -one -half hour) $62.50 per hour
Each additional outlet • 63 * State Contractor Boiler Certification required for units >200k BTU.
TOTAL COMMERCIAL $ `*Residential A/C requires site plan showing placement of unit.
VALUATION:. . . All New Commercial Buildings require 2 sets of plans.
I:\dsts'forms\rnech- fees.doc 12/26/01
CITY OF TIGARD ur S- U
BUILDING In ction Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received ? p Date Re uested AM PM BUP
Location c 9 0 ( Suite MEC . - DO ( Z
Contact Person G�m- Ph ( ) Ci c)-7C7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation cce s:
Ftg 4/� pi O V I y tit ELR
Drain
Crawl Drain
Slab Inspec n Notes: Y SIT
Post & Beam ► ' l�
Shear Anchors
Ext Sheath/Shear AgJ
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm ( c 3 6 6 1
Susp'd Ceiling
Roof
Other:
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
P FAIL
ECHAN
Post & Beam
Rough -In
Gas Line
o m ke Dampers
SS ART FAIL (-0
TRICAL
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 Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line z/
ADA J �j
Approach/Sidewalk Date ( l ►J - Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION QIVISION Business Line:. (5031639 -4171 MST
BUP
/
Received O Date Re uested / AM PM B' -/V) d - t } b/ �'1'q
Location / 11' l� ( Suite MEC ? — mod /
Contact Person AZ Ph ( ) 6 c LF a"7' T PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access: �\ m
Ftg Drain U ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam ✓ � 2& L� /,2 _ � 9
Shear Anchors ((//
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing 61)df---eic Firewall /„ [ /} e �j Fire Sprinkler f ' v �Y
Fire Alarm
•
Susp'd Ceiling
Roof
If %��/ ..- lam? #./
Other: _
Final i - -
PASS PART FAIL /
PLUMBING AI
Post & Beam �2 / �� // t /_, '--->:, _.M Under Slab
Rough -In / /_ ,
i I /� ; - 1 . '
Water Service , ! f -�/ �� I�
Sanitary Sewer
Rain Drains 4.111,,4 , �,' `,
i
Catch Basin / Manhole /
Storm Drain / -
Shower Pan - f, _.•• / .1 � �� / / __ _ � '
•ASS PART FAIL -
MECHANICAL
Post & Beam
Rough -In i
Gas D
Smoke Dam s
GIs
,� PART FAIL
�CTRICAL � / .* IK
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 ❑ Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA �y�
Approach/Sidewalk Date WC/O Inspector r / �� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL