Permit CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2001 -00364
13125 �I�� DEVELOPMENT H O BMENg Tigard, R 9 SERVICES
639 -4171 DATE ISSUED: 10/17/01
PARCEL: 2 S 102 B D -02600
SITE ADDRESS: 12965 SW PACIFIC HWY
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT: 037 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: 1
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 bathroom exhaust duct.
Owner: FEES
KIM, ROBERT + HAE LIM Type By Date Amount Receipt
1360 SW WOODWARD WAY PRMT CTR 10/17/01 $72.50 2720010000
PORTLAND, OR 97225 5PCT CTR 10/17/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
SONSHINE PRODUCTS. INC.
8596 SW DAKOTA DR.
TUALATIN, OR 97223 REQUIRED INSPECTIONS
Duct Inspection
Phone: 503 - 885 -0997 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 -0010 rough OA'4
952 - 001 -0080. You may obtain copies of these rules or direct questio o UNC by
(fl 94F -q1
Issue By: ` 4 „, j , Permittee Signature y✓ ' `Z Q
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
j ih, Date received: �� Permit no.:Pnerjety
'..� i! City of Tigard Projecdappl. no.: Expire date:
City of Tigard Add 13125 SW Hall Blvd, Ti ard, O 223 Date issued: By:f45 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 0 Tenant improvement
0 New construction —41 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: (29 S s V � . • /kc i r‘ l'f'w..k Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: ic/ I Suite no.: AVA value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ •
Lot: Block: I Subdivision: *See checklist for important application information and
Project name: 4wA ; CA's CA-S )-} co S jurisdiction's fee schedule for residential permit fee.
City /county: "ri- d..6,Lb I ZIP: 9122 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: iti S 1 � - ` AND COMMERICAL /INDUSTRIAL EQUIPMENT SCHEDULE
V to o>� F 7) Oc 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? 0 Yes 0 No Air handling unit CFM
Is existing space insulated? 0 Yes l 0 No Air conditioning rati fxi existing HVAC C system
g P Alteration of existing HVAC system
MI CIIANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: .SO,t,ISfrp.) - _Pro •ycf's Toc. HP Tons BTU /H
Address: $(, ,A). b . Fire/smoke dampers/duct smoke detectors
City: ' t 4.lJS 1�. I Stated I ZIP:q'7o G L. Heat pump (site plan required)
Phone/72g gam' - 0511 I Fax: I E - mail: Instal /replace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: I i s z oo Install/replace/relocate heaters-suspended,
City /metro sic. no.: oo eo 6 651 fh wall, or floor mounted
Name (please print): 12... W E,..t E,tt, s• /:s_ Vent for appliance other than furnace
CONTACT PERSON efngeraUon:
Absorption units BTU/H
Name: RI („ 1JJ WS-a-) C-►$.L. Chillers HP
Address: 8�g s_ t.0 44. -k.34 4 ✓-' Compressors H P
Environmental exhaust and ventilation:
City: 7 41%•,.. I StateCy I ZIP: 9 10 6 L Appliance vent I
PhonS f Sgf =oYS7 Fax: E - mail: Dryer exhaust
OWNER Hoods, Type U IUres. kitchen/hazmat
hood fire suppression system
Name: 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 NG Oil
Phone: 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/pellet stove
Other:
Applicant's signature: I Date: Other:
Name (print):
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ 70 . ir0
0 Visa 0 MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan (at %
Credit card number: review ( %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ �/ �U
Name of cardholder as shown on credit card accepted as complete.
. $ TOTAL $ / 0 p . 3C)
Cardholder signature Amount 440-4617 (6NO/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 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
$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 . C Pump ' Cond
fraction thereof. footnotes below. p ••
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 .5 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
to 100k BTU 19) Commercial or industrial type incinerator
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:
Domestic incinerator 1 170 1 Inspections outside of normal business hours (minimum charge -two hours)
$72.50 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 $72.50 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) $72.50 per hour
Each additional outlet 63 'State Contractor Boller Certification required for units >200k BTU.
TOTAL COMMERCIAL $ '*ResidenUai A/C requires site plan showing placement of unit.
VALUATION: All New Commercial Buildings require 2 sets of plans.
is \dsts \forms\mech- fees.doc 08/29/01
CITY OF TIGARD BUILDING INSPECTION DIVISION ST . 4
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
UP
Date Requested / 0 --- AM PM /d
BL
Location I 9 (, . S - Suite 4.2 D cv OO
Contact Person Ph Or ' ec PLM
Contractor Ph ei.3 �WR
BUILDING Tenant/Owner atl . . C
Retaining Wall / ELR
Footing Access:
Foundation FPS
Ftg Drain
•
Crawl Drain Inspection Notes: SGT
Slab Kectil SIT
Post & Beam
Ext Sheath /Shear
Int Framing th /Shear VfA �� I A n x [ C '` Insulation VL 7, �
Drywall Nailing LAD/
Fire j r s o �
Fire Sprinkler l ���"�(J�—
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 42ART FAIL
ECHANIC
am
our ••.-
Ga ine
Smoke Dampers
= S PART FAIL
TRICAL
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 / ‘71;t
O t he oach /Sidewalk 1 Z� / 0 ) Inspector U EXt3
Date
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.