Permit A
C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2001 -00359
44- • II DATE ISSUED: 10/12/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111 AD -11600
SITE ADDRESS: 08880 SW REILING ST
SUBDIVISION: SCHECKLA PARK ESTATES ZONING: R -4.5
BLOCK: LOT: 043 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:
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: 1 OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: •
Remarks: Replace heat pump and air handler. Cannot be placed within the required setbacks.
Owner: FEES
MICELLE BRASHEAR Type By Date Amount Receipt
8880 SW REILING PRMT CTR 10/12/01 $72.50 2720010000
TIGARD, OR 97224 5PCT CTR 10/12/01 $5.80 2720010000
Phone: 503-684-7047 Total $78.30
Contractor:
HEATING SPECIALIST INC, THE
9300 NE HALSEY
PORTLAND, OR 97220 REQUIRED INSPECTIONS
Heating Unt lnsp
Phone: 257 -7000 Final Inspection
Reg #: LIC 00056628
PLM 26 -494PB
ELE 26 -893CL
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
rny4\2aA_Q1 R.
Issue By: Permittee Signature: 4_
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
• Mechanical Permit A 'cation
. 7? C�J' . Date received: Permit no.: a
�1 - i :.�
City of Tigard 1 _y- Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, T .',..1!-1- -' ° " Date issued:
Phone: (503) 639 -4171 b Receipt no.:
Fax: (503) 598 -1960 OCT 1 2001 Case file no.: Payment type:
Land use approval: Building permit no.:
COMMUnl I r u€VELOPMEAT
TYPE OF PERMIT
A1,1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: e ` So tS4> � e..► I t r- 09 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite Ao.: 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: (3retSheae jurisdiction's fee schedule for residential permit fee.
- q _.• -�- , - - --
City/county: T « ( a�d ZIP: `� --7,2_2_4 -7,2_2_4 - - -- : .1-i $ �21 D« 'LTA ., PTL fT J . . 16 -'
.
Description and`Yocation of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPM ENT SCIIEDULE
,[n eo, ‘_41∎2a_r;pcuxe 4 Ci_a_J., iviA cki. - a.i Fee(ea.) Total
Est. date of completion/inspection: 10 — 20.0 1 Description Qty. Res. only Res. only
f HVAC:
Tenant improvement or change of use: Air handling unit CFM ( 1 O
Is existing space heated or conditioned? 0 Yes 0 No Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: 2. �,�c t tc, 9 -.>%c--, HP Tons BTU/H
Address: r1 3Cc a _ I4.
)'24. f Fire/smoke dampers/duct smoke detectors
City:4 tL/Ly,sD "State:0 I ZIP: ''1z�.. Heat pump (site plan required) 1 1d./
Phone: a_5-d. '70,90 I Fax: a3� - �7cal E - mail:
Install/replace furnace/burner BTU /H
CCB no.: S fo z Including ductwork/vent liner O Yes O No
InstalVreplace/relocate heaters - suspended,
City /metro lic. no.: t 31 a wall, or floor mounted
Name (please print): - - „„ e- Vent fora . r liance other than furnace
C ONTACT PERSON e. : eratton: .
Absorption units BTU/H
Name: Chillers HP
Address: a- / • Compressors HP
!� Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
Hoods, Type U 11/res. kitchen/hazmat
hood fire suppression system
Name: l Gh e l /.s. T3 raj h p1.,r Exhaust fan with single duct (bath fans)
Mailing address: S g W S w Re t 1, Exhaust system apart from heating or AC
9
City: - .Li a ,, - 6, State: r2, ZIP: el - 7..1_,./
Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: to C q - 10 U 7 Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: Number of outlets
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 `s w. , ,,,. I Date: t o_t t _ o t O lter:
Name (print): �ioa r n e_ 1- s t u- s
Not all jurisdictions accept credit cards, please can jurisdiction for more information. Permit fee $ - 125D
El Visa ❑ MasterCard Notice: This permit application Minimum fee $
credit card number: / /
expires if a permit is not obtained
w ithin 180 days after it has been Plan review (at %) $
Expires Y State surcharge (8 %) .... $ 5' 8 a
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 7 4- 3 d
Cardholder signature Amount • 440 -4617 (6100/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
$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. Comp* **
7) <3HP;absorb unit ;
to 100K BTU I ) 14.00 ( c.l . Vp .
I ASSUMED VALUATIONS PER APPLIANCE: 8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60 i
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 I 10.00 (O.v d
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
>50 hp; absorb. unit, 5,725 18) Domestic incinerators 17.40
mil. BTU 19) Commercial or industrial type incinerator
Air ha
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 72, -50
Other unit, including wood stoves, . 656 8% State Surcharge $
inserts, etc. 5 84
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: 753°
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 NC requires site plan showing placement of unit.
,
i:\dsts\formsniech- fees.doc 10/11/00
le
du •
•
\ IS
r)
C
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /1 AM PM --- BLb
Location $ d Suite MEC v( CO 357
Contact Person Ph 4 PLM
Contractor Ph ,, S 7-7000 SWR
BUILDING Tenant/Owner ELV D-00/ 0
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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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
PA ART FAIL
ANICA •
os & Beam
Rough In
Gas Line
Smoke Dampers
Fi
eraP. PART FAIL
Rough In
UG /Slab
Low Voltage
Fire Alarm
q-it 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date / 7 " --, `Q Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.