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Permit CITY TIGARD MECHANICAL PERMIT l 4 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00700 cal II 13125 SW Hall Blv Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/29/2004 PARCEL: 2S1 10 D C -00700 SITE ADDRESS: 11205 SW SUMMERFIELD DR SUBDIVISION: WILLOW BROOK FARM ZONING: R -25 BLOCK: LOT: 016 • JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: A3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: ELE 3 - 15 HP: 4 COMML.INCIN: MAX INPUT: 60,000 BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: Remarks: Replace (4) 5 -ton AC units. Project Value: $24,708 Owner: FEES CONGREGATE CARE ASSET V, LTD PTN Description Date Amount BY FALCON FINANCIAL [MECH] Permit Fee 10/22/20( $429.95 PO BOX 12188 [TAX] 8% State Surchari 10/22/20( $34.40 SALEM, OR 97309 [MECPLN] Plan Rev 10/29/20( $107.49 Phone: Total $571.84 Contractor: JET HEATING INC PO BOX 7362 SALEM, OR 97303 REQUIRED INSPECTIONS Phone: Cooling Unt Insp hone: 363 2334 Cooling Unt Insp Reg #: LIC 3944 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- 10 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503 6 -6699. Issu d By: C.& • Permittee Signatur �•� Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next usiness day w c Mechanical Permit pk oiic�� ® i t� v cc ` cis ©v'1 � I'G� ! ie o fo y �- Perm,tNo.: H ?' e 70 w Phone: 503.639.4171 Fax: 503.598.1960 �oo� � ,•; Date/By: Other Permit: Inspection Line: 503.639.4175 Oln '31 Date Ready/By: / t El See Page 2 for Internet: www.ci.tigard.or.us © Notified/Method: /047/6 / /an Supplemental Information ,, ," °t ? ro , mcc�� , ( OIVIMERRCI4L FEE* SUitDiJ)sE` JSE;CHE:CKLISP' ❑ New construction y '4 Addition/alteration/replacement echanical permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, la r, ver eea, andd 7 d ofit. � u , Value: $ i o / 7 C7s Q° CATEGORY 'OF • CONSTRUCTION' 4 -= _ • ... Or _ ° R SIDEStr AL*QUIPMENt 4 .$ - STEMS FEES!'.,,, ._ r ❑ 1- and 2- family dwelling lig Commercial/industrial ❑ Accessory building ` For special information use checklist ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I - Ea. I Total :i ';IOB:;< SITE INFO1tMTATION LOCATIO1V: 'w Heatin Job site address: L Air conditioning or heat pump 1 av ,1 c 11 l 1 y Un i �/ l 1 (requires site plan showing placement) 14.00 City/State/ZIP: y ©a_ q-1 a Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) t i 17.90 Suite/bldg. /apt. no.: Project name l j rivpme.Ei -d Gas heat pump 14.00' Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), ' ) in -wall, in -duct, suspended, etc. 10.00 • Subdivision: I Lot no.: Flue/vent for any of above 10.00 Oth 10.00 Tax map /parcel no.: Other fuel appliances . v., nri; T •':i::: s: .J)E S_ CRIPTION . O OBdG. Water heater 10.00 n , _ ,q t� Gas fireplace foe 10.00 V Q ,(in� 41 -- 5- -h_5'r ti_1) Flue vent for water heater or gas """" 11 fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/tnsert 10.00 ■ "' PROPERTY; OWNER: r1-:,,,,,•..,,,,,...‘;.: ty . TE NANT Chimney/liner /flue/vent 10.00 Other: I 10.00 Name: r00,AtaCret, C4. k f AS6tT V k Pri3 Environmental exhaust and ventilation' Address: 925 h„.4.4.04,. A J E t 11,,, 3 equipment Range hood/other kitchen 10.00 City/State/ZIP: 6.E 4 - (, q- c if( l O tI Clothes dryer exhaust 10.00 • Single -duct exhaust (bathrooms, Phone: ( 5th, (ego.. SIB o Fax: ( ) toilet compartments, utility rooms) 6.80 ' • .: + ' :' ®' APPLICANT ::`, ,-` •.'`-'• P i � 0,: coN'PACT� 'F.�soly: •, - , :,;� Attic/crawlspace fans 10200 � : Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four, $1.00 for each additional Address, Furnace, etc. Gas heat pump City/ State/ZIP: Wall/suspendedhmit heater Phone: ( ) Fax: : ( ) . Water heater • Fireplace E - mail: Range " .1. • ,• .:,fq ;CONTRACTOR ;.. . . ". Barbecue Business name: 1•�cut.:�1(\ (7 Clothes dryer (gas) (� ' "' O Address: 1 ' ) j)( � 31.o'a MECHANICAL F T : ^ FEES " . _ } �a�-Q n� , 62 a--17)D3 Subot, City/$tatelZlP: Minimum permit fee ($72.50) Phone: 4:3)3) 3 � ` a'� 7 Jr- � Fax: ( � j Le 3 Z� a, a, Plan review (25% of permit fee) / ems- -q eeB lip.: 3C\ i State surcharge (8% of permit fee) 1) , 4.4 0 4 TOTAL PERMIT FEE 1 p 4 .% Authorized signature: This p ermit application expires if a permit is not ob within 180 <'�` days after it has been accepted as compete. ge aa 'f- CO 70 • • Form 4a . Project Name: Page • . SYSTEMS .:GENERAL' .. . Applicability • Plaat3 /Specs • Discussion of qualifying' • exce eons on e 4 - , .. ',:' (;. •,, -, ..{- I i'' n mbar, apadflratl011 et2lon end subparagrdphelall , : 1: Applicablity (Section 1317) Is this •form required? Form Required: Complete form if • a new HVAC :system Is being installed, or : components:of an existing •HVAC system are being`replaced (I.e., equipment,' controls, ductwork, and insulation.) DExcep building or part ofthe building qualifies fora exception., '• ' • %;from'HVAC code, requirements. Applicable code exception is r • P ions - of.th • buildin th Section ,1317. :Portions e building at qualify:.• �; Ar - : • ea: •: Exception . i ❑:: I I . 1 ., 2. 3.: ❑` Arena I:. Exception 1' 0: ;,2. ❑ .3 Areal .:1 `•❑ :' "2 ` :3': I: • :',0 Form No t Required. This project does not contain work required to comply with code.: :. 2 . Simple or Comp Systems . (S e cti o n 1317.9 of 1317. Simple System:`:Building: ony Simple HVAC System(s). Complete.this l eq 4 ; . • - form-:(4a) and equipment efficiency worksheets as•re wired. `Forrm4b: is not re wired. -�� ;' �.`• : � :• �' � ` .•�'', ❑ Complex System. Project includes a Complex System., •:Complete•this form 4b and equipment efficiency worksheets as required : , and Zone. Controls ( Section 1317:4:1 'and ,1317.4:2 �: Com - lies:.:All new HVAC systems include. at'leest•one;tem ereture .control device.' _ P P. fes ondin to temperatures within the zones. • ;, Exception: HVAC.'system ,qualifies for an exception'from zone . control requirements. The applicable code exception is Section 1317:4.2 Exception 1 p: 2,.1j Portions •of the building that qualify . The inns /s acs show compliance in the followin' locations:: `.� :'' ". "` � ° • ;., :;4: :Control.Capabilitiies (Sea 1317.4:2.4'i ❑ Complies :.:Zone .thermostats.are capable of being set to the ; ,•described•in Sec: 1'317.4.2 :1 . :Where used' to.centrol both. heating and cooling, zone • controls" shell be capable ofproviding .`a.temperature;renge or deed band. of at least ...:.'. 5 degrees.F within which the'supply of heating 'and cooling energy to the,zone is 1 shut ofor reduced to a minimum: 4 Exception: The:building;qualifies for exceptionto the`deadband requirements:.::,, The a pplicable:code exception Is S ection 1317.4:21 ;Exception 1 : : ❑ 2 ❑. • Portions of the'building that quality: • I I ` The plans /specs show compliance in the following locations:.. • 1 I • • Form 4a Project Name: Page: SYSTEMS - GENERAL 5. Off -hour Controls 5.1 Automatic Setback or Shutdown (Section 1317.4.3) Complies. Systems must have at least one of the following features: ill Control Setback Complies. Each system is equipped with automatic control capable of reducing energy through control setback during periods of nonuse or alternate use of spaces served by system. ❑ Equipment Shutdown Complies. Each system is equipped with automatic control capable of reducing energy equipment shutdown during periods of nonuse or alternate use of spaces served' by system. HVAC systems with equipment shutdown are equipped with at least one of the following: ❑ Programmable controls (1317.4.3.1 (1)) ❑ Occupant sensor (1317.4.3.1 (2)) ❑ Interlocked to a security system (1317.4.3.1 (3)) ❑ Manually activated timers with 2 -hour operation max ❑ Exception. The building qualifies for an exception to the requirement for automatic setback or shutdown controls (first set of exceptions) The applicable code exception is Section 1317.4.3 Exception 1 ❑ 2 ❑ The plans /specs show compliance in the following locations: 5.2. Shutoff Damper Controls (1317.4.3.3) ag Complies. Each outdoor air supply and exhaust system is provided with motorized dampers or other means of automatic volume shutoff or reduction during periods of nonuse or alternate use of spaces served by system. ❑ Exception. The building qualifies for an exception to the motorized damper requirement. The applicable code exception: Section 1317.4.3.3, Exception 1 ❑ 2 ❑ 3 ❑ 4 ❑ The plans /specs show compliance in the following locations: • 5.3. - Optimum . Start Controls (Section 1317.4.3.2) Pig Complies. Separate HVAC systems have controls capable of varying start-up time of system to just meet temperature set point at time of occupancy. ❑ Exception. HVAC systems have a design supply air capacity not exceeding 10,000 cfm. The plans /specs show compliance in the following locations: • 6. Heat Pump Controls (Section 1317.4.4) LK No Heat Pump. The plans /specs do not call for a new heat pump ❑ Complies. All new heat pumps equipped with supplementary heaters are controlled to minimize the use of supplemental heat as defined in Section 1317.4.4. The plans /specs show compliance in the following locations: 7. Equipment Performance (Section 1317.5.) • ❑ No New HVAC Equipment. The building plans do not call for new electrical HVAC equipment, combustion heating equipment, or heat- operated cooling equipment. Complies. All new HVAC equipment have efficiencies not less than those required by the code. The following equipment efficiency worksheets are attached: 4a 4b 4c 4d • 4e 4f 4g 4h 4i 4j Sf ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 4 -2 Form 4a .. Project Name: Page: SYSTEMS - GENERAL • 8. Hot Gas Bypass (Section' 1317.5) - 0 No Hot Gas Bypass ❑ Complies. See allowable amount of hot gas bypass as a percentage of total cooling capacity in table below. Hot Gas Bypass Unit ID Rated Cooling Capacity Capacity . ' Allowable Hot Gas Bypass Rated'Cooling Capacity. Max Hot Gas Bypass ... Capacity <240,000 Btu /h 50% >240,000 Btu /h; :' 25% ID Exception. Unitary packaged system with cooling capacity no greater than 90;000 Btu /h 9. Economizer Cooling (Section 1317.3); ' ❑ No Cooling. The building plans do not'call a new fan system with mechanical cooling.: (Complies. Each new fan system has an air economizer capable of modulating outside -air and return -air dampers; to provide up to 100 percent, of the design, supply air as outside air. - • ❑ Exception. At least one new fan system qualifies for an exception. The :applicable code exception is Section 1317.3; Exception 1 ❑ 2 03 04 05 ❑ 6 ❑ If Exception •3 is selected complete the following: • - (a) Total cooling capacity of exempt units • (b) Total installed building cooling capacity ;•'. ❑ Complies. Sum of exempt:units rated at less than 54,000 btu/hr is < 240,000 or a/b.< 0 :10(10% of total building cooling capacity): • Unit' Identifier of exempt units '' ~ : p p cs Show m laps /s e w compliance in the following Iodations: - .. 10. :Economizer Pressure Relief es Integration (Section 1317.3:1. and 1317.3.2) ❑. No Economizers Required. The project does not contain anew fan system requiring economizers. ❑ Overpressurizatlon Complies. The drawings specifically identify a. pressure relief mechanism for'each fan system that:will relieve the extra air introduced by the.economiizer. ❑: Integration .Complies. Economizer. is capable of providing partial cooling even when additional mechanical cooling. is.required to meet the remainder of the cooling load.' p Exception. The applicable exception is Section 1317.3.2,' Exception 10 20 The plans /specs show compliance in the following locations: , Form 4a Project Name: Page: • SYSTEMS = GENERAL • 11. Duct Insulation and Sealing (Section 1317.7 & Section 1317.8) .jlif No Ducts. The building' plans and specifications do not call for new HVAC ducts or plenums ❑ Complies.: The plans and specifications call for all air - handling ducts and plenums ' to be, insulated and sealed as required by Sections 1317.7 &1317.8. 12. Piping Insulation (Section 1314) 14 No New Piping. The building plans and specifications do not call for new piping serving a :heating or cooling system or part of a circulating service water heating system. ❑'Complies. All new piping serving a heating or cooling system or part of a circulating seniice • :- water heating system complies, with the requirements of the Code, Section 1314.1. ' p Exception.'New piping qualifies for exception: Section 1314.1. Exception 10 20 13 Gravity Vent Controls (1317.4.5) - ❑'Complies. Stair shaft vents. Stair shaft vents. shall be equipped with motorized_ dampers that are capable of being automatically closed during normal building operation and are - , interlocked to open as required by fire and smoke detection systems. p Complies. Gravity hoods, vents and ventilators. All outdoor air supply and exhaust hoods, vents and ventilators shall be equipped with motorized dampers that will automatically shut when the spaces served are not In use.' . ❑ Exception. The building qualifies for an exception to the gravity vent controls. The, applicable code exception is Section 1317.4.5.2 Exception '1 02 ❑ 'Compliance details in plans /specs: 14. Dam _ pers.(1317:5.5) :..:• . ' .,...._ ..:. ,, :.::. ...::. .:• , .�� ,:: `: - .- .. ❑ Complies. Motorized outdoor air supply and exhaust air dampers have a maximum leakage rate of 3 cfm /ft2 at 1.0 in w.g. when tested in accordance with AMCA Standard 500 - 1989. The plans /specs show compliance in the following locations: . 15.: Service Water Heating (Sec. 1315) - ❑ No New Water Heating... The building plans and specifications do not call for new water heaters, hot water storage tanks or service hot water distribution systems.. ..: . . • ..p Complies. All new water heaters, hof water storage tanks'or service hot water distribution systems comply with the requirements of the Section 1315. ❑ Exception. The applicable code exception is Section: I Exception: n Portions of the building that qualify: I I 16. .' Distribution Transformers :(Section 1316.1) ❑ No Distribution Transformers. The plans /specs do not call for new distribution transformers: ® Complies.' ' All new distribution transformers comply with efficiency; testing, and labeling of Section :1316.1.1. c' The plans %specs show compliance in the following locations: , ( Worksheet 4a . • • - Project Name: ' • Page: - . UNITARY AIR CONDITIONER - AIR COOLED • Equipment (a) , • (b) (:C ) (d) Discussion or equipment : r. . r Discussion equi e .. ' .. Proposed Performance . cus and me : , Capacity".. Seasonal or ' : Compliance definitions on page' 4-19. , Equip. ID Model Designation (Btu/h) . ' Steady State Part Load St hedule (A -E) • S 7-8 -/0 '07 00/ 40ooO /O seer T / � J • • • • Required Indicate source of information Documentation ARI Unitary Directory, Section AC; page: ARI'Applied Products, directory, Section ULE Page:.,: _ Product data (Atta data furnished by the equipment supplier, i.e., 'cut sheets' " . Cooling Capacity '( btu /h)..: Compliance • Equipment Required P 'Sctiedule :. Seasonal or Efficiencies Over But not over - Steady State Part Load, • • : Single, Package Without a' 65,000 -,: „135,000 1'0.3 -'EER n/a ...::' This schedule of A Heating Section or With Electric 135,000:.: 240,000. 97 EER: n/a equipment eitidencies Resistance Heat 240,000 760,000 9.5 EER ` t'' 9 5 IPLV was T aal a 13 - from the:, 760,000' . - 9:2 EER. - 9.2'IPLV : code, Table f3=L . • Split System Without a Heating " 65, 000;': 135,000 10,3 EER ': n/a ;. • B ` ` Section or With Electric 135,000 {. '' 240,000 '9.7 EER . Resistance Heat '; :: "; '„ _ _ 240,000: ,, - ' ,.760;000 .:' .: _. '•9,5:EER ' ' L 9.5 IPLV: ° EER . • 9:2 IPLV: r 0 65,000 ; na: 1,0 SEER" - ; .SinglePackage With a Heating 65 000 135 '10.1. EER /a: • C. .Section Other. Than' Electric : :1 :35,000 .`' '240,000 9:5 EER n/a , • ,,,: , ;Resistance: 240;000 - ` 760,000 9.3•EER 0 65,000 na 10 SEER" . "Split SystemWith a Heating 65,000r . 135,000,' ` 10 :1'EER n • D Section Other Than Electric ., '..' 135;000 : 240,'000•' 9.5= EER:''..> :;`," /a Resistance`' "240,000 760,000., 9;3'EER' : :'9.7.. IPLV ` • .,. ...,, , .. _ ,000 . ;.• _ :...;; :._:_•9.OEER' :.... 9:4IPLV .. E'r:. . >;...' :. :Condensing Unit Only,; :' q';'135,000! . . 10.1:; EER: :.11':2 IPL'V 4 -10 CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2004 -00700 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/29/2004 Phone: (503) 639 -4171 A ��� F :�l�l Inspection Requests (24 Hrs.): (503) 639 -4175 ''__.. INSPECTION WORKSHEET FOR DATE: 6/27 /2005 TIME: 7:09AM PAGE: 85 SITE ADDRESS: 11205 SW SUMMERFIELD DR CLASS OF WORK: SUBDIVISION: WILLOW BROOK FARM LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMERFIELD RETIREMENT HOME DESCRIPTION: Replace (4) 5 -ton AC units. Project Value: $24,708 OWNER: CONGREGATE CARE ASSET V, LTD PTN, PHONE #: CONTRACTOR: JET HEATING INC PHONE #: 363 -2334 Inspection Request Scheduled For: Date: 6/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 009926 -01 503-363-2334 Y Corrections /Comments /Instructions: tCQ kf■A AI ....._____ ormwaimintrimminonmal. ETWIlklapteMSIMMILIPAVALMFEC , _ . _ ,------ e l , 1 •-- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL El CALL FOR INSPECTION ❑ ADDIT NAL F ES ASSESSED '/, On ---- Inspector: AL • & Date: #: (503) 718 -