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Permit
• 4, CITY OF TIGARD MECHANICAL PERMIT PERMIT #: MEC2001 -00305 ,1 �l DEVE HO B ME N g r S�ER V 2 639 -4171 DATE ISSUED: 08/24/2001 PARCEL: 2S1 02 BA -01000 SITE ADDRESS: 09530 SW TIGARD ST SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. ZONING: I -P BL LOT: 057 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: 1 VENT FANS: OCCUPANCY GRP: B 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: Replace unit heater. Owner: FEES GREEN VALLEY DEVELOPMENT LLC Type By Date Amount Receipt BY GARY HELMER PRMT CTR 08/24/20( $72.50 2720010000 10585 SW WALNUT ST 5PCT CTR 08/24/20C $5.80 2720010000 TIGARD, OR 97223 Total $78.30 Phone: Contractor: SPECIALTY HEATING & COOLING 9528 SW TIGARD ST TIGARD, OR 97223 REQUIRED INSPECTIONS Heating Unt Insp Phone: 620 -5643 Final Inspection Reg #: LIC 66578 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 -pies •f these rules or direct questions to OUNC by calling (503)246 -9189. Issue By: _ li 'i Al / Permittee Signature: }1 (2j2 e_ed/�! 622 Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Rug 22 01 03:04p Specialty Heating 503 598 0718 p.1 le v ' Mechanical Permit Application I e_2(9 Date rece � � a I Pennitno.: ( t , ,; // -00306 At, Iyi City df Tigard s�1� g P roject/appl. no.: Expire date: Ciryo/Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Datelssued: By: Receipt to.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 . Case file no.: Payment type: Land use approval: Building permit no.: TYPE" OF PERMIT I ❑ 1 & 2 family dwelling or accessory Commercial/industrial ❑ Multi - family Pk improt t:ment '❑ New construction a Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHE MIEN . Job address: . -om .. �s- t / a."7 $r Indicate equipment quantities in boxes below. Indict re the dollar • Bldg. no.: r Suite no.: - value of all mechanical materials ,squip ant, labor, : Tax map /tax lot/account no.: profit. Value $ / / fj 70 r Q Lot: IBlock: I Subdivision: 'See checklist for important application information, and Project name: fwx jurisdiction's fee schedule for residential permit fee. Man d - � - (,i/,4 - if I ZIP: 9 J �-3 1 & 2 F%.MILY DWELLING PERMIT FEE S ; I RULE D p Ion and l ocation of work on premises: 9. ?_..2 I COMMERICAL/INDUSTRIAL EQUIPMEN• I CHEDULE - Fee (ea) Total Est. date of completion/inspection: 8'/ r /0(• Description Qty. Re . only Res. only Tenant improvement or change of use: 1�VAC: • Is existing space heated or conditioned? 1:11 ❑ No Air handling unit CFM space insulated? es ❑ No • Air conditioning (site plan required) Is existing P Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business nam•• 4„./4__ 4_. • AMY • • t 4 d 1NG State boiler permit no.: HP Tons BTU/H Address: • 5- 61.v al S T 1: ire /smokedampers/duct smoke detectors City: T$' 1i d I State: p,e.l ZIP: q 7a v. 3 Heat pump (site plan required) — Install/replace - BTU /H I ^ rn Phone 5o3G �� Fax: .598 07/ E -ma Including ductwork/vent liner 0 Yes ❑ No CCB no.: e4.,5 7 F1' Install/replace/relocate heaters-suspended, City /metro lic.no.: !b y ( e . wall, or floor mounted Name (please print): • , p pY(rQ. '1-'x{ Vent for appliance other than furnace `_ CONTACT PERSON Refrigeration: Absorption units BTU /H Name: '/4- Lee /■ / h • e 4 Chillers HP Address: 0 75,9- S' SW' 7 1 ee ST Com ?ressors HP Envu exhaust and ventilation: City: W1 J I Sta e:GQ [ ZIP: ei 7,44-2 Appliance vent Phon 6.7.0 -SC ' Fax: 59(p718' E -mail: D'ryesexhaust OWNER Hoods, Type l/ lures. kite e hazmat hood fire suppression system Name: 6 &km e4 J' £ I')CP1Lt t Exhaust fan with single duct (bath fans) Mailing address: /05 b SW (,() 2tt tG vS r. Exhaust system apart from heating or AC City: r/y 61 q/ I StateD/C I ZIP: 9 7,1 P- Fuel piping and distribution (up to 4 outlets) q Type: LPG NG Oil Phone: Fax: E -mail: Fuel pi . ing each additional over 4 outlets ENGINEER ' rocessp . . g (schematic required) Name: N umber of outlets Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert -type Phone: Fax: J E -mail: Woodstove/pelletstove Other: Applicant's sign ure :�1i,t Date: 8- ,,,..:9.- Other: Name (print): ° wr y ee N r54'I4,1I1/tr • 2 s--0 � N}5°N�I jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ _ - c visa ❑ MasterCard p Notice: This permit application Minimum fee $ _ credit card number. u )i azq to 05? 4 "d 6w /Dq{ expires if a permit is not obtained Plan review (at %) $ t - _ Shr'. t 1 Ma l° L� Expires within 180 days after it has been State surcharge (8%) .... $ _ g-•. ' ? ' l Natr) o r c rho non r card accepted as complete. TOTAL $ _ 7 �(/ older signature Amount .0 -1617 (6i00/COM) Aug 22 01 03: 04p Specialty Heating 503 598 0718 p.2 ' It u • • • MECHANICAL PERMIT FEES COMMERCIAL FEE, SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description; - Price Total Table 1A Mechanical Code Qty (Ea) Amt ' $1.00 to $5,000.00 Minimum fee $72.50 1) Furnace to 100,000 BTU $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and including ducts 0 vents 14.00 $1.52 for each additional $100.00 or 2) Furnace 100,000 BTU+ $10,000.00. fraction thereof, to and Including Including ducts & vents 17.40 $10 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Fu rnace $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 12 15 $50,000.00. . $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 1.1, ; see or Pump . Cond fraction thereof. . foo(notes.beloW. '.. .Comp'' ' ** .. 7) <3HP;absorb unit to 100K BTU 14.00 • ASSUMED VALUATIONS PER APPLIANCE: 8) 3 - 15 H absorb Value Total unit 100k to 500k BTU 25.60 Description: Qty (Ea) Amount g) 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 (mace Including vent 955 ` unit >1.75 mil BTU 87.20 Suspended heater, wall heater or ( 955 12) Alr handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 - . 13) Air handling unit 10,000 CFM+ permit 17.20 Repair units 805 14) Non - portable evaporate cooler to 00 < 3 hp; absorb. unit, 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 . 18) Domestic Incinerators >50 hp; absorb. unit, 5,725 17.40 >1.75 mil. BTU - 19) Commercial or Industrial type Incinerator Air handling unit to 10,000 cfm 656 69.95 Air handling unit >10,000 ctm 1,170 20) Other units, including wood stoves Non - portable evaporate cooler 656 10.00 Vent fan connected to a single duct 44 21) Gas piping one to four outlets Vent system not included in 656 5.40 appliance pemtlt 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: .1 $ Commercial or industrial Incinerator 4,590 , Other unit, including wood stoves, . 656 8% State Surcharge _. $ inserts, etc. 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: . Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum cho !le-two hours) $72.50 per hour. • 2. Inspections for which no fee le specifically indicated (minim] in charge -half hour) $72.60 per hour 3. Additional plan review required by changes, additions or rev m ions to plans (minimum charge-one -half hour) $72.50 per hour * State Contractor Boller Certification required for units > ' )Ok BTU. ** Residential A/C requires site plan showing placement r I unit. l:\dsts \forms\mech- fees.doc 10/11/00 • CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspecti6n.Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested / AM PM BLD Location / J- Suite MEC 0 / - 6 030, - Contact Person R O > Ph a S70 PLM • Contractor Ph SWR BUILDING Tenant/Owner ELC 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 n (XAS ppE ccz Insulation Drywall Nailing D 4 z - , Firewall Fire Sprinkler 3, . u/Jir - c,ii eAth- 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 PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers na P ASS PART I ELECTRICAL 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 Approach /Sidewalk Date / i/ n Insp Other ector E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION - 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST © BUP Date Requested / — 7 AM PM BLD Location ?,5 30 / i' Suite MEC .2--06 / - 0030 S� Contact Person , w �� Ph CO 20 -.- 93 PLM Contractor ,� - / �. , Ph SWR of BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation r �y FPS T-d 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 PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smok- ! - pers 'v PART FAIL RICAL 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 Otheoach /Sidewalk Date q11 O ( Inspector C� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.