Permit CI TY OF TIGARD MECHANICAL PERMIT
1i ; 2/5/01 1 -00045
"I- DEVELOPMENT SERVICES PERMIT #: -' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/5/01
PARCEL: 1S134CD-10000
SITE ADDRESS: 11530 SW TIGARD DR
SUBDIVISION: BURLWOOD NO.4 ZONING: R -4.5
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 1 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Furnace replacement, add on a /c. Placement of a/c unit must comply with standard setback requirements.
Owner: FEES
BAKER, ERIC A + JOELLE L - Type By Date Amount Receipt
11530 SW TIGARD DR PRMT CTR • 2/5/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 2/5/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 • REQUIRED INSPECTIONS
Gas Line Insp
Phone: 453 -4822 Heating Unt Insp
Reg #: LIC 62196 Cooling Unt Insp
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 -00 010 throtOAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calli (503)246 -9189.
Is a By: �� 1 %��L t Permittee Signature:
__ Call (503) 639 , 175 by 7:00 P.M. for inspections neede • the next business day
,.
_:.
r . . Mechanical Permit Application
Date received: ,2 -5-o/ Permit no.:MEC der/ - •�
.2 City of Tigard ProjecUappl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
•
X I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: //5 3U ,5t j 716 RD 1 . 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 $ .
Lot: IBlock: I Subdivision: • *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: Tj4/�p / //As4'. p I ZIP: 922,3 1 S 2 FAMILY DWELLING PERMIT FEE SCIEDULE
d AND COMMERICAL /INDUSTRIAL E UIPMEN'TSCHEDULE
Description and locati n of work on premises: /V�9tL� Q
. {�l'1ed t/ /HD - ow A/G Fee (ea.) Total
Est. date of completion/inspection: 2..1, 7 / Description Qty. Res.only Res. only
Tenant improvement or change of use: HVAC:
Air handling
Is existing space heated or conditioned? 0 Yes 0 No unit CFM
Air conditioning (site plan required) / _ /%f, oo Mee
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: CL /"n 477,...---- Conl7)PoL State boiler permit no.:
HP Tons BTU /H
Address: /6504 5(. 7.Z.Ad Fire /smokedampers/duct smoke detectors _
City: PpR-7 I State: eik I ZIP: 97ZZ� - Install/replacefurnac (o BTU /H
Phone: 5 3- y53-�8 F 5 3'968 71Z -mail Including ductwork/vent liner�'Yes 0 No � /�.OD / Z'
CCB no.: EZ196 Install/replace/relocate heaters- suspended,
City /metro lic. no.: /'/!f wall, or floor mounted
Name (please print): /VA-A' aGv�.e._ Vent for a. p fiance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: / /we POtygz_ Chillers HP
OI / Compressors HP
Address: Environmental exhaust and ventilation:
City: ���� /5 State: I ZIP: Appliance vent
Phone: 5)3 -e/53 -1/872 Fax: E - mail: Dryer exhaust
OWNER Hoods, Type 1/ IUres. kitcheil/hazmat
hood fire suppression system
Name: Lz7 <'/C /3,4 Exhaust fan with single duct (bath fans)
Mailing address: / /C30 sjAJ 7 ,) i Exhaust system apart from heating or AC
�R Fuel piping and distribution (up to 4 outlets)
• City: 64W) I State: ZIP: 9 722 Type: LPG NG Oil / 5: l ief S qU
Phone: 503 5791127 Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
/ Number of outlets
Name:
' y /ly Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: 1 Fax: Ami I E - : 'I: Woodstove/pellet stove
Other:
Applicant's signature: �� - /„ _ , � iAralaU 'O/ Other:
Name (print): • - A ,-
Not all jurisdictions accept credit cards, please call jurisdiction for more information. t Permit fee $ 3 3.4
❑ Visa 0 MasterCard Notice: This permit application Minimum fee $ 72 • SD
expires if a permit is not obtained Pl review
(at %
Credit card number: / / %) $
Expires within 180 days after it has been State surcharge (8%) "" $ S.
a ( 8% O
Name of cardholder as shown on credit card accepted as complete. o
$ TOTAL $ 78.3a
Cardholder signature Amount 440-4617 (6/00/COM)
MECHANICAL PERMIT FEES °
•
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
(Ea) Amt
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code • Qty
$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. r" Comp* ' ; *" .
7) <3HP;absorb unit
to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: 8) 3 -15 HP; absorb •
Value Total unit 100k to 500k BTU 25 60
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 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
< 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 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 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 ,
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 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 Boller Certification required for units >200k BTU.
** Residential A/C requires site plan showing placement of unit.
i:\dsts \forms\mech- fees.doc 10/11/00
. .i,
LIMATE CONTROL 16500 SW 72nd Avenue Portland, OR 97224
503-453-4822 FAX: 968-7224
HEATING & AIR CONDITIONING 503-453-HVAC
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SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE
i
PORTLAND • 453-4822 VANCOUVER • 360-254-3063
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1, -c!
CITY of TIGARDBUILDING INSPECTION DIVISION 'lib sT
2 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested - AM �,PM B
Location //,3' 5 a' 12 Suite A /
Contact Person Ph 453 - es& Z' PLM
Contractor Ph SWR
BUILDING Tenant/Owner • ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain •
Crawl Drain Inspection Notes: r:. j..: ,.. SGN
Slab �' a;�l 'T"'" Li�/V 'L
SIT
Post & Beam
Ext Sheath /Shear • -
Int She
Framing ath /Shear P I /' 2 _ 000 c z' N
�( J
Dry a 1/�,�/.. _00
. Drywall Nailing V V \li 1
Firewall
. Fire Sprinkler
Fire Alarm 5L / ' r l/1 n s 5 _ b
Susp'd Ceiling v (/ wT �-C ��� J
Roof
Misc: 4?--t + I v 9-7\ i V o
Final
PASS- PART FAI a , s AM_ !�- - LA:;\
•
PLUMBING •
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
V AIslirAt) -
Beam
Rough In
Gas Line
Smoke Dampers
C.Final3 • -
PASS PART FAIL _
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 �
Other Date Inspector 4i1 Ext3 1.
Final -
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY"OF TIcARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
602:::
Date Requestedd 61 AM PM BLD
Location 4 (5 k.1 \ Suite , IQ — d‘b4T
Contact Person Ph PLM
Contractor C vv\ o _ C_ .a 1 Ph SWR
BUILDING Tenant/Owner • ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear. V&A) b _ c ` ^ 5
Framing 4-✓�a� �,LJ�®
Insulation S
°
AI
1/V\ �
Drywall Nailing � w`
Firewall
Fire Sprinkler ` V •
Fire Alarm I A Essoloi
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
Post & Beam. -
Rough In
Gas Line
Smoke Dampers
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
Approach/Sidewalk 3 t
Other
Date Inspector Ex
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from th'e job -site. .