Permit C ITY OF T I GA R D MECHANICAL PERMIT
Al DEVELOPMENT SERVICES
PERMIT #: MEC2001 -00234
..411. ~�' �! 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: 07/06/2001
PARCEL: 2S112DD -01300
SITE ADDRESS: 15650 SW UPPER BOONES FERRYRD
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
•
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: UNK 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: CLO DRYERS: •
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of new walk -in cooler.
Owner: FEES
HOLLAND, INC. Type By Date Amount Receipt
109 W 17TH AVE. PRMT CTR 07/06/20( $72.50 2720010000
VANCOUVER, WA 98660 PLCK CTR 07/06/20( $18.13 2720010000
5PCT CTR 07/06/20( $5.80 2720010000
Phone: Total $96.43
Contractor:
ROYAL COMMERCIAL EQUIPMENT LTD
2736 SE 15TH AVENUE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 236 -1370 Final Inspection
Reg #: LIC 68375
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 les adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -001 € /ugh OAR 952 - 001 -0080.
You may obtai . opi e of these les or direct questions to OUNC by call A � j )246 -9189.
// � � '-� - -'
Issue By: ��// _�/i L. / Permittee Signature
� / i7
Call (503) 639 -4175 by 7:00 P.M. for inspections needed they (business day
7Z! C5
Mechanical Permit Application .
D atereceived: 6 .,/ ,,/ Permit no.: H .... A
rr..w. . •
City of T>tgard C� Project/appl. no.: Expire date: •
City of Tigard Add 13125 SW Hall Blvd, ' , OR 97223 Date issued: By: Receipt no.:
r
Phone: (503) 639 -4171 r --
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
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❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction ' Addition/alteration/replacement 0 Other:
: '. JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 6 R ( LI )-.. JS[�O 5. IA.) OM 5 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: h .v I Suite no.: value of all mechanical materials, equipment, labor, overhead, t
OCO 5=
Tax map /tax lot/account no.: profit. Val $ g .
Lot: (Block: I Subdivision: *See checklist for important application information and `b
Project name: (‹EF2lG6t1/4170f\ jurisdiction's fee schedule for residential permit fee. Z'
City /county: j7 tz.!J dZ 'ZIP: I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE t')
Description and location of work on premises: 41.574f•-1-- AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE Z '
(iai -IT -In coo y..F l Fee(ea.) Total k
Est. date of completion/inspection: 7 /1 0l0/ Description Qty. Res. only Res. only •,
Tenant improvement or change of use: HVAC:
Air handling unit CFM
Is existing space heated or conditioned? U Yes 0 Air conditioning (site plan required) .
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
NI ECIIAN CONTRACTOR Boiler /compressors
Business name: .yam,, +1('tE(If-f 1tV oP )..,-TO State boiler permit no.:
HP Tons BTU /H
Address: 2.7 3t , 5 . r 1 S'' �F Fire/smoke dampers/duct smoke detectors LI
. City: e 0 I State: niz, I ZIP: 97 ZLQ Heat pump (site plan required) \
Phone: 23 G - 1370 I Fax:o3 E -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes O No
CCB no.: 178376 Install/replace/relocate heaters - suspended,
, City /metro lic. no.: 3155 wall, or floor mounted
Name (please print): nr^.egn jcrrEcL - Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
''nn Absorption units BTU/H
Name: 4 } -F l !l .5F-F {aS Chillers HP
Address: X73( 5E 1st` AuF Com ressors X I HP
- Environmental exhaust and ventilation:
City: ( o I State: 2 I ZIP: 9 7 2 C7 'L Appliance vent
Phone: 236-1370 Fax: 93(, -0i 7 E -mail: Dryer exhaust
- OWNER — Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
Name: J -/01 -. till ' AC Exhaust fan with single duct (bath fans)
Mailing address: I O 1.)./ 1.)./ 17 s 1 Exhaust system apart from heating or AC
_
City: FI- C1Couv I State: 14/41 ZIP: d f $(�(� 6 Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel pi ing each additional over 4 outlets
rocess piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: / State: I ZIP: Insert - type
Phone: 1F.:: 1E-mail: - Voodstove/pelletstove
.D /
?G Other
N pplicant's signature: Date: / Other: _
ame (print):
Not all junsdictions accept credit cards, please call jurisdiction for more Information Permit fee $
Notice: This permit application Minimum fee $
0 Visa 0 MasterCard ' k.
Credit card number: / / expires if a permit is not obtained Plan review (at %) $ ` � �Qto
■ Expires , within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as.shown on credit card accepted as complete. TOTAL $
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
$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
including ducts & 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
$
$10,001.00 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 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 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 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 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 Boiler Certification required for units >200k BTU.
** Residential A/C requires site plan showing placement of unit.
is \dsts \forms\mech- fees.doc 10/11/00
/2 7 j
CITY OF TIGARD BUILDING INSPECTION DIVISION •MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
•BUP
Date Requested 7 AM PM l3LD
Location i G5v Scv / Suite MEC 2 3y
Contact Person Ph Z.3- /3 20 PLM
Contractor 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
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
IGAi�
ost& Beam
Rough In
Gas Line
Smoke Dampers
Fi
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
Approach /Sidewalk Date 1 )\0 0 I Inspector Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By / Inspection Description bate Passed By
Footing /Setback Underground cover
Found; Pion walls _ Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing ' Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
4 Inspection Description Date Passed By
Drywall nailing
Post/beam mechanical
Suspended ceiling
Gas line
Engineered soils
Welding Lab Final Mechanical rough -in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector
Fireproofing Lab Final Mechanical final ? /ZD /o / R9
Final inspection
PLM - Plumbing Permit
BUP — Fire Protection System Permit Inspection Description Date Passed By
Plumbing underslab
J Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
•
is \dsts \ forms \InspRecordBUP.doc 04/17/01
CIT OF TIGAR® MECHANICAL PERMIT
DE SERVICES PERMIT #: MEC2Q01 -00234
-- Y'. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 07/06/2001
PARCEL: 2S112DD -01300
SITE ADDRESS: 15650 SW UPPER BOONES FERRYRD
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: UNK 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of new walk -in cooler.
Owner: FEES
HOLLAND, INC. Type By Date Amount Receipt
109 W 17TH AVE. PRMT CTR 07/06/20( $72.50 2720010000
VANCOUVER, WA 98660 PLCK CTR 07/06/20( $18.13 2720010000
5PCT CTR 07/06/20( $5.80 2720010000
Phone: Total $96.43
Contractor:
ROYAL COMMERCIAL EQUIPMENT LTD
2736 SE 15TH AVENUE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 236 -1370 Final Inspection
Reg #: LIC 68375
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved (�
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended V
for more than 180 days. ATTENTION: Oregon law requires you to follow les adopted in the Oregon O
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -001$ 4 7. h OAR 952 - 001 - 0080.
You may obtaiy opi— of these les or direct questions to OUNC by call , _ )246 -9189.
Issue By: ` .. , // � � � / / Permittee Signature A•�" �-
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the rbusiness day