Permit •
c •
C ITY OF TIGARD MECHANICAL PERMIT
r DEVELOPMENT SERVICES PERMIT #: MEC2002 -00193
-r' =�� I' 13125 SW Hall Blvd., Tigard, OR 9 (503) 639 -4171 DATE ISSUED: 5/9/02
PARCEL: 2S113AB -00600
SITE ADDRESS: 16160 SW UPPER BOONES FERRYRD BLD.0
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 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: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of (6) gas turrets in labs
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 5/9/02 $72.50 2720020000
PORTLAND, OR 97224 5PCT CTR 5/9/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97292 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 236 -4152 Misc. Inspection
Reg #: LIC 172 Final Inspection
PLM 26 -83PB
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 The e rules are set forth in OAR 952 - 001 -0010 through OAR
952=001 -0080. You'may obtai. copies of these rules or direct questio . to • NC b - ing
rnr4»4.R -(11 Ra TO 1' /
' 'i
Is ue B r ,�,.0 � � / Pe rmittee Signature:
Y 4 _ _ � L
\ ''Call (503),639 -4175 by 7:00 P.M. for inspections needed the next business day
r
Mechanical Permit Application .
Date received: 5 9 ' 19-- Permit no.* aocv -00 / 93
' - I L City of igar Project/appl. no.: a ':+ date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: , B 21 Receiptno.:
Phone: (503) 639 -4171
NI Fax: (503) 598 -1960 Case file no.: =ayment type:
Land use approval: Building permit no.:
TYPE OF PERM_ IT
❑ 1 & 2 family dwelling or accessory Commercial /industrial 0 Multi - family ❑ Tenant improvement
❑ New construction ' Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION - COMMERCIAL VALUATION SCHEDULE
Job address: / t I ( st ,, w Op Rooivt -s Fob‹ y 4 indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.:
3 I Suite no.: value of all mechanical materials,, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Valu $ rX d a R —
Lot: IBlock: ISubdivision: *See checklist for important application information and
Project name: Ex EL / x t S jurisdiction's fee schedule for residential permit fee.
City /county: 7 6.- . I ZIP: CZ aa/.. -_ 1 & 2 FAMILY DWELLING PERMIT FEE SCIEDULE
Description and location of work on premises: SN S TA LL.. (o AND COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE
j \( (,- -- 7' k AA. tars 1 ry L.4 h Fee(ea.) Total
Est. date of completion/inspection: / /ylO Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM
space insulated? 0 Yes ❑ No Air conditioning rati fxi ti ngplanrequired)
Is existing P Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: D E A,/ W A4Q, - p�, State boiler permit no.:
J HP Tons BTU /H
Address: 3 ‘ 1/4. 5 E / 3 --- Fire/smoke dampers/duct smoke detectors
City: )9047-L,6,,.,, I State:0 g I ZIP: C) 7 Re, a Heat pump (site plan required)
Phone:a3( LI! $a� Fax:36 - 1 7 1 E -mail: Install/replacefurnace/burner BTU /H
Including ductwork/vent liner O Yes 0 No
CCB no.: 2 / 7 a Install/replace/relocate heaters - suspended,
City /metro lic. no.: / C f ei wall, or floor mounted
Name (please print): (_ la,rtiN FtE.- LA W 5 Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: �� /` _ L-Lo w Chillers HP
Address: Comyressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust •
OWNER Hoods, Type If lUres. kitchen/hazmat
t TE hood fire suppression system
Name: Its % 3 00 Exhaust fan with single duct (bath fans)
Mailing address: 153 SO S t�.t S . lx.Ol PKw y Exhaust system apart from heating or AC
City: / 6 - ,4. � .�C I S R ZIP: Cr? Aa Fuel piping and distribution (up to 4 outlets)
T 4 Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: A ZIP: Insert - type
Phone: t F. 4 - 91! Woodstove/pelletstove
Applicant's signature: W ���t� � l� - :! � �/7 i Cheer: • , '
Name (print):
(Not all jurisdictions accept credit cards, please call junsdiction for more information. Permit fee $ .-1
i Notice: This permit application Minimum fee $ -72. ❑ Visa ❑ MasterCard
Credit card number: / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ 7 7
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount 440-4617 (6/00 /COM)
l y
• i
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price 1
$1.00 to $5,000.00 Minimum fee $72.50
y-..,
Table 1A Mechanical Code Qty (Ea) Ar,,,
$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 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 1,170 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 y 360 /y ` - 25% Plan Review Fee (of subtotal) $
Each additional outlet a 63 1 o26 Required for ALL commercial permits only
TOTAL COMMERCIAL $ , cz TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION: J .5 6 G
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 (mi• 1
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.
is \dsts\forms\mech- fees.doc 10/11/00
CITY OF TIGA . - 24 -Hour •
BUILDING 1 Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171 :.
BUP
Received Date R- quested /U AM PM BUP
Location I `o i 6. / / ' l' Suite MEC 200 610/5
Contact Person Ph ( ) �. /.S°Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain - ELR
Crawl Drain
Slab Inspection Notes: YI SIT
Post & Beam ,...0..., ,...0..., a �4
Shear Anchors _-•?-^,N
at Sheath/Shear
Int Sheath/Shear
Framing ,
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling .
Roof
Other: _
Final .
• PASS PART FAIL
PLUMBING
- • Post & Beam , illr _
. Under Slab
Rough -In _ j .
Water Service .
Sanitary Sewer
.z/l - —
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
,=�,',y FAIL L..
Rough -In
•
Smoke Dampers
F
PART FAIL
E ICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
' SITE ❑ Please call for . nspection RE:_________ ❑ Unable to inspect — no access
Fire Supply Line "
( ./c51.4„....
ADA X
Approach /Sidewalk Date b U -- $nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
0..