Permit •
CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2001 -00017
— ���� DEVELOPMENT SERVICES DATE ISSUED: 1/17/01
13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111A6 -08800
SITE ADDRESS: 09435 SW VIEW TERR
SUBDIVISION: PENROSE TERRACE ZONING: R -4.5
BLOCK: LOT: 033 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: DOMES. INCIN:
WOD 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 woodstove insert into existing fireplace.
•
Owner: FEES
ANGARAN, JAMES M + Type By Date Amount Receipt
SALLY J PRMT CTR 1/17/01 $72.50 2720010000
4163 SUNRAY AVE S 5PCT CTR 1/17/01 $5.80 2720010000
SALEM, OR 97302
Total $78.30
Phone:
Contractor:
MIKE LARKIN
11901 NE COUCH ST
PORTLAND, OR 97220 -2361 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 503- 256 -4909 Final Inspection
Reg #: LIC 68996
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 obtain ie f these rules or direct questions to OUNC by callin• 503)246 -9189.
Issu By: , / i yyyt ,j; Permittee Signature: A i-e
Call (503) 639 -4175 by 7:00 P.M. for inspections needed - tie - next -b - iness day
. , t•
A Mechanical Permit Application
Date received: / /J -0/ Permit no.: fci9/-42,/
.A.1 City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9722
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
7Y1'E OF P 212M IT
family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCIEDULE
Job address: cJ SL J 5 5 .r) fr/ EA/ i'�Q124, F- 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: 'Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: 71& 1"/A Ca, , I ZIP: 9 ZZ4L_ 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCI
lit/0 f,1f ,(4/ //V( //t/54Wr /A/ Fee(ea) Total
Est_ date of completion/inspection: ! / — /ff — p / Description Qty. Res. only Res.only
Tenant improvement or change of use: HVAC:
Air handling unit CFM
Is existing space heated or conditioned? ❑ Yes ❑ No Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
Business name: fr/ // L!� re /� State boile permit no.:
HP Tons BTU/H
Addre s : / /9a/ &ts H ,r--- Fire/smoke smoke detectors
City: `o Q 1`.tb I State: 6 I ZIP: `j' 7 Heat pump (site plan required)
Phon 0 3 )25-4- y? Fax I E -mail: Install/replace furnace/burner BTU /H
CCB no.: ln Including ductwork/vent liner ❑ Yes ❑ No
Qb �
Install/replace/relocate heaters - suspended,
City/metro lic. no.: wall, or floor mounted
Name (please print): Al K - -4i k/ A/ Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: CA/f470. 724 4 Chillers HP
Address: ,ie335 5W !/ /St'z c Compressors HP
Environmental exhaust and ventilation:
City: 17&floe -l) I State:G I ZIP:77) K- Appliance vent
Pho r . ;5 >3 )- • ('7? ax:47e - ; mail: Dryer exhaust
OWNER Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
Name: ✓ ,4' /4/1. Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: ,/il I Stater' ZIP:
Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phon '3)37/ -1/ 3 Fax: E -mail: Fuel i ing each additional over 4 outlets
ess p pmg (schematic required)
Name: Number of outlets
Address: Other listed appliance or equipment:
Decorative fireplace
City: I State: I ZIP: Insert-type 1A.6D rm /
Phone: I Fax: I E-mail: Woodstove/pelletstove
Other.
Applicant's signature I Date: / —/ 7-c./ other.
Name (print): /�,e2
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ i
❑ Visa ❑ MasterCard Notice: This permit ap Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8%) of cardholder as shown on credit card accepted as complete. g ( ) $ 8�
$ TOTAL $ 7 g . -ep
Cardholder signature Amount 4444617 (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
$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
ASSUMED VALUATIONS PER APPLIANCE: to 1 BTU 14.00
3-
Value Total 8) 3 -15 5 HP; absorb 25.60
unit 100k to 500k BTU
Description: Qty (Ea) Amount 9) 15 -30 HP; absorb
Fumace 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 fumace 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
15-30 h absorb. unit, 501k to 1 2,310 16) Ventilation system not included in
mil. BTU appliance permit 10.00
30 -50 hp; absorb. unit, 3,400 17) Hood served by mechanical exhaust 10.00
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725 18) Domestic incinerators 17.40
mil. BTU
Air handling 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 69.95
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656 20) Other units, including wood stoves 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.
is \dsts\forms\mech- fees.doc 10/11/00
CITY OF TIGARD BUILDING INSPECTION DIVISION � I r •
241-Hour Inspection Line: 639 -4175 Business Line: 639
BUP ,
Date Requested ! V� ° AM 'M c/A-'00 BLD
Location 91 $ I� I ELL) x-Q AI^£ Suite ' MEC goy-601/7
Contact Person eh /SO Ph (po —47 / 7. PLM
Contractor Ph SWR
BUILDING Tenant/Owner C,*/3 -0 - 7;4-D .; /C4 ELC
Retaining Wall ELR
Footing 4,(...y)6/ 1� Foundation Access: � FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab Ace, hti
.Q
("xVU�- �r�-✓� SIT
Post & Beam
Ext Sheath /Shear L-Aey 4)Al
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 jr7
Rain Drains
Final
ART FAIL
ECHANICAL
Post & Beam A
Roug
Li In �, ,
Gas Line
Smoke Dampers
PASS 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 ca I for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date I Inspect Ext
Final
PASS PART FAIL DO NOT REMOVE this inspectio record from the job site.