Permit CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2002 -00597
. y �I�� DEVELOPMENT Tigard, ) 639 -4171 DATE ISSUED: 12/20/02
PARCEL: 1 S 126BC -01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 520
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: 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: Relocation of ducts and grilles.
Owner: FEES
PORTLAND OFFICE ASSOCIATES Description Date Amount
BY TC PORTLAND, INC
8930 SW GEMINI DR [MECH] Permit Fee 12/20/02 $72.50
BEAVERTON, OR 97008 [TAX] 8% StateTax 12/20/02 $5.80
Phone: Total $78.30
Contractor:
BEWLEY MECHANICAL
5591 SW ARCTIC DR
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Phone: 626 - 8986 Mechanical Insp
Final Inspection
Reg #: LIC 63582
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
requir yourto- follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
/ i .
Issue -By: , _ 01/ a . /,,i ; / Permittee Signature:
Call (50 639 -4175 by 7:00 P.M. for inspections needed the next business da
Mechanical Permit Application
Date received: • , A -, —0 Permit no.: Me, +, s i. ii • 7
► City of Tigard !1,L � _.. � g PfojeCdappl. no.: da dji i i , date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: Receipt no.:
Phone: (503) 639 -4171 1
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory • ommercial/industrial ❑ Multi- family ❑ Tenant improvement
CI New construction CI Addition/alteration /replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: qp 2 0 5(,1.) WC's :eja , S�. ' . Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Spite no.: 5 d value of all mechanicalerials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ f9D/90-- .
Lot: IBlock: I Subdivision: *See checklist for important application information and
Project name: (X, 5.- e-L Prtc inr, ly jurisdiction's fee schedule for residential permit fee.
City /county: %j ' I ZIP: q-7 -LZ 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
_ Descri lion and ideation of work on premises: t �ji -t e--.860A-A141-12- AND COMMERICALIINDUSTRIAL _ EQUIPMENT SCIIEDULE
!`e � ts t A/e_ , e vi S At A!5 tie. P S Fee (ea.) Total
Est. date of completion /inspection: V Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
•
Is existing space heated or conditioned? iVes 0 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 name: '..p..,, • N a, � r State boiler permit no.:
HP Tons BTU/H
Address: C tj 4 ( 5 L .,) i_nr/ j t Nr Fire/smoke dampers/duct smoke detectors
City: iZeaver� -m,t_ I State: 15 re! ZIP:11 6-05 Heat pu
Install/replace furnace/burner plan
required) BTU /H
Phone: (prt �aS et I Fax� t l
�- ( g Email: Including ductwork/vent liner O Yes O No
CCB no.: Co3 G Ii3 .. Install/replace/relocate heaters - suspended,
City /metro lic. no.: to 'Z e5 wall, or floor mounted
Name (please print): - et_ ,Q Vent for appliance other than furnace
—
CONTACT PERSON efngeration: •
Absorption units BTU/H
Name: 1Z.e. -. i e W ty-a..1 Chillers HP
Addres : cc 9 t $ ,, !f ro' t D,-, Compressors HP
Environmental exhaust and ventilation:
City: rqil -e_ri-ev I State: ((2I ZIP: SQ Q d j Appliance vent
Phone: to S , Fax: , -d 3./ E -mail: Dryer exhaust
OWNER Hoods, Type U lUres. kitchen/hazmat
hood fire suppression system
Name: 4 eAa j .,,,, ,o i � A e.„1- Exhaust fan with single duct (bath fans) _ii;
• Mailing address: / J f ( Exhaust system apart from heating or AC
e p pmg an . distribution (up to 4 out ets
City:9 State:( ZIP: t Z' Type: LPG NG Oil _
Phone: 2 OiId d Fax: 7-1 - 'i'a) E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
` Number of outlets
Name: ue. Ou c L Z, Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: F � mail: _Woodstove/pelletstove —
Applicant's signature: /� Date: Other
�r� /2-20 - Q2. _ Other: _
Name (print): .hart 2 .e.i..il r
` Not . all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ '2 ' �`'
❑Visa 0 MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained
Credit card number: / / Plan review (at _ %) $
E within 180 days after it has been State surcharge (8 %) .... $ .....h'/ ire)
Name of cardholder as shown on credit card accepted as complete. TOTAL $ F 50
■ 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
$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 100K BTU 14.00
8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60 ,
Description: , Qty (Ea) Amount g) 15-30 HP; absorb 1
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 induding 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 _
>50 hp; absorb. unit, 5,725 18) Domestic incinerators 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% 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 NC requires site plan showing placement of unit.
I: ldsts\forms\mech- fees.doc 10/11/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Busin Line: (503) 639 -4171 MST
4 .
BUP
Date Requested ( a� AM PM BUP 2,6V 2 -600
Location g 0 S RD. Suite 5 Z O , , 2-6 - U 1
Contact Person Ph ( 7 06, .)-3 13 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall l' -- h aLJg LOter A04 PO°
Fire Sprinkler
Fire Alarm r? C/ 6 s v geZ
Susp'd Ceiling
Roof __ _
Other:
ART FAIL
P - N — G
Post & Beam -
Under Slab
/
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS _PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
•
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: - Unable to inspect — no access
Fire Supply Line
ADA 1 2 i —v 7 V
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL