Permit ,.
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00163
- II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/1/03
PARCEL: 2S 102BC -04800
SITE ADDRESS: 10645 SW WATKINS PL
SUBDIVISION: WATKINS PLACE ZONING: R -4.5
BLOCK: LOT: 005 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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace gas furnace and add a/c unit.
Owner: FEES
VOLK, KENT J + Description Date Amount
VANDYKE, JUDI A
10645 SW WATKINS PL [MECH] Permit Fee 4/1/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 4/1/03 $5.80
Phone: Total $78.30
Contractor:
B +S HEATING
67396 CRANE/BUCHANAN RD
BURNS, OR 97720 - REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 45838 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 u- to- fol_ow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
I , I ,
Iss d B Y: ',lc) �) i � /�, / / ' Perm Signature:
lc) � � % ELI_' ► / _�_S; ,
Call (503) 6 -4175 by 7:00 P.M. for inspections needed the n `usiness
/1/I C •r0 3 - c)o I CP 3
Mechanical Permit Application FOR OFFICE USE ONLY
Received Mechanical
Date/By: Permit No •
Planning Approval Building
City of Tigard DatcBy Permit No.:
13125 SW Hall Blvd. Plan Revi Other
Tigard, Oregon 97223 Date /By. Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
hiaro,I I iii Date/By: Case No .
Internet: www.ci.tigard.or.us _AI. cal I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 - " Name/Method: Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ w construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
I dition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
f & 2- Family dwelling ❑ Commercial /Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** d 14.00
Job site address: / 061/4 -S P. !v j -1GWS PL. Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
Kee Iti ` Q. a lc`Cj 6115 6f.S FV `' t e- Flue vent (water heater /gas fireplace) 10.00
wx.t. N'e G*' • ift ✓ d. 4-C Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
'PROPERTY OWNER I ❑ TENANT Other: 10.00
Name: , (' i- Pei k Environmental Exhaust & Ventilation
A Range hood/other kitchen equipment 10.00
Address: / b 6'Lis s .W. 1 ✓g f k•Lvs / Clothes dryer exhaust 10.00
City /State /Zip: T; &A, d... &/. 9 7 7 2 3 Single duct exhaust
Phone: 620 • `O 3 ? Fax: (bathrooms, toilet compartments,
® APPLICANT INCONTACT PERSON utility rooms) 6.80
Name: P7 .. �S Attic /crawl space fans 10.00
0 c 0 0 x 'i 62 3 Other: 10.00
Address: / Fuel Piping
City /State /Zip: p,e 2 Q h C." c L ?O 95 * *($5.40 for first 4, $1.00 each additional)
Phone: ?,S o • Gcr s k- Fax:! Furnace, etc. **
Gas heat pump **
E -mail: Wall /suspended/unit heater **
CONTRACTOR Water heater **
Business Name: al S /ieca ini Fireplace **
Address: /°. p c $ o 123 Range **
City/State/Zip: D C . 0R R 70 VJ'
BBQ *_
Cit
}� p �/�. Q7 h Clothes dryer (gas)
Phone: D U (9 • p 5 'J' Fax: tyl /9S.2br5 Other: **
CCB Lic. #: 1.1 , Total:
Authorized M echanical Permit Fees*
i Subtotal: $ 7A.5ei
Signature: A .r4 � y �`Z
/ .� Date: .aP03 Minimum Pernut Fee $72.50 $
f92 S k Plan Review Fee (25% of Permit Fee) $ 5,$0
$0
(Please print name) State Surcharge (8% of Permit Fee) $ •
TOTAL PERMIT FEE $ 7 k, :50
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000 00 $72.50 for the first $5,000 00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000 00
$10,001.00 to $25,000 00 $148 50 for the first $10,000.00 and
$1.54 for each additional $100 00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000 00 $379.50 for the first $25,000.00 and
$1 45 for each additional $100.00 or
fraction thereof, to and including
$50,000.00
$50,001.00 and up $742.00 for the first $50,000.00 and
$1 20 for each additional $100.00 or
fraction thereof.
Assumed Valuations Per Appliance:
Value Total
Description. Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace> 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp, absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700 • ° - • •
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to I mil 2,310
BTU
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
•
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170 -
•
Non - portable evaporate cooler 656 , •
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit ..
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590 •
Other unit, including wood stoves, 656
inserts, etc.
•
Gas piping 1-4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $ ,
VALUATION:
i•\Dsts\Permrt Forms MecPermitAppPg2.doc 01/03
i
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Lf BUP
Received Date Requested / °�J AM PM BUP
Location / 0 (e LI S to _ J 0._ suite 1 MEC 3 / G 3
Contact Person Ph ( ) a -05C8 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext 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
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 ft - C •
Final
PART FAIL
CTRICAL
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 Li Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector 7 Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL