Permit i- CITY OF TIGARD
MECHANICAL PERMIT
At t w o , DEVELOPMENT SERVICES PERMIT #: MEC2000 -00461
�'" „� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/27/00
PARCEL: 2S1 10 BA -06600
SITE ADDRESS: 12102 SW WILDWOOD ST
SUBDIVISION: SHADOW HILLS NO.2 ZONING: R -2
BLOCK: LOT: 049 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:
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.
Owner: FEES
SMITH, VISTON R JR + SUSANN B Type By Date Amount Receipt
12102 SW WILDWOOD PRMT CTR 11/27/00 $72.50 2720000000
TIGARD, OR 97224 5PCT CTR 11/27/00 $5.80 2720000000
Total $78.30
Phone:
Contractor:
SPECIALTY HEATING + FABRICATIO
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 620 -5643 Final Inspection
Reg #: SUP 2570RET
LIC 006657
ELE 34 -341CR
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
1.
Utility No • is tion Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ay obtain pies of t ese les or direct questions to OUNC by calling (503)246 -9189.
Issu y: _ Permittee Signature: 1, ci
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
/ ($
i / Mechanical Permit Application
A Date received: Permitno.:/ -/g -Co s/ /
, r 11
,
- �• � City of Tigard Project/appl. no.: Expire date:
Ali. City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
•
Land use approval: Building permit no.:
TYPE OF PERMIT •
X1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family O Tenant improvement
0 New construction )Addition /alteration/replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: /a/ 0 (J
cu /(j9 (0QO / ` 57 -- 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: 1 Subdivision: 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ')' l 4 (,J4/f � ZIP: � I & 2 FAMILY DWELLING PERMIT' FIE SCHEDULE
Des and °cation of work on premises: gad AND COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use:
HVAC: r han .
Is existing space heated or conditioned? 8tYes 0 No Air cndit unit CFM •
space insulated? Yes 0 No • Air conditioning
Is existing P Alteration of existing HVAC system
M ECIIANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business namedS ixJ4L I° .
Y et a 6 i7 11C HP Tons BTU/H
Address: / 5 LSO-) % a 1 s' Fire/smoke dampers/duct smoke detectors
City: "7 ' I State:OI ZIP:q 70 9•3 Heat pump epla a plan
a required)
equ er BTU /H
Phone 6 kx. Fax59& 0 9 /('E -mail:
CCB no.: t,4.5 7 Including ductwork/vent liner es�'No I
Install/replace/relocate heaters– suspended,
City /metro lic. no.: 1 Cel`o wall, or floor mounted
Name (please print): ' s /`N?14 , • -1-i{ eis Vent for a . pliance other than furnace
CONTACT PERSON efngera' on. _,
Absorption units BTU/H
Name: /4- Ti-f (e N , -7— h ' e A. Chillers HP
Address: 9'.5'.9. $' S(-t� / et S 7- Environmental ssors HP
Environmental exhaust and ventilation:
City: Tiga^d I Sta :G2 I ZIP: 9 ?oLa - _ Appliance vent
Phone 3 6. -66 ' Fax: 59g - c /S' E -mail: Dryer exhaust
OWNER Hoods, Type 1/ II/res. kitchen/hazmat
hood fire suppression system
Name: VLs Tr ' '7 44 St4.44 1 .,..5/41.47>f Exhaust fan with single duct (bath fans)
Mailing address: /a /Q.2 S (,J //�DARV CI .17 Exhaust system apart from heating or AC
- Fuel piping and distribution (up to 4 outlets)
City: - rip/lee I State: ae I ZIP: q 7
Type: LPG NG Oil
Phone: 4 •$ / Fax: E - mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: I Fax: I E - mail: Woodstove/pelletstove
� p Other: —
Applicant's signature: /(g4 J t.siI Date: ///027/0-0 —Other:
Name (print): —7<4 -4 1/- L C t✓M SK{/✓i✓C/'
Not all jurisdtcuons accept credit cards, please call jurisdiction for more information. Permit fee $
0 Visa ❑MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been
Name of cardholder as shown on credit card accepted as complete. State surcharge (8 %) .... $
$ TOTAL $
Cardholder signature Amount }, 5 ° 440-4617 (6/00 /COM)
P
'"1
Commercial Schedule
1&2 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE
Description
Furnace to 100,000 BTU Table IA Mechanical Code Oty Price Total
including ucts & vents 955 1) Furnace to duds & vents BTU
g including duds & vents 14 00
Furnace > 100,000 BTU 2) Furnace 100,000 BTU+
including duds & vents 17 40
including ducts & vents 1,170 3) Floor Furnace
including vent 14 00
floor furnace 4) Suspended heater, wall heater
including vent 955 or floor mounted heater 14 00
suspended heater, wall heater 5) Vent not included in appliance permit 6 80
or floor mounted heater 955 6) Repair units 12.15
Check all that apply: 'Boiler Heat Air
Vent not included in appliance permit 445 For Items 7 -10, see or Pump Cond Oty Price Total
Repair units 805 footnotes 1,2 Comp •
7) c3HP; absorb unit to
< 3 hp; absorb.unit 100K BTU 14 00
8) 3 -15 HP, absorb unit
to 100k BTU 955 • 100k to 500k BTU 2560
3 -15 hp; absorb.unit 9)15-- -0 P Hii . ab 35.00
101k to 500k BTU 1700 10) 30-50 HP: absorb
unit 1 -1 75 mil BTU 52.20
15-30 hp; absorb.unit 11) >50HP; absorb unit >1.75 mil BTU
87.20
501k to 1 mil. BTU 2310 12) Air handling unit to 10,000 CFM
30 -50 hp; absorb.unit 1000
13) Air handling unit 10,000 CFM+
1 -1.75 mil. BTU 3400 • 17.20
> 50 hp; absorb.unit 14) Non-portable evaporate cooler 10.00
> 1.75 mil. BTU 5725 15) Vent fan connected to a single dud
6.80
Air handling unit to 10,000 cfm 656 16) Ventilation system not included in
appliance pennd 10 00
Air handling unit > 10,000 cfm 1170 17) Hood served by mechanical exhaust
• 10.00 •
Non - portable evaporate coller 656 18) Domestic incinerators
vent fan connected to a single duct 446 17.40
19) Commercial or industrial type incinerator
Vent syst not included in appliance permit 656 69.95
Hood served by mechanical exhaust 656
20) Other units including wood stoves 10.00
Domestic incinerator 1170 21) Gas piping one to four outlets
5.40 •
Commercial or industral incinerator 4590 22) More than 4-per outlet (each)
1.00
Other unit, including wood stoves, inserts, etc. 656 Minimum Permit Fee 372.50 SUBTOTAL ism gas - -
Gas piping 1-4 outlets 360 8% SURCHARGE l
Each additional outlet 63 PLAN REVIEW 2F SUBTOTAL
Required for ALL commercia O l permits only _ . .
TOTAL EOM
Other Inspections and Fees:
1 Inspections outsde of normal business hours (minimum charge -two fours)
572 50 per hour
2 Inspections for WW1 no fee is specifically indicated (muirnum charge -han hour)
$72.50 per hour
Total Valuation Fee 3 Additional plan renew required by lunges. saddens or revisions to plans (nvnrtnum
charge-one-had hour) 572.50 per hour
'State Contractor Boner Certification required
$1.00 to $5,000.00 Minimum $72.50 "Residential A/C requires site plan showing placement of unit
$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
$50,000.00 and up $742.00 for the first $50,000.00 and $1.20
for each additional $100.00 or fraction
thereof
•
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MsT
24 -Hoer Inspection Line: 639 -4175 Business Line: 639 -4171
UP .%
Date Requested ) 2 — J 3 AM PM BLD
Location / Z/ o Z- S •i /4 wa6 5 f' Suite OiA■
Contact Person Ph 563 4 z61 '{3
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation `Q, k.9104.5 j �N &C.-� FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
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
PJ.SS..PART FAIL
N�ECHA
Post & Beam
Rough In
Gas Line
Smoke Dampers
tt. PART FAIL
E CTRICAL
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 `��
�
Other Date J A S � Inspector Ext J
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.