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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.