Case File f�
N
N
0
Ln
c
X
z
H
O
z
d I
H
[TJ
I
I'r
12205 SW ANM4 DR
CITY OF TIGARD BUILDING INSPECTION DIVISION MS1
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- --- ----
BLIP _
Date Requested �Z_—AM �� PM _ BLD
Location1 .a-- '-�-- &.S ��_��,,�� � Suite VIEC D-021 1�2
Contact Pe,son Phi. PLM `
Contractor P., SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Ccess. FPS
Foundation ���
Ftg Drai^ SGN
Crawl Drain Inspection Notes. -------------
Slab rL� � �v ,- y SIT
Post&Beam
Ext Sheath/S'aear
Int Sheath/Shear
Framing _—._-- ------ --_—._- — - -_ - ------- --
Insulation
Drywall Nailino _ _-- -----------.-_-__._------.- ------Firewall
Fire Qpr!r,�er -- ------ ----- ---- -- - _ .-
Fira Alarm
"lusp'd Ceiling --- ---- ---- ------ -------_�._�
F nal
PASS PART FAI'. -- - - - -- -- -- -----
PLUMBING
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Pout&Beam --- -- ------ -..-- __
Rough In
Gas Line I , -- -- ---- ---- -- --
Smoke Dampers
.6 PART FAIL
ELECTRICAL ------ - .. -
Service
Rough In -- - -.. -- --- -
UG/Slab
Low Voltage
Fire Alarm ---
Final
PASS PART FAIL -.--
SITE
Backfill/Grading — - -`
Panitary 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 reirfspection RE: [ ]Unable to inspect-no access
ADA
Approach/Sidewalk Date 2_ Inspector Ext
Other --
Final
PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site.
CITYOFr I G AR D MECHANICAL PERMIT
DEVELOWMENT SERVICES PERMIT#: MEC?001-00292
` DATE ISSUED: 8/16/01
13125 SW Hall -iIvd., Tigar(S, OR 97223 (503) 639 4171 PARCEL: 1S134CB-14800
SITE ADDRESS: 12205 SW ANTON DR
SUBDIVISION: ANTON PARK NO. 2 ZONING: R-7
BLOCK: LOT: 075 .LIRISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPF OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS.
bTORIES: BOILERS/C_O_ MPREISSORS _ HOODS:
FkIEL TYPES �~ 0 - 3 HP: 1 DOMES. INCIW
—� 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPER; ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNI i S OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of a/c unit.
Owner: ----� FEES
JERRY LIEBERTZ. Type By Date Amount Receipt
12205 SW ANTON DR PRMT CTR 8/16/01 $72.50 2720010000
PORTLAND, OR 97223 5PCT CTR 8/16/01 $5.80 2720010000
Total $78.30
Phone:503-579-8955
Contractor:
CENTRAL VALLEY AIR
830 VALLEYWOOD DR. SE
SALEM, OR 97306 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone:503-930-8304 Final Inspection
Reg #:LIC 127032
This permit is issued subject to the regulations contained in the Tigard Mp ir;,-ipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is -suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rule are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-91,69.
Issue B y � , ( � l �/ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Date received: ►l,�(� Permit no.: -� y
City of Tigard Projecdappl.no.: Expire date:
City q,fTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issu, f: 1 By: Receipt no.:
Fax: (503) 598-1960 Case rite ne.: Payment type:
Land use approval: _ Building permit no.:
-I-YO OF WERMIT
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
r U New construction -Lr Addition/altcmtion/re laceme.nt LI Other
P '
JOWSITIK INFORMATION COMMERCIAL VALU,�,JJON
Job address: U T I9�a y Indicate^quipment quantities in boxes trclow. Indicate lltc dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivisi .n: *See checklist for important application information ant'
Project name: iurisdiction's f'ee schedule for residential permit fee.
City/county: y ZIP: t
Description and 16dation of work on premises: 01-A: t t
Gr1 t ev(ca.) Total
Est.dale of completion/inspect ion: _)U i Ueseription Ijly. Res.on1v Re,4.onh
Tenant improvement or change of use: t — —�
Is existing space heated or conditionedviifYes U No Air handling unit C,�,
IS existing space insulated? rr con itiomng(site plan required)
Yes U No Alteration of existing _C system -
XI111j.jL10 in]1111111111113101111 liftlill till oi er compressors
Business name: / ✓ State boiler permit no.
Address: j v (/� r „�, Y f' HP _7 ons BTU/H
.1r smoEc amper uct smoke 4-I.ectors
City: qJ,w, State: C��' ZIP: dd 3 eat pump(site plan rrquirc )
Phone: 11"7 ps',r I Fax: 3 jo,J/ )o& E-mail: nsta rep acefurnac urner /
CCB no.: o? Including ductwork/vent liner O Yes U No
nsta rep ac re ocate heaters-suspended,
City/metro lic,no.: Q _ wall,or floor mounted
Name( lease rint): t rr/►h ti ant fora fiance of to t t�an f lmacc
e gest on:
lug Absorption units BTU/"
Name: Chillers H1'
Address: Com,ressnrs - til' —--
Environmental ez list and ventilation:
City: State: ZIP: Appliancevent
Phone: Fax: f,-mail: )rycrcx gust r —�
Hoods,Typeres. tic a azmat _
hood fire suppression system
Name: � 6 e, Exhaust fan with single duct(bath fans)
Mailing address: p ayt Exhaust system apart from heaun or7_C __
City: ai-7�M / State: D� ZIP: �e � Fuelpiping an st ut on(up to 4 outlets)s
Phone: 7X51 I Fa x I E-mail: type: L'CND Oil
ne piping
cacti a nal over 4 outlets
Process piping(schemadcrequire )
Name: Number of outlets
Other sr appliance or equipment:
--
Address: D,!corative fireplace
City_ State: ZIP: nsert- type --
Phone: I Fax: I E-mail: he stov pelietstove
Ot r:
Applicant's signature: / _ Date: if `1 t �:
Name. (print): - p --
S
Nd all Juri diction accept credit cents,please call Jutirdie0on for mare Informndon. Permit fee.....................$
O visa U MasterCard Notice:This permit applicat:,- Minimum fee................$
Credit.,,r(number expires if a permit is not obtained Plan review(at _ %) $
`€xplr within 180 days after it has been
Nurse of cardholdet u ehawn ort c t caro State surcharge(896)....— accepted as complete. $$ --�
$ TOTAL ....................... t C)
('udhn�;er ef`ritttrrc Arnow( TOTAL
(6M(Vrt)M)
MECHANICAL PERMIT FEES .
COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Qty (Es) 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 c;r Including ducts 8 vents 14.00
fraction thereof,to and Including 2) Fumsoe 100,067 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
_
$25,000.0 . or floor mounted heater 14.00
$25,001.00 M$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit 6.80
$1.45 for each additional$100.00 or
fraction thereof,to and including 6) Repair units
$50,000.00,
12.1'-
$50,001.00 and up $742.00 for the first$50,000,00 and Chu. :all that apply: Bailer 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
Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14.00
8)3-15 HP;absorb
6•/.State Surcharge $ unit 100k to 500k BTU 25.60
9)15-30 HP;absorb
25%Plan Review Fee(of subtotal) unit.5-1 frill BTU 35.00
Reaulred for ALL commercial permits only 10)30-50 HP;absorb
---f COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 5220
11)>50HP:absorb
- ------ unit>L75 mil BTU 87.20 _
_ _ 12)Air handling unit to 10,000 CFM
ASSUMES V_ALUATIO_NS PER APPLIANCE: 10.00
Value Total 13)Air handling unit 10,000 CFM+
Desai tp Ion: __ _ Qt Ea Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts&vents _ 10.00
Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a single duct
ducts&vents _ 6.80
Floor furnace Includingvent 955 16)Ventilation-vstem not included in
Suspended heater,wall heater or 955 appliance permit 10.00
floor mounted heater _ 17)Hood served by mechanical exhaust
Vent not included in applicance 445 10.00
permit 18)Domestic Incinerators
Repair units _ 805 17'40 -
c 3 hp;absorb.unit, 955 19)Commer Jal or Industrial type Incinerator
to 100k BTU _ 89.95
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101k to 500k BTU 10.00
15-30 hp;absorb.unit,501 k to 1 2,310 21)Gas piping one to four outietr
mil.BTU 5.40
30-50 hp;absorb.unit, 3 A00 22)More than 4-per outlet(each)
1-1.75 frill.BTU 1 00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL:
1.75 mil.BTU
Air handling unit to 10,000 dm656 - 6%State Surcharge $
Air handling unit>10,000 cffn L 1,170 _ _
Non txtable eva orate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: S
Vent fan connected to a single duct 446 _
Vent system not included In 658 -- - - -
a Ilanoa rmit 0111er Insoectlons snd Fees:
Hood served by mechanical exhaust 856 _ 1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic Indne'-rotor 1,170 $72 50 per hour
Commercial or industrial Incinerator 4,5902 2 Inspections for which no fee is specifically indicated (minimwn charge-half hour)
656 $72 50 per hour
Other unci,Including wood stoves, 3 Arlditional plan review required by changes,additions or revisions to plans(minimur
Inserts,etc. - charge-one-hatf hour)$72.50 per hour
Gas I in 1-4 outlets 360
Each additional outlet _ _ 63 'State Contractor Boller Certification required for units>200k BTU.
'"Residential A/C requires site plan showing placement of unit.
TOTAL COMMERCIAL $
VALUATION: _
I:\dsts\forms�inech-fees doc 08/06!01
08.15-01 WED 07:58 FAX 9007509999
I I
' I t
I
I I
I
I 1 _
I
I
Il
• I 1 1
i
I � ,