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12980 SW Carmel Street
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CITY OF TIOARD
MECHANICAL PERMIT
\ DEVELOPMENT SERVICES � —PERMIT#: MEC2002-00337
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/30/02
PARCEL: 2S116AD-18400
SITE ADDRESS: 12980 SW CARMEL ST
SUBDIVISION: KING CITY NO. 18 ZONING:
BLOCK: 23 LOT: 007 JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCU'PANCY GRP: R3 VENTS W/O APPL.: VENT SYSTEMS:
STORIES: _BOILERS/COMPPE_SSORS _ HOODS:
_ FUEL TYPES _ _ 0 3 HP: DOMES. INCIN:
LPC, � 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR
FIRE DAMPERS?: 30 - 50 HP: OODS UNITS:
GAS PRESSURE: 50 + HP: COD DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITS CLO R UNITS:
----- - OTHER UNITS:
FURN —100K BTU: <= 10000 ctm: GAS OUTLETS: 1
> 10000 ctm:
Remarks: Install gas line, outle, and gas logs
Owner: FEES — —
LEE, ROBERT L + JOYCE G TRS Type By Date Amount Receipt
12980 SW CARMEL ST PRMT CTR 7130/02 $72.50 2720020000
KING CITY, OR 97224 5PCT CTR 7/30/02 $5.80 2720020000
Total $78.30
Phone: — ---
Contractor:
AMAIN ENTERPRISES INC
PO BOX 230849
TIGARD, OR 97281 REQUIRED INSPECTIONS
Gas Line Insp
Phone:503-620-4534 Mechanical Insp
Reg#:LIC 101803 Misc. Inspection
This permit is issued subject to the regulations contained in the 1 iydrd Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. T0s permit will expire if work is rot started within 180 days of issuance, or if work is suspended
for morF- than 180 days. ATTENTION: Oregon law requires you to follow tyles adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling
ren,i)9A ,-q1RCP
Issue By: � Permittee Signature �1 -.. - I,
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Applicatio"
--� -— — - Date received:7 30 L !T.,,,t . )� ���,) - J7 7
('lay of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall lilvd,'1'igard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171 a
Fax: (503) 598-1960 �_� Case file no.: Payment type:
Land use approval: - Building permit no,:
e
U 1 &2 family dwelling or accessory U Commercial/industrial J Mtllll i•unilN f J., I i u l irnpru�rntcnl
J New consiniclitm 'J Addition/alteration/replacement 0111"I +-
ri � 0&AS _
JOB t ' t t t
Job address: �� jO _ � Indicate equipment quantities in boxes below. Indicate the dollar
Bidg.no.: Suite no,; value of all mechanical matctiWs#quipntent,labor,overhead,
Tax map/tax lot/account no.: profit. Value$ _Z=ff_T_9z
Lot: Block: Subdivision: 'See chct-kh-,l for important application information and
Project luu»e: jurisdicn 1�-e schedule for residential I emit fee.
City/counly:
Description and location ttf work Onff r�emises: ,�.
1 _ + LAS
Est.date ofcompletion/inspection: U,.v,putam (Xy. Res.only Re..onh
Tenant improvement or change of use: Air hanr han
Is existing space hc,i 11 ur condo �ncd?A Ycs L No Adling unit CPM _
Ali conditioning(silepanrcyuirc )
Is exisliitg space im.ul.,l tl'''J l r J Nn 7 A tcration of existing AC system
t Boiler/compressors
M) ��� —' State boiler permit no.:
Business name. _ HP _ Tons B fU/H
Arldrcss �y9Map CL_ _ �ir•smoke damp-r-sIductsmo a detectors
City: Tl� _ Starr: 1.1 P: Z,'fr _1 cal pump(site plan-require )
Phone: I ;t�(tom�� Email: nsta rep acefurnnce urner__ i'fU/11
Including ductwork/vent liner U Yes U No _
CCB no.: nsta Urep are rc ocatc heaters-suspen ed.
Cily/metro tic.no.: wall,or floor mounted
Name( lease print): cat for o lance othcr than furnace
e gent ore
CONTACT PERSON
' J Absorption units BTU/11
Name: Chillers----- - -- lip
Address: Com ressors fill
e Snv ronmental exhaust and vent arroT n
City: I Stale: ZIP: Appliance vent
Phone: Fax E-mail: Diyerex aust
floods,Type / /res. itc en/hamnat
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
ress
Mailing add : x ust system apart from teaun or C
--- -- taue p ping end distr on(up troutlets)
City: State: llf TYfx LPG V NG Oil
Phone:(o IF mail: Fuel—M-1---F—Ritional over 4 outlets
roces+piping(schematic required)
Name: Number of outlets
Otherli�appliance or rq1 pmrnt:
Address: Decorative fireplace _
City. -- - I State: ZIP: nsert-type — --
I'ttonC: Fax: E-mail: oda stov et stove
Other: ZSA di,
Applicant's signature: Date: ter:
Name (print): _ _
Not all jurisdiction,magi credit card%,plea,cnll juNMiction(or more mrormittdon. Minim fee fee
................$ d
D Visit U MastetCanl Nolice:1lmis permit application Minimum fee................$
expires if a permit is not obtained Plan review(at _ %) S
Credit card number _�___�__.— within 180 days otter it has been --
E, ilei 5'
p accepted as complete. State surcharge(A96)....$
Name o c oldrr a%,hown on credit cm S PTOTAL ................ ......$ 1)
Cantholder denature Amount .140-4617(WWOM I
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
Description: Price Total
TOTAL VALUATION: PERMIT FEE:--- Table 1A Mechanical Code - _ Oty (Ea) Amt
$,.U-to$5,000.00 Minimum fee$72.50 1) Furnace to 100,000 BTU
$5,001.00 to$10,000.00 $72 50 for the first$5,000.00 and including ducts 6,vents 14.00
$1.52 for each additional$100.00 or Furnace 100,000 BTU+
fraction thereof,to and including 2) FurnacIncluding ducts&vents 17.40
$10,000. 0. 3) Floor Furnace
$10,001.00 to$25,000.00 $14e.50 for the first$10,000.00 and includin vent 14.00
$1.54 for each additional$100.00 or Suspended heater,wall heater
fraction thereof,to and including 4) SSfloor mounted heater 14.00
_ $25,000.00. or
$25,001.00 to$50,000.60 $379.50 for the first$25,000.00 and 5) Vent not included In appliance permit 6.80
$1.45 for eacii additional$100.00 or
fraction thereof,to and Including 6) Repair units 12-15
__ $50 000.00. _ ---
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply; Boiler Heat Air
or Pump Cod
$1.20 for each additional$100.00 or For items 7-11,see Comp
fraction thereof, footnotes below. ` -
7)<3HP;absorb unit 14.00
Minimum Permit Fee$72.50 SUBTATAL: $ - to 100K BTU
- 8)3-15 HP;absorb 25.80
State Surcharge $ unit 100k to 500k BTU
_ - -- - 9)15-30 HP;absorb
25%Plan Review Fee(of subtotal) $ unit.5.1 mil BTU 35.00
_ -Required for A_LL corrmercialpermit9 onl _-__ 10)30 50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20
11)>50Hp;absorb 87.20
unit>1.75 mil BTU
12)Air handling unit to 10,000 CFM 10.00
ASSUMED VALUATIONS PER APPLIANCE:
Value - Total 13)Air handling unit 10,060 CFM+
Descri tion 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
6,80
ducts&vents -- -- 955
Floor furnace Includin v� enl - 955 -- 16)Ventilation system not fncludau in 10.00
Suspended heater,wall healer or a (lance ermit
floor mounted healer _._ - 445 17)Hood served by mechanical exhaust 10.00
Vent not Included in appliance
ermit -- 805 18)Domestic Incinerators 17.40
Repair units
<3 hp;absorb.unit, 955 19)Commercial or Industrial type incinerator
69.95
to 100k BTU -- 1,700
3-15 hp;absorb.unit, 20)Other units,Including wood slaves J10.00
101k to 500k BTU - 2,310 r
15-30 hp;absorb.unit,501k-to1 21)Gas piping one to four outlets + 5.40 7•4-0_
mll.BTU
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1.00
1-1.75 mil.BTU 5,725
>50 hp;absorb.unit, Minimum Permit Fee$7,.50 SUBTOTAL: $�,L
>1.75 mil.BTU - - ---Air handling unit to 10,000 cfm !_P446
8%Stale Surrharge
Air handlingunit>10 000 cim _
Non• op rtable evaporate cooler TOTAL. RESIDENTIAL PERMIT FEE: $��
Vent fan connected to a sin Is ductVent system not Included In
a Ila_nce permit 6513 --- - - - Other Insoectioni end Fees:
Hood served by mechanical exhaust -- 1 inspections outside of normal business hours(minimum charge-two hours)
Domestic Incinerator 1 170 $62.50 per hour
Commercial or Industrial incinerator 4 590 2 Inspections for which no fee is specifically indicated (minimum charge-hall hour)
856 $62 50 per hour
Other urlt.!ncliIdling wood stoves, 3 Additional plan review required by changes,additions or revisions to plans(minimum
Inserts etc. 380 charge-one-half hour)$62 50 per hour
Gas I Ing 1-4 outlets -63
Each edditlOnal outlet - "State Contractor Boiler Certification required for units>200k BTU.
"Residential AJC requlies site plan showing placement of unit.
TOTAL COMMERCIAL
VALUATION: _. _ All New Commercial Buildings require 2 sets of plans.
I.\dsts\formsUnech-fees.doc 02/11/02
KING CITY
15300 S.W. 118th Avenue,King City,Oregon 97224.2693
Phone:(503)639.4082•FAX(500)639.37 71
Notice To Contractors `Vorking In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in Kine City are issued and inspected by the City of Tigard.
If your permit application DOES NOI REQUIRE PLAN REVIEW. simply complete the
appropriate application legibly and submit it to the King City staff. The King Cite staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
t,;:' permit. issue the permit. and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is readv for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete. legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simple sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 1312 SW
Hall Blvd. Tigard, to submit applications and plans. Development Services Technicians are
available at 639-4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King Citv hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: �A S /, I �( GAS
located at: 2-180 SW C
V2iRepresent five
I D5TS KCMT DOC
i
CITY OF TIGARD 24-Hour
BUILDING; Inspection Line. (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BUP _..-
Received -_�— Date Re nested_� AM_—___ _ PM—_- _ - Bt.1P
Location Suite_�_ ,, MEC o2-0,02, G� 3
Contact Person _ �./�—� j Ph(__ _ - _) �' �. PLM
Contractor _ _ �_- ___ Ph( -_) .__ SWR _
_BUILDING _ Tenant/Owner - __- - - ELC
Footing
Foundation ELC _
Ftg Drain Access:, � ' -
ELR
Crawl Drain
Slab Inspectio otes: 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 8 Beam
Under Slab
Rough-In
Water Service - —
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - ---
Shov..-er Pan
Other: --
Final
PASS PART FAIL -'
MECHANICAL
Post_$_Beam
�v
as i
Smoke Dampers
Final
PART FAIL ------ -
- TRICAL
Service -__--- --
Rough-in — --`— -- - ---
UG/Slab
Low VoltageFire Alarm
Alarm
Final [� Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvri.
PASS PART FAIL
SITE- Please call for reinspection RE: _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date ! Inspector ! Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job fs.lte.
PASS PART FAIL