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11750 SW ;IRLCREST DR
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 635-4175 Businass Line: 639-4171 MST
BLIP
Date Requested Z Z L---AM-----!71M OLD _
Location �SZ S��% .� 4>5 fi Suite --
MEC c?o-0
Contact Person _ //Pic-{ Ph ` PLM
Contractor ph c/-')jf a f Z Z SWR ---�--
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access
Foundation FPS
Ftg Drain --�"-- -
Cra-I Drain Inspecticn Notes: SGN
Sla'j
Post&Beam SIT
Ext Sheath/Shear
Int Sheath/Shear ---
Framing ��1"'fid� � /��.?��tictf.. CA S it-I-El wA s
Insulation -�-- -
Drywall Nailing S, n-1 Cr •-rS- - /Etiar- ,---Ex77CAL
Firewall - - ---
Fire Sprinkler Lv 5-,'k 433
A -
Fire Alarm -
Susp'd Ceiling C2
Roof
Misc: — —
Final
PASS PART FAIL
f LU;WING
Post& Beam -
Under Slab
Top Out
Watcr Service
Sanitary Sewer — —
Rain Drains
Final
PA PART FA!L
Post& Beam ——
Rough In
Gas Line —
S oke Dampers
PASS PART FAIL
ELECTRICAL - - - ---- -- ---
Service _
Rough In
UG/Slab _
Low Voltage -'
Fire Alarm _
Final
PASS PART FAIL -_
SITE
Backfill/Grading -
Sanitary Sever
Storm Drain ( ]Reinspection fee of$ required aefore next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch 3asin
Fire Supply Line [ )Please call for reinspection RE._ ( )Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date /Z - z 4 Inspector - Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYO F T I r_ n R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: h1EC2000-00507
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/2.7/00
PARCEL: 1 S 134CA-06900
SITE ADDRESS: 11750 SW BURLCRES F DR
SUBDIVISION: BURLWOOD NO. 2 ZONING: R 4 5
BLOCK: LO'r: 009 JURISDICTION: FIG
CLASS OF WORK: ALT FLOOR FURN: EV5kP 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. NCIN:
LPG — -- 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTO JES:
GAS PRESSURE: 50 + HP:
CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
— OTHER UNITS:
FUR14 >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfin:
Remarks: Replace existing furnace and piping.
Owner: �--�_-- FEES - ---_
JURGENSON, NEAL/MARSHA A Type B/ Date Amount Receipt
11750 SW BURLCREST DR PRMT CFR 12/27/00 $72.50 272000000C
TIGARD, OR 97223 5PCT CTR 12127/00 $5.80 272000000C
Phone: Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Gas Line Insp
Phone:453-4822 Mechanical Insp
?eg #:LIC 62'196 Final Irspection
This permit is issued subject to the regulation- contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other app!icable laws All -vork will ;e done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adoptee in the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by
calling (503)246-9189.
Issue By: Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Datereceived: 4-V7 s 7 07) Permit no.11t.'-006��5,
City Of Tigard Project/appl.no.: Expire date:
CirvnfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: ! eccipt nn.:
Phone: (503) 639-4171 —._
Fax: (503) 598-1960 Case file no.: Payment type-
Land use approval: Hi ilding permit no.:
TYP&QF
=constn
y dweltirg or accessory ❑Commercial/industrial U Multi-family U Tenant improvement
1.:1 -lion U Addifion/altcration/replacement U t)flier.
COMMERCIALIf SITE INFORNIA1116N
Job address: ��-JSG �_�� �/�_�'/?r_=LT 7 Indicate equipment quan::ties in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/accomtt no.: profit.Value$ _
l.ttt: Block: Subdivision: _ 'Sse checklist for important application information and
Project name: jurisdiction's fee schedule !err residtnitial permit fee.
City/county: 77&Afa/,,fpsll 7_-3 — I t
Description and location of work on premises:
Fee(".) Tofal
Est.date of completion/inspection: / Description Oly. Rrw.only Rts_onl}
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes O No A
Is existing sir handling unit ___CFM
ac^insulated?U Yes U No Aircon conditioning(site plan required) _
P Alteration o exxisting f VAC system
oiler/compressors
State boiler permit no.:
Business name: L("(`/1y�Z CCi�?` _ HP Tons BTU/H
Address: OG S W 71 1— _'ire/smokeamper uct smo a detectors
City: p Sir ate:0,C. ZIP: x,21 cat pum (sitcp cqui,,u;
Phone:Sp - 3-q82-?- Fax:501-W 7 E-mail: I
nst rep I ace funtac rner
including dn enf:finer U Yes U No Ay�v /1y CQ
CCB no.: 62/96 _ lista rep ace to ucale ieaters-suspended.
City/metro lie.no.: wall,or floor mounted _
Name(please print): ?J 4 ,� 11_ ant c r gerat on:or n fiancember t an furnace
Absorption units BTU/ll _
Name: / plt/ Chillers HP
Address: 0504 -574,) 7.2-Ad Coln rossors_ HP
mvirlinuental exhowd and ventilation:
City: � StateO�P ZIP: 7 Appliance vent
Phone:moo'-V6 -y81Z Fax: E-mail: ryerex taunt
0o s Type /res.kitchenAiazmat
hood fire suppression system _
Name: (, /9�'S�/19 (,/PC.(/ Exhaust fan with single duct(bath fans)
Wiling address: e i UkL Exhaust system a artrom heattn or AC
Fuel piping an s1 Won(up to 4 outlets)
City: Slate:OR ZIP: 72 Type: LPG NO Oii 5-y4 G
Phone: I`ax: E-mail: Nuel pipingeach additional over 4 out
Process piping(schematic requirc )
Name: Number of outlets
0(her st appliance or equ prnent.
Address:_ _ __ Decorative fireplace
City: —--- i State:_ ZIP: Insert-type• — —
Phone: r Fax: E-frail: oo stov pe etstovc
Applicant's signattr = Date: / ,z licr:
Name (print): _
Na ail jurisdictionsaccept.redo card,,please eau jurisdiction for more mrarmxuon. Permit fee.....................
Phi
U visa U Mastercard Notice: s permit application
iMinimum fee................$ 7,rZ_ •SG
expires f a permit is not obtained
Credit card number: plan review(at -__ %) $
___.. ___� �L1_
Expires within IRO days after it has been State surchatge((%)....$ S��
Name or cardholder as shown on credit card - accepted as complete. TOTAL . $ 7S•30
Cardholder signature Amount 410-4617(6)(101170M)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
_ -_f -- Description: - ------ - Price T
TOTAL VALUATION: FEE: .
- Table na Mechanical Coda Gty (Ea) A m
$1.00 to$5,0011.00 Minimum fee$72.50 1) Furnace _
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and ce t 0 B TU
$1.52 n'each additional$100.00 or including ducts
ucctsls&vents _ 14.00 .�
fraction thereof,to and including 2) Furnace 100,000 BTU+
_ $10,000.00_. including ducts&vents 17.40
$10,001.00 to$25,000.00 $148.50 to, the first$1u,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or includinjq vent _ 1400
fraction thereof,to and Including 4) Suspended heater,wall heater
$251000.00, or floor mounted heater _ 14.00 _
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Ven;not included in appliance permit
$1.45 for each additional$100.00 or
fraction thereof,to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional$100 00 or For Items 7-11,see or Pump I Cond
fraction thereof. _ footnotes below. Corm
7)<3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: to boat BTU _ 14 00
Value Total 8)3-15 HP;absorb i
unit 100k to 500k BTU _ 25.60
Description: Qt Ea Amount g)15.30 HP;absorb
Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU _ 3500 _
ducts&vents 10)30.50 HP;absorb
Furnace>100,000 BTU including 1,170 unit 1-1.75 mil BTU _ 5220 _
ducts&vents 11)>50HP absorb
Floor furnace Including vent 955 unit>1.75 mil BTU _ 8720 _
Suspended neater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted healer 1000 _
Vent not Included In applicance 445 13)Air handling unit 10 000 CFM+
emtit 17.20
Repair units 805 _ 14)Non-portahle evr,porate cooler
<3 hp;absorb.unit, 955 10,00
to 100k BTU 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 6.80
101k to 500k BTU 16)Ventilation system not included in
15-30 hp;absorb.unit,501k to 1 2,310 appliance permit 10.00
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 1000
1.1.75 mil.BTI/ 18)Domestic Incinerators
>50 hp;absorb.unit, e,,725 17.40
>1.75 mil.BTU - 19)Commercial or Industrial type incinerator
Alr handling unit to 10,000 cftn 656 _ 69.95
Air handling unit>10,000 cfm 1,170 20)Other units,Including wood stoves
Non-portable evaporate cooler 656 10.00
Vent fan connected to a single duct 446 21)Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22)More than 4-per outlet(each)
Hood served by mechanical exhaust 656 1,00
Domestic incinerator 1,170 Minimum Permit Fee$72.50 SUBTOTAL:
Commercial or Industrial Incinerator 4,590 $7,7• SU
Other unit,Including wood stoves, 656 8%State Surcharge $
Inserts,etc.
Gas piping 14 outlets 360 - --�" 25•/.Plan Review Fee(of subtotal) $
Each additional outlet 63 _ Renuired for ALL coma ercial permits only
TOTAL COMMERCIAL $ - TOTAL RESIDENTIAL PERMIT FEE:
VALUATION: _
f.
Other Inspecllgns and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72 50 per hour
2 Inspections for which no lee is ripecitically indicated (minimum charge-half hour)
$72 50 per hour
3 Additional plan review required by changes,additions or revisions to plans(minimum
charge-one-half hour)$72 50 pe-hour
State Contractor Boller Certiflcatr,,n required for units>200k BTU.
"Residential A/C requires site plan showing placement of unit.
I:\dsts\fomts\mech-fees.doc 10/11/00