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12885 SW GLACIER LILY CIRCLE ro n 2F85 SW Glacier Lilly Circle CITY O F TIf /�'R __ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2001-00049 13125 5W Hall Blvd., Tigard, OR 3722:3 (503) 639-4171 DATE ISSUED: 217/01 PARCEL: 1 S 133GA-02500 SITE ADDRESS: 12885 SW G1 AC:II-R L IL Y 0R SUBDIVISION: AMART UMMERLAKF ZONING: P-7 BLOCK: LOT: 047 JURISDICTION: TIG CLASS OF WORK: U--R FLOOR FURN, FVAP COOLERS: TYPE OF USE: 3F UNIT HEATERS: VENT FANS: OCCUPANCY GRP. R3 VENTS WIO APPL: VENT SYSTEMS: STORIEt,: BOILERS/COMPRESSORS _ HOODS: FUEL T_YPES 0 3 HP_ DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INPUT- BTU 15 - 30 HP: REPAIR UNITS: FIR' DAMPERS?: 3C - 50 HP. WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING_ UNITS OTHER UNITS: FURN >-100K BTU: <= 10006 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Replace existing furnace and a/c unit with like kind. Owner: _ FEES HEIM MICHAEL RAY ANDpe B Date Amount Receipt Y Y LINDF, K PRMT CTR 2/7/01 $72.50 272001000C 12885 SW GLACIER LILY CIR 5PCT CTR 2/7/01 $5.80 272001000C TIGARD, OR 97223 17ota1 $78.30 Phone: ----- Contractor: BELL HEATING (GRE(- MILLETT) 15550 SE PIAZZA AVE RFaUIRED INSPECTIONS CLACKAMAS, OR 97015 Heating Unt Insi-, Phone:656-1184 Cooling Unt Insp Reg#:LIC 447 Final Inspection PLM 5-286PB This permit is issued subject to tr�e regulations contained in the Tigard Munic�pal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accorcb-nce with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted in the Oregon Utilit o ificatiorrQenter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 Yo may obtain cop' of t ,v rules or direct questions to OUNC by calf g (503)246-9189. Iss a By: 14 Perinh -ie Signature: Call (50at 639-4175 by 7:00 P.M. for inspection;: needed t next business y R _ Mechanical Permit Application —�— Uate received: j(- _ Permit no.;/�£ce /-! �9 City of Tigard Pro'cUappl.no.: Expire date: City of Tigard Address: 13125 SW flall Blvd,TigarJ,OR 97223 Oate issued: By: Receiprno.: Phone: (503) 639-4171 — Fax: (503)598-1960 Case file no.: Payment type: Land Ilse approval: Building permit no.: t E�&2 family dwellnu;or accessory U Co ercialhndutilnal U Multi-family U Tenant improvement U New�.onstra-tion ddition/alteration/:eplacement U Other: Job address: (, r C Indicate equipment quantities in boxes below. Indicate the dollar Bldg_.nc.: Suite no.: value of all mechanical materials,equipment,labor,overhead, profit. Value$ Tax map/tax lot/account no.: Lot: Bloxk Subdivision: r *See checklist for important application information and Project name: — jurisdiction's fee schedule for residential permit fr, City/coumy_T';,tey�_ zip: 9 712 3SCHEDULE. Aff Description and lr n'fi'on�of work on premises- l Z. I¢ G• Fee(ea.) Total Est.date of completionhnspceti� Descri(Nion tp>. Rei.mdy Res.only Tenant in,provement or change of use: A handling unit CFM I• existing space heated or conditioned? es U No Alrconditioning(site tan requ re ) / Is existing space intiulaft-d'43 'es J No Alteration o existing A 'system ofer compressors State boiler permit no.: Business Hanle: .9 a �G- • HP --Tons Tons BTU/H Address: U'L _ _•ir•smoke dampers/duct smoke etec!urs City: e- c:(yR ZIP: 476/S I eat puri�p(sue p an require / Phone: ev _ /$ Fax��751I E-mail:,�-.cE,�f,�_// t t? nae turner _ _ ntl g vent liner 'Ves O No _ CCB no.: In,,ta rer;ac rcocate eaters-susper, ec, City/metro lic.no.: _ wall,or floor mounted Name(please print): �'• j "e-4 Vent ora i— aT nee of et�r than furnace e r acral un: Absorption units ___ PTU/l4 Name: �[,�bL/ Chillers_____._ - HI, Cum ressors_^— HP Address: _ my ronmenta ex tw an vent ret on: City' State: "LIP: Appliance vcil _ Phone: _ Pstx: f:-mail ryerex aunt _ ype res. itc en hazmat hood fire suppression system Name OIL— Exhaust Exhaust fan with single duct(hath fans) Mailino address: 1 ;�Q e ,L/(�U r x aunt syster a art far tom earn orAC ue piping au r,cti rut on nip to outlets) City: Slalc: l.IP: �� Type. LI'(; _ NG Oil Phone: `_3 Fax: E-mail: ueT i in r.acT ditiona over out ets rocess piping(sc tmiallc require J__— Nuntbcr of outlets Name: ter st app ance or equ pment: Address: Ihxorativefireplace all City: State: ZIP: nserr.-typeWio<Ttiiv�jieTiefstovePhone: Fav I nail Ot ter: Applicant's sib ature: _�t� _ Date: 7 tet: Name(print): iPermit infor , all Jurl%dk1iona-ceps credit cards,pleau call jurisdiction for mac nulim. Minimum n m fee ................$ N Notice:This permit application Mnimum feeee................$ U visa j l,.i..stetCard d a if expires permit is not obtained , P P Plan review fat _ %) $ Credit card nunbm __—.__. - --/—L-- within I80 days it bac tree n Expires y State surcharge(8%). _$ Naive 4 cardholdef u-shown on cmdlt cord S accepted as complete. TOTAL ................... ...$ Cardholder signature Amount 440-4617 16AOROM, MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: --- Description: Price Total ' UTAL VALUATION: FEE - Table 1A Mechanical Code oty (Ea) Amt to$5 0000.00 Mlnlmum fee$72.50 1) Fumace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and Includin ducts&vents 14'00 - $1.52 for aach additional$100.00 or 2) Fumace 100,000 B-rU+ fraction thereof,to and including Includin ducts&vents - 17.40 $10,000.00. 3) Floor Furnace $r0,001.c0 to$25,000.00 $148.50 fol the first$10,000.00 and Includin vent 14.00- $1.54 fir each additional$100.00 or 4) Suspended ea jr,wall hoater fraction thereof,to and Including or floor mounted heater - 14 00 $25000-00. 5) Vent not included in appliance permit $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 6.80 $1.45 for each additional$100.00 or 6) Repair units fraction thereof,to and Including 12.15 _ $50000.00. Boller Heat Air $50,001.00 and up $742.00 far lne first$50,000.00 and Check all that apply: $1.20 for each additional$100.00 or footnotes items es belowee m .Pump Cortd fraction thereof. _- -- - -- 7)<3HP;absorb unit 14.00 - to 100K BTU - ASSUMED VALUATIONS PER APt'LIANCE: 8)3-15 HP;absorb 25.60 - Value Total unit 100k to 500k BTU - Description: _ Q Ea Amount g) 15.30 HP;absorb 35.00 Furnace to 100,000 BTU,Including 955 unit.5-1 mil BTU ducts 8 vents 10)-3656 HP;absorb b2.20 Fumace>100,000 BTU including 1.170 unit 1-1.75 mil BTU - -- ducts&vents 11)>50HP:absorb 87.20 BTU Floor Fumace Including vent 955 - unit>1.75 9! - Suspended heater,wail heater or 955 12)Air handling unit to 10,000 CFM 10.00 fluor mounted heater -- -445 Vent not Included in applicance 13)Air handling unit 10,000 CFM+ 17,20 emlit 805 _ - Repair units _ ____ -955 14)Non-portable evaporate covler 10 00 --Z-3 hp;absorb.unit, to 100k BTU __ - 15)Vent fan connected to a single duct 6.80 3-'Shp;absorb.unit, 1,700 - 101k to 500k BTU _ -- 16)Ventilation system not Included In 10.00 1°•30 hp,absorb.unit,501k to 1 2,310 appliance permit Trill.BTU 3,400 17)Hood served by rnechanir�a!exhaust 1000 30-50 hp;absorb.unit, 1 1.7.5 mil.BTU 18)Domestic Incinerators 17.40 >5G hp;absorb.unit, 5,725 >1.75 mil,BTU _ 658 19)Commercial or industrial type Incinerator 6c.95 Air handlin unit to 10 OGJ cfm 1-170§ '- Air handling unit>1_ 0,000 cfm856 20)Other units,Including wood stoves 10.00 Non- ortable evaporate cooler Vent fan connected to a single duct 446 21)Gas piping one to four outlets 5.40 Vent system not Included In 856 -- a Ilanit 22)More than 4-per outlet(each) 1.00 Hood served by mechanical exhaust 660 Domestic incinerator - 1 _ Minimum Permit Fee$72.50 SUBTOTAL: Commercial or Industrial Incinerator 4,590 Other unit,Including wood stoves, 858 State Surcharge a Inserts etc. 3625•/.Plan Review Fee(of_0 $ Gas i In 1.4 outlets _ subtotal) Each additional outlet -- _ __ 63 Required for ALL commercial permits only TOTAL RESIDENTIAL PERMIT FE TOTAL COMMERCIAL $ E: 72- VALUATION: -- - -- other Inspactlons and Fees: I Inspections outside of normal!usiness hours(minimum charge-tw(;hours) $72 50 per hour 2 Inspections for which no tee Is specifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(min!mun charge-one-half hour)$72 5c per hour *state Contractor Boller Certification required for units>200k BTU Residential A/C requires site plan showing placement of unit. 1:\dsts\forms\jnech-fees.doc 10/11/00 CITY OF TIGARD BUILDING INSPECTIONre: ?3��,:4171 MST 24-Hour Inspection Line: 639-4175 Business BUPDate Requested J © % _AM BALD . Location Z S rf L -e Suite /MEC A f) Z - Contact Person Ph ,.SZ 51 .3i;`3 PLM _ Contractor Ph _ SWR BUILDING Tenant/Owner ELr, Retaining Wall ELR Footing Access: 4- " `�s y'�Y FPS Foundation o��'- Ftg Drain U 'N` ' ` �`� SGN Crawl Drain Inspection Notes: r G ;lab IM l ►-✓ r,1. SIT -- - - Post&Beam r. Ext Sheath/Shear -- Int Sheath/Shear Framing - --- Insulation Drywall Nailing Firewall Fire Sprinkler -- - Fire Alarm - r "SX/MC/ 3 � Susp'd Ceiling ----�/ Roof Misc: Final - -� PASS PART FAIL PLUMBING Post 8[seam - Under Slab lop Out Water Service _ NIN Sanitary Sewer �- Rain Drains -- Final PASS RT FAIL Post&Beam -- Rough In Gas Line — - -- -- - -1 SMpIke Dampers PART FAIL Qrvice h/ — Rough In UG/Slab Low Volta IL1� � ? Fite. larm � PART FAIL -— - - - - -SITE _ Backfill/Grading --- `— Sanitary Sewer Storni Drain ( ]Reinspection fee of$ _ required be,3re next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ] Please call for reinspection RE: -. ( ]Unable to inspect-nn access Fire Supply Line ADA ..,, 'I �.' / " Approach/Sidewalk Date �Z -- C. �_Inspector_ Ext - Other Final PASS PART FAILJ DO NOT REMOVE this inspection record from the job site.