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CITY OF T I G A R D __ MECPKANICAL PERMIT
^ DEVELOPMENT SERVICES PERMIT 0: MEC2002-00532
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 11/26/02
PARCEL. 1 S136AD-02100
SITE ADDRESS: 07010 SW OAK ST
SUBDIVISION: VILLA RIDGE ZONING: R-4.5
BLOCK: LOT:002 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: __ BOILERS/COMPRESSORS HOODS:
_
FUEL TYPES !� 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCsN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: OVOODSTOVES: 1
GAS PRESSURE: 50 + HP: CLQ DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Wood Stove
Owner: _ FEL.
VITKOCZY TOM I Description Date Amount
7010 SW OAK ST
TIGARD, OR 97223 [MECH] Permit Fee 11/26/02 $72.50
[MECH]Permit Fee 11/26102 $0.00
[TAX]8%StateTax 11/26/02 $5.80
Phone: 501-24J-3550 [TAX] 8%StateTax 11126/02 $0.00
Contractor: _ Total $78.30
REQUIRED INSPECTIONS
Phone:
Final Inspection
Reg :
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This permit is issued subject to thr. regulations contained in the Tigard Municipal Code, State of Ore.
LU Specialty Codes and all other auplicable laws. All work will be done in accordance with approved
plans. This pemiit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699. f
Issued By: Permittee Signature: . _
Ca!I (504 639-4175 by 7:00 P.M.for Inspections needed the next b slnsss day
Mechanlical Permit Application
Hate received• Permit n
'pity of Tigard Pmject/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: — By: Receipt no.:
Fax: (503) 59b-1900 Case rile no.: Payment type:
Land use approval: Building permit no.:
U I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family 0 Tenant improvement
❑New construction U Addition/alteration/replacement U Other.
/ lob address: O'L !cICO C)a �--`— Indic aie equiptr ent quantities in boxes below.Indicate the dollar
Bid&.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Let: Qlock• Subdivision: 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee
City/county: TiZIP:
Description arld lo6tion of work on premises:
Lo u O cl _ Fee(taft) Total
Est.date of completion/inspection: -Descripthm Qty. Res.only Res.ed
Tenant improvement or change of use:
_.
Is existing space heated or conditioned?O Yes ❑No Air handling unit CFM
KFr conditioning(silo vian requ re )
Is existing space insulated?O Yes 0 No ieration o ex sung HVAU system
Boiler/compressors
Business name: State boiler permit no.:
HP Tons B'ru/H
Address: 0 Q efLr- trc smo a dampers/duct smoke detectors
City: Stale: ZIP: Watpump site pan rc� u_—F
Phone: Fax: E-mail: nsta rep—tU—lacefurnecdburn�F
Including ductwork/vent liner 0 Yea 0 No
CCB no.: nstal Vreplacefrelocate heaters-suspen e .
City/metro lic.no.: wall,or floor mounted
Name(please print): eu V17 Foc Tlg, ent ora f anceot et than furnace
e Brat n:
Absorption units BTl)/H
Name: C ( 0c Chillers HP
Address: C7 (] e L) C)Ce- Co ressors HP
Mvironmental exhatm sald vent at on:
City: State: ZIP: Appliance vent
Phone: g Fax: E-:nail: )ryerex gust
Dods,Type U 111res. rte a azmat
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
Mailing address: G Exhaust system a art from heatingor AC
City: State: ZIP:
se piping• st up to outlets)
Type: LPG NO Oil
Phone: Fax: E-mail: ueTT ineachad trdi-ionalover 4 outlets
t� meeapiping(schematic requi
Name: — _ Number of outlets
Address: Other ■ ee or eq pmeart:
Decorative fireplace
City: State: ZIP: nun-type
WPhone ax: &rrtail tovel et�ve
a Applicant's signature' (( Date: ( ` (`•D�
mj
Name(print): cOther
I C
/ Permit fee.....................$
Na an jettedlenoas.xept.redit r",please call jmincWO"for more Infarnrtfon, Notice:This permit application
O Viw O MasterCard Minimum fee................$ _
expires if a permit is not obtained
ere dtt care aamMr._____d __ Ex" within ISO days after it has been Plan review(at _ 96) $
State surcharge(1396)....$
tsne of ear older u sMwvn on cre&cwd
S accepted at complete. TOTAL
Crdholder slpurure Amount 4104617(610tH O n
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 $ 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERM-FEE: � Description: Price Total
;1.00 to$5,000.00 _ Minimum fee$72.50 Table 1A Meftnical Code City (Es) Amt
$5,001.00 to S10,17100.60 $72.50 for the first s5,666.66 and- 1) Furnace to 100,000 BTU j
$1.52 for each additional$100.00 0. Includingducts 8 vents 14.00
fraction thereof,to and Induding 2) Furnace 100,000 B
$10 OW.00.
Including ducts b ve 17.40
$10,001.130 to$25,000.00 5148.50 for the first$10,(100.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or Indudln vent 14.00
fraction thereof,to and including 4) Suspended ater,wall heater
$25,000.00. _ or floor r, nted heater 14.00 _
$25,o01.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vont t Included In appliance permit 6.80
$1.45 for each additional$100.00 or -
fraction thereof,to and Including 6) pair units
__$50 000.00. 12.15
$50,001.00 and up $74 . for the first$50,000.00 and C ck all that apply.�t3o 101 Heat Nr
$1.20 each additional$100.00 or r Rome 7.11,soe or Pump Cond
fraction th eof. footnotes botow.
Comp ••
$
7)<3HP;absorb unit
Minimum Permit i,'ee 572.80 SUB TAL: to 100K BTU 14.00
8Y.State Surcha : 8)3-15 HP;absorb
unit 100k to 500k BTU 25.60
25%Plan Review Fee(of subtotal) 9)15-30 FIR absorb
unit.5-1 mil BTU 35.00
Required for ALL commercial permits only
10)30-50 HP;absor'j
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mll BTU 52.20
11)>50HP;absorb
unit>1.75 mil BTU L- 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 1000
Value Total 13)Air handling unit 10,000 CFM+
Description: Q Ea Amount 17.20
Furnace to 100,000 BTU,Including 955 )Non-portable evaporate cooler
ducts&vents 10.00
Furnace •100,000 BTU including 1,170 15) t fan connected to a,Ingle dual
ducts 8 vents 0.80
Floor furnace Including vent 9 18)VentlI opt system not Included in
Suspended heater,wall heater or 6 a lien mgt 10.00
floor mounted heater 17)Hood seqby rnechanical exhaust
Vent not Included in appliance 45 10.00
$mitZT
805 18)Domestic Indr orators 17.40
Repair units _
<3 hp;absorb.unit, 955 10)Commercial or Industrial type incinerator 89.95
to 100k BTU _
3-15 hp;absorb.unit, ,700 20)Other units,Including wood stoves
101k to 500k BTU 113.00
15.30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
mil.BTU 5.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1.75 mil.BTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.60 SUBTOTAL: $
>1.75 mil.BTU
Air handling unit to 10,000 cfm 656 8%State Surcharge $
U) Air handling unit>10,_000 cfm 1,170 ^
Von rtable v .-.re cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan conne%.ed to a stn le duct 446
L Vent systerr,not Inducted In 656 - --- -
L9 a Ilance rmit Other InsplrpQrts and Fsss:
W Hood served b mechanical exhaust 656 i. Inspections outside of normal business hours(minimum charge-two hours)
J Domestic Incinerator 170 $62,50 per hour.
Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee Is specifically indicated (m;nlmum charge-he"hour)
Other unit,Including wood stoves, 656 $62.50 per hM.0
Inserts etc. 3 Additioaat,tan review required by changes,additions or revisions to plans(minimum
G88 lin 1 4 outlets 360
charge-one-half hour)$62.50 per hour
Each additional outlet 83 'State Centractc,r Bolla Certification required for units>200k BTU.
TOTAL COMMERCIAL S "Residential AIC rsqulrss site plan showing placement of unit.
VALUATION: All New Commercial Buildings require 2 sets of plans.
I:tdstsVormstrnech-fees.doc 02/11/02
CITY OF TIG,ARD 24-Hour
BUILDING . 0 Inspection Line: (50)639-4175
INSPI`CT'ION DIVISION Business Line: (503)639-4171 MST
SUP24
— —�
Received Date Reque ted__ AM PM SUP
Location �_2 QA � —Suite
(� r1` 2 r _ MEC .2-(9
Contact Person _ _ Ph(_ ) > Z .fib PLM
Contractor_ _ Ph(Z&&—) 3 sem' SWR
BUILDING � TenanUOwner ELC
Footing--�
Foundation ELC
ACCdSS:
Fig Drain ELR
Crawl Drain
Slab Inspection Not!is: SIT
Post A Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling — ---- — — --
Roof
Other: --
Final ^—
PASS PART FAIL ---
PLUMBWO
Post&Siam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Main Drains -- _�__ ____•- --�
Catch Basin/Manhole
Storm Drain — ----- __� — —_
Shower Pan
Other:
Fi;ial
PASS PART FAIL --------
MECHANICAL
--.---MECHANICAL
Post&Beam --..�_.�_-------_
Rough-In
Gas Line
Smoke Dampers — --- -- -----.----------_.._
H PART FAIL
ELECTRICAL
Service
Rough-In ____
m U3/Slab
Low Voltage
r Fire,Alarm
final Reins ection fee of$_. _.required before next ins
PASS PART FAIL L p — pectior,. pay at City Hall, 13125 SW Nall Blvd.
SITE _ [] Please cell for reinspection RE:_—_ —___ — Unable to Inspect—no access
Fire Supply Line
ADA _
Approach/Sidewalk
Other:
Final D 0 NOT REMOVE this Inspection mord hom the job site.
PASS PART FAIL
CITY OF TIGAND MILDINC iNSPIECTION DIVISION MST
24-Hour Inspection line: 639-4175 Business Line: 6394571 --- -----
BID _
—_ Requested_equested C � BLS
)r/V0()--AM PM
Location Suite _ MEC _
Contact Person �t� Ph Z -7 SS _ PLM
Contractor^ Ph — SWR �!
f!3UILDINf3 'Tenant/Owner 1WOOL/
Retaining Wall ELR _
Footing Access:
Foundation ,&_ FPS
Fig Drain ------- SGN
Crawl Drain Inspection Notes: ---
Slab -- - SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Insulation — --'
Drywall Nailing
Firewall
Fire Sprinkler W, �•—YK e-
Fire Alarm t
Susp'd Ceiling
Roof
Misc:
Final _ 4 �-
PASS PART FAIL_ —
PLUMB0113
Post&Beam --
Under Slab
Top Out �—
Water Service
Sanitary Sewer --
Rain Drains
Final —
PASS PART FAIL _
MECHANICAL
Post&Beam - ----
Rough In
Gas Line
Smoke Dampers
Final ------ —- _ --
P SS PART FAIL
X Rough In —
UG/Slab -
�. Low Voltage
EkaALprrn
JF
S PART FAIL ..______—__ —_
'Jl
Backfill/Grading
Sanitary Sewer
Storm Drain [ ]Reinspection fee of 3 ! _ __rPluired before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f 1 Please call for reinsoecticn RF:_ @—_ . [ ]Unable to inspect -no access
ADA
O he�ach/Sidewalk Date 1.� 0 -Inspector—r�—r _ 9LoQ�_Ext
[Final
PASS PART FAIL DO NOT REMC iE this Inspection record from the job site.
CITYO F T i G A R D ELECTRICAL PERMITELC2 _e
DEVELOPMENT SERVICES PERMIT*:SUED: 1/5/00 1/5/00 O-0000a
Axiom f
13125 SW Hall Blvd.;Tigard,OR 97223 (503)639-4171 '`� PARCLL: 1S136AD-01100
SITEADDRESS: 07010 SW OAK:>T �
SUBDIVISION: VILLA RIDGE R, ZONING: R4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: Reconnect of electrical service. Job No. 14-5.
RESIDENTIAL UNIT� TEMP SRVC/FEEDERS MISCELLANEOUS
LESS:1000 SF OR 0 - 200 amp:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp; SiGNAUPANEL:
MANF HMI SVC/FDR: 601+amps -1000 volts: MINOR LABEL (10):
SERVICEIFEEDER _ BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: `— PER
201 - 400 amp: lot W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L SRNCH CIRC: IN PLANT.
601 - 1000 amp: PLAN REVIEW SECTION
i 1000+amplvolt: - > : >IgOUyOL :
Reconnect only: 1 SVC/FDR>s 225 AMPS: CLASS AREAISPEC OCC:
Owner: Contractor:
CEARLEY, MICHAEL D ABC ELECTRIC CORPORATION
7010 SW OAK ST 135 NE 9TH
TIGARD, OR 972.23 PORTLAND, OR 972.32
Phone: Phone: 233-7551
Reg 0: UC 000002
SUP 12415
PLM "•SEE-
ELE 26-2C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
?RMT DEB 1/5/00 $53.50 00-320909 Elect'I Final
5PCT DEB 1/5/00 $4.28 00-320909
Total $57.78
This Permit is issued subject to the regulations contained In the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws Ali
work will be done in accordance with approved plans This pern.�will a)VIre If work Is not started within 180 days of Issuance,or K work is suspended
d. for more than 180 days. ATTENTION: Oregon law requires you to fov nv rules adopted by 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 rubs or direct questions to OUNC at(503)246-1987.
�j PERMI TEE'S SIGNATURE ISS 4D BY
� ?'�
(� O44-
R INSTALLATION ONLY
ku The installation is being made on property I own which s not Intend M. for sae, lease, or rent.
OWNER'S SIGNATURE: DATE:—
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC'N: ,4Og _ �,�✓� r_ DATE: a
LICENSE N0: ---_/AiU6
Call 639-4175 by 7:00pm for an Inspection the next business day
Joq-04-00 11 :02A P_02
•
CITY OF TIGARD Ele0rical Permit Application Plan Cti-c
13125 SW HALL BLVD. Recd By I m. .i
TIGARD OR 97223 Date Rx•d ,/ 777
Date to P.E
Phone(503)639-4171, ,:304
Print or Type Date to Ds'r.�__-_
Inspection(503)639-4175 Incomplete or illegible will not be nccepta d Perrot 0
Fax (50311 F' . 1297 Called _
1. Job Address: 4. Complete Ne Schedule Below:
Name of Development_ _ _ Number of Inspections per poll tit allowed
Name(or name of business) -- SeMce included: Items Cost Sum
Address _ 4a, Residential-per unit
IOnQ aq,ft.or teyE •,_,_ $110.00
City/State/Zip r Each adriltionel 600 a%n.or
Commercial❑ Residential Limited
Energthervy
l $2500 1
Umlled Eroergy 525.00 �
Each Marnufd Home or Modular
Llwelling Sorvico or Foc9or $68,00 _ 2
2a, Contractor installation only: __.___
(Anach copy of all current Ilosnee_s) 4b.Services or Feeders
Electrical Cont rBl for iInatatlation,alteration,or ralocation
�"r' 200 amps or loss 1 0,00 2
Addr _
201 gimps to 400 gimps 38r1.00 2
City State X Zip_024321� ____ 401 amps to Bon amps $12000 T� 2
Phone No. 1 $01 ergs to 100^amps $180 00 2
Job No.IQ - Over 1000 wnps or volts _ $340.00 2
r- _
Elec.Cont. Lloe. No. Exp,Oata cleconnecl only Tso.CO 2s� �
OR State CCB R® No. -Exp. to 4c.Temporary Services or Feeders
COT Business Tax or fro OEx Dated Installation,ollerntion,or relocation
_ `_`• 200 amps nr leas $60.00 _ 2
Signature ` 201 amps to 400 amps 175.00 _ 2
9 �- do amps to 800 ampR _ _ $100.00 _ 7
Over 600 amps 10 1000 welts,
License No. ?v Ex .Date see"b"abeve
Phone No. 05-
` ed.Brach Circuits
New,alteration or extent:on per panel
2b. For owner Installations: a)The fee for branch t irruila whit
Purrhsse of service or
Print Owner's Name feeda►roe.
Address - Eat:h branch circuit $5.00 -- 2
-- h) 1 he lou for branch circuits
City- State zi w/fhtwf purchase of
Phone No, aerdce or Preder fire.
First branch circtdt $35.00 2
The installation is being made on properly 1 own which is not Face additional•uronch circuit $5.00 2
Intended for sale, lease or rent. ore.IUlsrellengous
Owner's Signature (Servire or feeder not In ludn0)
9 _. Each pump or Irrigatlon circle $40.00 �_ 2
Ill. Each sign n outline Nghting $40,00 2
3. Plan Review section (if required):* Signal cimurt(s)or a limited energy—
panel,aherstlon or extonsl,x► $10.00 2
Please check appropriate Item and enter fee.n settlor, 5H. Minor labels(10) $100.00
4 or more r"sidentfel units in one structure 4t.!tett additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00 _
as describod In N.E.C.Chapter 5 In Plant $65.00
W
'Submh 2 sets of plans with application where any of the above appy. S. Fees:
Not required for temporary construction sarAcea. So.Enter 1olNl ter above fees i�.�V
5%Surcharge(.05 X total tees) :
N 1TLGE subtotal
Sb.Enter 25%of hna 5a for
PERMITS BECOME VOID IF WO 1K OR CONSTRUCTION AUTHORIZED IS Plan Rtevhrw((ate(Sec.3) $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 190 DAYS AT ANY ^
TIME AFTER WORK IS COMMLNCED. n Trust Amount N_ _
`rota/belatee Ow :