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10522 SW 1NAEVE ST
\ CITY OF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00225
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639.4171 DATE ISSUED: 2511 1
PARCEL: 2S110DA-02400
SITE ADDRESS: 10522 SW NAEVE ST
SUBDIVISION: RENAISSANCE SUMMIT ZONING: R-3.5
BLOCK: LOT:015 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEAT" 4S: VENT FANS:
OCCUPANCY GRP: VENTS W/O ADPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15-30 HP: REPAIR JNITS:
FIRE DAMPERS?: 30-50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: CLCD DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
OTHER UNITS: 1
FURN >=100K BTU: <= 10000 cfm: —
` > 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A/C unit. Unit not to be placed in the equiied setback
Owner: _FEES _!-
LORENZ, RUDOLF W+ ANGELA Type By Date Amount Receipt
10522 SW NAEVE ST PRMT CTR 6/20/01 $72.50 2720010000
TIGARD, OR 97224 513CT CTR 6/20/01 $5.80 2720010000
Phone: Total $78.30
Contractor:
DAVE FITZ.PATRICK HEATING+ REFRIGTN
8900 SW BURNHA.M STE F-6
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone:215-3870 Final Inspection
Reg#.LIC 00052335
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expirf- if work is not started within 180 days of issuance, or if work it.: suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OU calling ( 06-Issue By: �i Permittee Signatur
Call 03) 639-4175 by 7:00 P.M.for Inspections needed the next busln
• Mechanical Permit Application
Datereceived: - ZO-D/ Permiln�a(�OD l�
City of Tigard Projecdappl.no.: Expiredate:
CirpofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 '—
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503)598-1960 Case file no.: Payment type:
Land use approval: _ — Building permit no.:
I &2 family dwell.ag or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Ad(lition/alteration/replacement U Other:
will �LusitaLl�l�m
Job address: U� t�� QA e__ Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: _ Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/accoui no.: profit.Value$ _.
Lot: Block: Subdivision:_ *See checklist for impottont application infem:ation and
Project name: jurisdiction's f'ee schedule for residential permit fee.
City/county: ZIP: Y11 10111H SELIMIREINI �milabil
Description and location of work on premises: — _ IN
Fee(est.) Told
Est.date of completion/inspection: fksni iatn Qt . Res.oaly Res.only
Tenant improvement or change of use:
7Arhan�lingg nit CFM_
Is existing space he ronditioned7l8)Yes J No dr conditioning?siteplan requir )
Is existing space insulated: T U No teratwn o xlstingHVAr system
of er/compressors
Business name: 172�'AT/11cit f f/- j Sate boiler permit no.:
- HP Tons WWII
Address: 1 U 5.11J11 rir smo a dampers/duct smoke detec,,ors
city: I stat ZIP eat pump(site plan regw )
Phonye�rFax: E-mail seta rep ace urnac urner _____A7
Including ductwork/vent liner U Yes U do
CCB"O" Install/replace/re-locate heaters-suspen.t ,
City/metro lic.no.: wall,or floor mounted
as
Name(please print): - end ora Iancce other antTi� furnace
e
Absorptionunjts, ___ BTU/H _
Name: Chillers.—__� HP
Address: Comm tressors HP
--- -- �►Tro�e Al ecIiiisl Zia t .
City: State: ZIP: _ Appliancevent
Phone: fax: E-mail: _ryc_r�� aust
Tr ne res. rte a azmHt
oppression system
Name: with single duct(bath fans)
IL Mailing address: I a sting or Ar
Cit State: ZIP:
!a.
ppnd 9t up to 4 out els
I- y' — Ty e. LPO NO Oil _
Phone: Fax: E-mail: Fuel pipingeach itiona over ou ets
v emat crequ )
J Name: Number of outlets
m otwilitiampeor
(9 Address: Decorative fireplace
W City: State: I ZIP: nsert-t
J Phone: Fax: Wail: Woodstovelpellet stove`
Applicant's signat4l. Date• - d_
oftr
Name(print
NM all jurisdictions accept credit cards,please call jurisdiction for more infnrmetion. Permit fee.....................$ _
U Visa U MasterCard Notice:This permit application
Minimum fcc................$
/ expires if a permit is not obtained Plan review{at __ °'�
Credit card Ron—*
_ L1_ ) $
- Eapirer within ISO days after it has been
_ Nof caMtol .r v shown nn it cid — accepted 99 complete. State surcharge(8%)....$
s TOTAL........................$
Crudholder aisnatttre Amoaet 41a�611(610QR OM)
MECHANICAL PERMIT FEES ,
COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION:_ tE Description. Price Total
Table 1A Mechanical Code UtY (Es) Amt
$1.00 to$5,000.00__ LL um fee$72.50 - 1) Furnace to 100,000 BTU
$5,001.00 to$10,000 00 50 for the first$5,000.00 and IncJudIngducts&vents 14., _
2 for each additional$100 00 or 2) Furnace 100,000 BTU —
frafraon thereof,to and including Including ducts&vents 17.40
000.00. _$10,001.00 to$25,000.00 .50 for the first$10,000.00 and 3) Floor Furnace
for each additional$100.00 or Indudmgvent - 14 00
n thoreof,to and including 4) Suspended healer,wall heater
0.00. or floor mounted heater 14.00
00to$50,000.00 0 for the first$25,000.00 and 5) Venl not included in appliance permit
5 r each additional$100.00or8.80ho thereof,to and Including 6) Repair units,00 00. 12.15$50,001.00and up 2.00 r the first$50,000.00 a;rdCheck all that apply: Boiler Heat Alr
0 for ach additional$100.00 or For Items 7-11,nee or Pump Cond
8on
nth eof. footnotes below. -- Com •
7)<3HP;absorb unit
— to 100K 6'+U 141q
ASSUMED VALUATIONS PER AP IANCE: 8)3-15 HP;ab3orb�
Value Total unit 100k to 500k BTU 25.80
DescriUp on: _ Q Ea _ Amamt 9)15-30 HP;absorb
Furnace to 100,000 BTU,including 95F unit.5-1 mil BTU 35:00 _--
ducts&vents 10)30-50 P;absorb
Furnace> 100,000 BTU including 1, 70 unit 1-1 75 mil BTU _ 'z
ducts&vents _ — — 11)> HP:absorb
Floor furnace induding vent 9 uni -1.75 mil BTU 87.20
Suspended heater,wall healer or� 95 1 Air handling unit to 10,000 CFM
floor mounted heater _ 101.00 _
Vent not included In applicance 445 13)Air handling unit 10,000 CFM+ _
-permit - - --- -----_ 17.20
Repair units _ _ 805 14)Non-portabre evaporate cooler
<3 hp;absorb.unit, 955 10.00
to 100k BTU 15)Vent fan con-ee-6 to a single duct
3-15 hp;abs;ab.unit, --- 1,700 8.80
101k to 500k BTU _ - -- 16)Ventilation systemot I
nncluded in
15-30 hp,absorb.unit,501k to 1- --- 2,310 appliance rmi
ance pet 10 -
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00 _
1-1.75 mil.BTU — 18)Domestic indnerators
>50 hp;absorb.unit, 5,725 17.40
>1.75 mil.BTU 9)Commercial or industrial type Incinerator
Air har,dlin unit to 100
, 00 afm r39
_-656 —_— -�
Alr`candling unit>10,000 cfm 1,170_
20) Cher units,Including wood stoves
Non-portable evaporate cooler _ 658 A — 10.00 —
Vent fan connected to a single duct 448 21)Ga Iping one to four outtein a
Vent system not included in 65fi — 5.40
�Ilance permit - -- 22)More th 4-pe�outlet(each)
Hood served bar mechanical exhawt 6 _ 1.00
Domestic indnerator 1.170. f � Minimum PernR Fee$72.30 SUBTOTAL: j
Commercial or Industrial indnerator 590 _-__�
!- Other unit,including wood stoves, 56 8%State Surcf.or"
N Inserts,etc. /�6%60
Gas I In 14 outlets 25%Pla Review Fee(of subtotal) $
Each additional oullel �._ Required for AL txnerdaf permits inly —
m TOTAL COMMERCIAL $ TOTAL RESIDENTI k PERMIT FEE: $
O VALUATION: --�
Other Imoscdone ani F��
1. Inspections outside of normal business tr1ltlMrKim charge-two lours)
$72 5r1 per hour
2 Inspectionn hr wtkh no fee Is sp,cidcktfy NtlMOalad (minirmim chergefiNf hour)
$72.50 per hour
3 Addilionel plan review regrdmd by diWV6 ,addlons or rrvfslons to plana(minimum
cheW one-K-31f hour)57250 per hour
*S"contractor BoW Cw0ka6on reill"ft Oft>2Mk BTU.
afMklendsl AIC r•Oillfai 3Ni wan chew �iM111NaM of unt/
I:\dstsVorms\mech-fees.doc 10/11/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-1,1our Inspection Line: 639-4176 Business Line: 639-4171
-2 r-C / BUP
—Date Requested —AM-Z- PM BLD
Location /_'S Z L S C✓ Suite MEC pQ/—OV2.2 9-
Contact Person —� v Ph _r 4 - p�S" PLM
Contractor Ph SWR _
BUILDING TenantlOwner ELC
Retaining Wall ELR _
Footing ACcew
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes: —---
Slab _ _ SIT
Post&Seam -
Ext Sheath/Shear
Int Sheath/Shear /
Framing r- rl Z I7 t G -_--
Insulation /
Drywall Nailing C`.5r I'G✓<O _ _ _—_
Firewall T7—
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --------
Roof
Misc:
Final
ASS PART FAIL
P�LUMBPJO
P st 8� am ---- ----
U er ab
To t ---------
Wa r Servir e
S i. ry Sewer
in rains
in
PAS FAIL
� iRCHANICA11
Rough In
Gas Line ------ --J -
S e Dampers
PASS PART FAIL
ELECTRICAL
a Service
Rough In
F- UG/Slab
Low Voltage
Fire Alarm
Final
m PASS PART FAIL _—_--
W SITE
_j Backfill/Grading
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspectlon. Pny at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE'. �— [ ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Cate G S Inspectors —
Ext
Other _ --- ------ -, _ ._
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the Joie sitq.
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