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8960 SW Pinebrook Street
\ CITY �+'1�F T I/"� /�, R® MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC,002-00066
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/15102PARCEL: 2S111AD-r14P,00
SITE ADDRESS: 08960 SW PINEBROOK ST
SUBDIVISION: FINEBROGK TERRACE ZONING: R-4.5
BL-OCK: LOT: ()71 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOD FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS-
OCCUPANCY
ANSOCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYS EMS:
STORIES: BOIL ERSICOMPRESSORS HOODS:
FUEL TYPES 0 3 HP: DOMES. INCIN:
LPG 3 15 HP: C;OMML, INCIN:
MAX INPUT: BTU "5 30 HP: REPAIR UNITS:
FIFE DAMPERS?: 30 50 HP: WOOD;.,TOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
F•IRN <- 100K BTU: 1 AIR HANDLING UNITS_ _ OTHER UNITS:
F 1RN -100K BTU: I<= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
F imarks: Replaceing existing gas furnace with same, 1 outlet.
Owner: ----- _ – -__-- FEES —_
JUDY, ROBERT S AND DEBRA L. Type By� Date Amount Rt,ceipt
19995 SW CHAPMAN RD PRMT CTR /15/02 $72.50 272002000C
SHERWOOD, OR 97140 5PCT CTR 2/15/02 $5.80 272002000C
Total $78.30
Phone: (--
Contractor:
COMFORT CONNECTION
3755 SE 150TH AVE.
PORTLAND, OR 97236 REQUIRED INSPECT IONS
Gas Line Insp
Phone: 503.761-7777 Mechanical Insp
Reg #:LIC 131215 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within '180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Orrlgon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. ,You may obtain copies of these rules or direct question to,.4Z)UN1 by calling
r,nlWAR-01 AP ,
Issue By _�, a L� �.y, r TLC _— Perrnittce Signature: _ �-
C-11 (503) 639-4175 by 7:00 P M for insl ,•.:tions needed the ne t business day
Mechanical Permit Application /-
—' Date received:"I" , Permit no.:
City !A Tigard Project/appl.no.: Expire date:
City of Tigard AddreSR: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By:Q:�L' Receiptno.:
Phone: (503) 639-4171ment Pa type:
Fax: (503) 598-1960 % � Case file no.: _ Y YP
I Building permit no.:
Land use approval
7NeLJ
&2 family dwelling or accessory U Commercial/industrial
JN1niti 1;I11111% UTenantimprovement
w co
U Addition/alteration/repla
ccrnenl J J1i�u' - --
Mau t
PBIdg.
s: , Lli l' , , .� Indicate equipment quantities in boxes below. Indicate the dollar
uile no.: value of all mechanical materials,equipment,labor,overhprofit.Value$
ax lot/account no.:
Block: Subdivision: •See checklist for important application infor nation and
fee schedule for residential permit fee
me:tycouty• ZIP: t t
All
Dcscr tion and location of work on premises: rAJ jFVLI►tA� `- Ir,e(r;,•) tot:d
t �A c 7��c�a 1, �• flit Res.only Res.old
r ----'—�� Ik�ril.tion Y• y >�
Est.date of completion/ pection:
Tenant improvement or change of use: Art handling unit _ CFM
Is existing space heated or conditioned?U 1 e:• U No Air con itwnmg(site plan require ) ___
J N A P leralinn of existing ii.. r svcrem
Is CxSsiiub space insuL•ur,l .1 Y� -
t i1 to cr compressors
t State boiler permit no.:
Busineisnamc: C[>�ti t 1 t✓rr —_ lip Tons BTU/11
Addrer-s: I ��►�t' f�/� 4 st a snipers' uct smo ce electors _
City• eat um (site an re uired —
Slatci;) ZIP: -2- L.. P P P 9 --
nstal rep nee urnace urncr ti j
Phone: Fax: E-mail' Including duclwork/venl liner Yes U No
CCB no.: 3 I�,1 l Lam'_'�G' J- nsta rep acc/re ocuie enters-suspende
— well,or floor mounted
City/metro lic.no.: _
Vent for lance otTier than furnace
Name( lease print): a gest on:
Absorption units- BTU/H
-- n 1.1)ujylCi Chillers --- HP
Name: — Com ressors Y HP
Address: MYronmentaF ex tint all vent at on:
City: _ State: ZIP: Appliance vent
`
( —
�, 7 Fax: E-mail: )ryerex aunt
Phone: �) 7 o s, ype res. itches/ azmat
hood fire suprrersion system
�' � Exhaust f?n with single duct(bath fans) _.
Name: 'r�L:_SL_ �t .� y 7 y -
.naust s stem apart I oro beau—'n
Mailing address:_ rnerpiping an o bution(up to out cis)
City: — Slate: _ ZIP: Type; LPG _ NU Oil
n + l ove
r outletso
Fit,
ilt
Phone:
11 raest;piping(sc ematicreyuiredl _
Number of outlets
Name: other 11 ed app ance or equ pment:
Address: Decorative fucplace
Stam
_ Z,IP: nsert-ty c -
City: oo stov pe et stave
Phone: f E-mail: (h er—
Applicant's signature: L'I Datc:2j/3C,Z_ ter —
Name (print):_ — —
Permit fee........•............$ •-
Nd ale jud dl li—;cep aredir Crud+,P Cdl jurldlcGar fa mcxe Infcxrrrerror+. Notice:Thisrmit application
Pg
Minimum fee................$ 7�
U visa U MasterCard expires if a permit is not obtained plan review(at __ %) $ ,--
Credit card number ._ —•— — — Expires within I Ro days after it has been State surcharge(8%) ....$
Nrvtx of c Chown on C"i cry accepted as complete. TOTAL $ r'
$
-- C elided r�Igruttue — Kim — 440-4617OOarCOMt
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILI DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: 1�-aole 1titn: Price Total
$1.00 to$5 000.00_ _Minimum fee$72.50 Toole 1 A Medlanical Code City (Ea) Amt
1) Furnace to 100,000 BTU
$5,001.00 tr,$10,000.00 $72.50 for the first$5,000.00 and Includiro ducts&vents 14.00
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
fraction thereof,to and Including Furnace
ducts 0 vents 17.40
$10000.00. Includin_ ---- --
$10,001,00 to$25,000.00 $148,50 for the first$10,000.00 and 3) Floor Furnace
Includin vent 14.00
$1.54 for each oto and
$100.00 or d Suspended healer,wail heater
fraction thereof,to and IrGuding )
$25000,00. or floor mounted heater 1400
_
$25,001.00 to$50,00 .00 $370.50 for the first 525,000.00 and 5) Vent not Included in appliance permit 6.80
$1.45 for each 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 CheGe all they apply: Boner Heat n
d
$1.20 for each additional$100.00 or For Items 7 11,see or Pump Co
fr_actlon thereof. footnotes below. Comp
Mi_ 7)<3HP;absorb unit 14.00
nimum Permit Fee$72.50 ,� SUBTOTAL: $ to 100K BTU
8)3-15 HP;absorb
_ 8%State Surcharge 5 �' unit 100k to 500k BTU 25.60
an Re9)15-30 HP;absorb 35.00
25%Plview Fee(of subtotal) $ unit.5-1 mil BTU
_Reoulred for ALL commercial-permits oni _._ 10)30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: S unit 1-1.75 mil BTU 52..o
__- 11)>50HP;absorb 677.0
-- _--_ - unit>1.75 mil BTU . -
-- 12)Air handling unit to 10,000 CFM 10.00
ASSUMED VALUATIONS PER APPLIANCE:
-' Value Total -1-3) 00 CFM+
Descn tion:_ D Ea Amount _ 17.20
Fumace to 100,000 BTU,including 955 14)Non-portable evaporate coolor
ducts&vents 1o.t o
Furnace>100,000 BTU Including 1,170 15)Vent fan connected to d single duct
6.60
ducts&vents _
Floor furnace including vent _ 955 -- 16)Ventilation system not Included in
Suspended heater,wall heater or 955 appliance permit 10.00
floor mounted healer -- 17)Hood served by mechanical exhaust
Vent not Included in applicance d45 s 10.00
permit - 805 - 18)Domestic Incinerators
Re air units _-_- 17.40
<3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator
69.95
to 100k BT
J
3-15 hp;at'sorb.unit, 1,700 20)Other units,Including wood stoves
101k to 500k BTU 10.00
15-30 hp;absorb.unit,501k to 1� 2,310 21)Gas piping one to four outlets
5.40
mil.BTU
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1.00
1-1.75 mil.BTU __-
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: 5
>1.75mil.BTU - __ ____ _
Air handlingtinit to 10,000 cfm 656 8%State Surcharge E
Alr handling unit>10,000 cfrn
Non- ortable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: a
Vent fan connected to a single duct 858
Vent system not included in
a� liianae ermit 856 - Other ns ec"ins and Fees:
Hood served by mechanical exhaust _ 1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic Incinerator1 170 $62 50 per hour
Commerclal or industrial Inclnerator d 590 2 Inspections for which no fec is specifically indicated (n,nimum c barge-half hour)
Other unit,including wood stoves, 656 $3 per hour
3 Addditiiti onal plan review required by changes,additions or revisions to plans(minimum
Inserts etc. 360 charge-one-hall hour)$82.50 per hour
Gas pipin�l 4 outlets 63
Each additional outlet State'State Contractor Boller Certification required to, units>200k BTU.
"Residential AIC requires site plan showing plac_iant of unit.
rVALUATION:
AL COMMERCIAL .? k $
1+ All New Commercial Buildings require 2 sets of plans.
I:klsts`,fonnsvnect!-fees doc 12!26/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST _
BUP
Received Date Requested_ Z�._ _ AM f_ PM _ BLIP
Location _ _ g v_P�.G �Ltrn-fL�suite_ MEC_gQ4) 6 CJL.1
Contact Person _ Ph( _) PLM
Contractor Ph( ) __— SWR — —
BUILDING Tenznt/Owner ELC
Footing —
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain _ --
Slab ( Inspeuion Notes: SIT
Post& Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear 00
y
Framing 0�e�'L',CC_��L_ b 1--Ude- Z y/4 —
Insulation � �
Drywall NailingOD -�!CJc�C�=-rR r.:rL.S = aD ,4�2le-
—
Firewall �l -47�z $r
Fire Sprinkler - �� (tic I�' S ?
Fire Alarm
Susp'd Ceiling V J Am7 _ 95.2W &y 7— as_ _
Roof
Other � +r
Final
____
-�
PASS PART FAIL -
PLUMBING
Post& Beam -�---- — — -
Under Slab -_-
Rough-In
Water Service ----------- -----
Sanitary Sewer
Rain Drains --- - --
Catch Basin/Manhole
Storm Drain `-
Shower Pan
Other: __ ----- ... -- - ------- -- --- -- --
Final _
PASS PART FAIL _--
Post&-Beam
Rough-In — — - -- -- _— - ---- -
P_n
e Dampers -- -- -----------—
S PART FAIL_
Service — --_--.-
_C_TRICAL
-- ------- ----- ----- -
Rough-In
UG/Slab -- �- — `--- -
Low Voltage - ----- ---- -- - ------ ---
Fire Alarm --^---
Final Reinspection fee of$, required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART L'AIL
SITE Please call for reinspection RE:_ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk pAts - =_.� dL.-- Inspector - ---_--- ___- --.____- ----"
Other: _
Final DO NOT REMOVE this Inspection record from the job Mt*,
PASS PART FAIT_ -�