10960 SW 79TH AVENUE i
10060 SW 79" Avenue
A ICITY OF
TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES r'ERMIT#: MEC2002-00502
13525 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171 DA—E ISSUED: 11/13/02
PARCEL.: 1 S 136CA-04700
SITE ADDRESS: 10960 SW 79TH AVE
SUBDIVISION: FRIENDLY ACRES ;'ONING: R-4.5
BLOCK: LOT: 001 JURISDICI TIG
CLASS OF WORK: AL r FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APP`: VENT SYSTEMS:
STORIES: BOILERS/COIVri"RESSORS _ HOODS:
FUEL TYPES _ 0 3 HP: 1 DOMES. INCIN:
LPG _ - 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K RTU: 1 _ AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: _ <= 10000 cfm:
GAS OUTLETS: 4
> 10000 cfm:
Remarks: Install Furnace and exterior AC unit AC cannot be placed in the required set backs.
Owner: --- _ - - -_ _FEES
GENIUCH, CHRISTA B � WALTER F Description Date Amount
10960 SW 79TH [MECH]Permit Fee 11/13/02 $72.50
TIGARD, OR 97223
[MECHj Permit Fee 11/13/02 $0.00
fTAX]8%StateTax 11/13/02 $5.80
Phone: [TAX]8%StateTax 11/13102 $0.00
Contractor: Total $78.30
ABLE HEATING + COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 579-2250 Mechanical Insp
Heating Unt Insp
Reg#: 00108535 Cooling Unt Insp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 da ) ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rus are set forth in OAR 952-001-00
Issued By: _ _ _ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. fur inspections needed the next business day
�A paha .:baa Z£i KIM illippi111Cation
Date received:
City Of Tigard Project/appl.no.: Expiledate:
City of Tigard Address: 13125 SW Hall Blvd.Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By:13/q Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
U 1 &2 Gunily dwelling or accessory U Commercial/industrial U Multi-family J Tenant improvement
U New construction U Addition/alteration/replacement U Other:
INFORMATION
Job address: f or 4,(7 'C/ Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: Sutte" no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ) ZIP: 21L MMEf
Descriptio d Ictio wo on premises; L 1
Est.date of completion/inspection: Deaerlptlon Q( . R .only Res.only
Tenant improvement or change of use: Air handling unit _CFM
Is existing space heated or conditioned?O Yes U No trcon utoning(siteplan required)
-- --_Is existing space insulated?U Yes U No Alteration of existing HVAC system
' I Kai K101 11MMILM I 1 4111 U f3oiler/compressors ---
Business name: Slate boiler pennit no.:
HP —Tons—BTU/14
Address: •irelsmoke groper uctsmo a detectors -
City: !t 1 a_,tV lAtatt Heat pump(site plan require )
Phone: Fax: E-mail; nsta rep ace urnac utner
Including ductwork/vent liner es U No +�
CCB no.: _
� _ l�s�1 nsla rep acclre ocute eaters-suspendc ,
City/metro lie.no.: wall,or flo-tr mounted
Name( lease rine): Vent tot vvpp�ianncceot erihan furnace
Re
frigeration:
nits _ BTU/H
Name: _ HP _
Addre," s —___ HP
ata ex laust an vent a!oow
City: State: ZIP: entPhone: Fox: E mail: 7nt��
Hoods.Type res. 1tc a atmat
hood fire suppression system _
Name: 1A Exhaust fan with single duct(bath fans)
Mailing address: c v x au's stem a art from heatingor AC
-
u,
p na an sir ut nn(up to outlets) --City: Stale ZIP: __t,PG NG Oil
Phon : Fax: E'Inatl: in enc t a t na over out ets
lincesep p Ist;(sc cmat ci�requirec�j���� ''
Name: Numher of outlets
t erapp once or equ pment:
Address: _ Decorativeftrepwic _
City: State: ZIP: nncn-type
Phone: C IF I E-mail: Wo0aslovelpellet stove
cr:
Applicant's sinat,ue: ,L e: / it)
Name(print): / - —'— —
Nd all handicnorn accept credal cards,please call)uriKliction fat ttrore inf minion Permit fee.....................$
U Visa U MasterCard Notice:Ibis permit application Minimum fee................$
expires if a permit is not obtained
Crediteard numMe•--_..---.-_-...---- Plan review(at i6) $
within ISO days after it has been State surcharge(8%)....$
— rnr nr�imirT,tr,a:Irmo„nn trtitt c�-- s accepted as complete. TOTAL $
irdlxrlJei tlpuhae - _-_ Aiaowit 1034617(69000M)
I
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATIO _ PERMIT Description: - Price Total
N:
-- Table 1A Mechanical Code atY (Ea) Amt
$1.00 to$5,000_.00Minimum fee$_72.50 1) Furnace to 100,000 BTU
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vents 14.00
$1.52 for each additional$100.00 or 2) Furnace 100,000 B'fU+
fraction thereof,to and including Furnace
luding 00,0 cts&vents 1'40
_ $10,000.00. 3) Floor Furnace
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and including vent 14.00
$1.54 for each additional$100.00 or 4) Suspended heater,wall heater -
fraction thereof,to and including 1a 00
$25,000.00. or floor mounted heater
$25,001.00 to$50,000.00 $,!79.50 for the first$25,000.00 and 5) Vent not included in appliance permit 680
$1.45 for each additional$100.00 or -----
fraction thereof,to and Including 6) Repair units 1 J
$50,000.00. - --- -
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Bober Heat P.r
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
_ fraction thereof. footnotes below. Comp
---- 7)<3HP;absorb unit
Minimum Permit Fee$72.50 SUBTOTAL: to 100K BTU 14.00
$
a 8)3-15 HP;absorb
8Y.State Surcharge unit 100k to 500k BTU _ 25.60 -
W 25%Plan Review Fee(of subtotal) $ 9) HP;absorb
unit
.5-1.5-1 mil BTU _ 35.00
_ Required for ALL commercial permits only 10)30-50 HP-ahsorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTI; _ 52.20
11)>50HP;abs t
-�---� unit>1.75 mil BTU :J_ _ _ 87.20
12)Air handling unit to 10,000 CFM
ASSUMED VALUATIONS PER APPLIANCE: 10.00
Value - Total 13)Air nandling unit 10,000 CFM+
Description: O Ea Amount 17.20 -
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts R vents_ 10.00
Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a single duct
ducts&_vents 6.80
Floor furnace Includin vent 955 16)Ventilation system not Included in
Suspended heater,wall heater or 955 a Ilanco permit 10.00
floor mounted heater _ 17)Hood served by mechanical exhaust
Vent not included In applicanue 445 10.00
rmit - 805 -- 18)Domestic incineratorsRe air units _ 1740 _
<3 hp;absorb.unit, 955 19)Commerch.:o Industrial type incinerator
to 100k BTU 69 95
3-15 hp;absorb.unit, 1,700 20)Uther units,Indy "^0 W^^d stoves
101k to 500k BTU _ 10.00
15-30 hp;absorb.unit,501 k 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 rtlll.BTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU _ _ --
Air handling unit to 10,000 cfm_-_ _858 - 8•/.State Surcharge $
Alr handlinq_unit>10,000 Ctm 1,170 - _ -
Non-portable evaporate cooler 858 - TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a sin Ig a duct 446
Vent system not Included in 656 _---.----
a lapp ianoe permit O,ILe�lsoectlons!n�Fee4:
Hood served by mechanical exhaust _ 656 - 1 Inspections outside of normal business hours(minimum charge-two hags)
Domestic incinerator 1,170 -_- $62 50 per hour
Commercial or IndusMal Incinerator_ _4 590 2 Inspections for which no fee is specifically indicated (minimum charge-hall hour)
Other unit,Including wood stoves, 656 $62 50 per hour
Inserts etc. _- 3 Additional plan review required by chsnges,additions or revisions to plans(minimum
Gas I Ip ng 1-4 outlets__ -
380 charge-one-half hour)$62 50 per tour
Each additional outlet 83 *State Contractor Boiler Certification required for units>200k BTU.
__ - "Residential AIC requires site plan showing placement of unit
TOTAL COMMERCIAL ''
VALUATION: All New Commercial Buildings require 2 sets of plans.
I!\dstskformslmach-faes.doc 12/28/01
Heating and Cooling Air Conditioning Site Plan
Customer
Address ! � �U `. � G City , LI)ez� z /; Zip
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST --_-------_.-__--_ _.._
BUP
Received _ Date Requested_,/ _ . AIA PM ____._ t3UP
Location D GO�5 �'L �'� _—_Suite MEC l-du?--G U
Contact Person — _ Pn( ) 1 f2 – 61 S q-J— PLM --------
Contractor _ Ph(—) . —_ SWR
BUILDING Tennnt/Owrer _ ___ --_ ELC _
Footing
ELC
Foundation
Access:
Ftg Drain -e / ELR
Crawl Drain r; _
Slab Inspecti rr�, otesSIT ----- - _-- - -
Post&Beam _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Sh-car
Framing -- - --- - -
Insulation
Drywall Nailing - - - -------__.-- --.-_-- _�_
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ---- - _
Roof
Other: --- - - - --
Final
PASS _PART FAIL
PLUMBING
Post&Beam
Under Slab -- — ---
Rough-In
Water Service - -- - ---- - --
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - -
Shower Pan
Other-
Final
therFinal
PASS PART FAIL - --
P & Beam u— -
n
an Lin �
C
Smoke Dampers4 - -- - - - - --
F
PA PART FAIL
- --- - -----_—___ _-_^---._ _
_CTRICALL
Service — ---- -------- ------------- --_--_ .-
Rough-In _
UG/Slab
Low Voltage -- - -- _ - - ------------ - -- —
Fire Alarm
Final sleinspection fee of$ _-_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE:—__.--�_ _._--__ _ Unable to Inspect no access
Fire Supply Line
ADA
Approach/Sldewalk Date. --- � -- InapeetOr- - ----------. _-._-- --Ext--
Other: _
Final DO NOT REMOVE this Inspection record from the Job site.
PA4Q PART FAIL