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14180 SW 98`" Court
\ CITY O F TIGARD _,MECHANICAL PERW!T
DEVELOPMENT SERVICES PERMIT#: MEC2002-00509
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/15/02
PARCEL: 2S111 BA-03600
SITE ADDRESS: 14180 SW 98TH CT
SUBDIVISION: MCDONALD ACRES ZONING. R-4.5
BLOCK: LOT: 011 .'URISDICTION: TIG
CLASS OF WORK: ALT FLOOR TURN: F VAP COOLERS:
TYPE OF USE: SF UNIT HEA'rERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTti s:
STORIES: BOILERS/COMPRESSORS _ ;'HODS:
FUEL.TYPES 0 - 3 HP: DOMES INC�N:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: B1 U 15 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRE:;SURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR _HANDLING UNITS OTHER UNITS
FURN >=100K BTU: <_ 10000 r.fm: GAS OUTLETS: 1
> 10000 cfm:
Rernarks: Run approx 30 gas line and install gas logs with 1 outlet.
Owner: _ -- FEES
LINDA DICKSON Description Date Amount
14180 SW 98 CT, i\il c lli 1'crmii I cc 11/15/02 $72.50
TIGARD, OR 97224 X11 c I I i 1'crnut I cc 11115/02 $0.00
I'r1XV. State]ax 11/15/02 $5.80
Phone: 503-670-0291 IA x"i,Statclax 11/15/02 $0.00
Contractor: Total $78.30
THERMAL FLO
14865 SW 74TH AVE.#190
TIGARD, 0 t 97224 REQUIRED INSPECTIONS
Phone: 503-o7o.8183 Gas Linp Insp
Final Inspection
Reg#: 151847
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 Stan ed within 180 days of issuance, or if work is suspended for more th n 180 da . ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those s are set forth in OAR 952-001-00
1
Issued By: v_ _ ,_ Permittee Signatur t
Call (503) 639-4175 by 7:00 P.M. for Inspections no ded the Aext business day
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE :SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to$10,000.09 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional$100.00 or including ducts&vents 14.00
fraction thereof,to and including 2) Furnace 100,000 BTU+
$10.000.00, Including ducts&vents 17.40
$10,001.00 to$25,000,00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 fat each additional$100.00 or Including vent 14.00
fraction thereof,to and including 4) Suspended heater,wall heater
$25.000.00. or floor mounted heater 14.00
$25,001.00 to$50,000,00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or _6.80 _
fraction thereof,to and Including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that onply: Boiler Heat Air
$1.20 for each additional$100.00 or For Items 7.11,see or Pump Cond
fraction thereof. footnotes below. Comp ••
Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<3HP;absorb unit
to 100K BTU _ 14.00
8%State Surcharge $ 8)3-15 HP;absorb
unit 100k to 500k BTU 25.60
25.Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb
Required for ALL commercial permits onl unit,5.1 mil BTU 35.00
_--_- 9 _n..__ _._..Y _. HP;absorb
-
TOTAL COMMERCIAL PERMIT FEE: $ unit 1 10)30-50-50 mil BTU 52.20
11)>50HP;absorb --
unit>1.75 mil BTU 1 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM
- 10.00
Value Total 13)Air handling unit 10,000 CFM+
Description: Ea Amount 17.20 _
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts&vents 10.00
Fumace>100,000 BTU Including 1,170
ducts&vents 15)Vent fan connected to a single duct
Floor furnace Including vent 955 16)Ventilation system not included in 6.80
Suspended heater,wall heater or 955 appliance permit 10.00
floor mounted heater
Vent riot Included In appliance 445 17)Hood served by mechanical exhaust
perm!t 10.00
Repair units _ 805 18)Domestic Incinerators
<3 hp;absorb.unit, 959 17.40
to 100k BTU 19)Commercial or Industrial type Incinerator
3-15 hp;absorb.unit, 1,700 89.9520 Other units,Including wood stoves
101k to 500k BTU_ ) 9
15-30 hp;absorb.unit, 501k to 1 2,310 10.00 _
mll.BTU 21)rias piping one to four outlets
5.40
30-50 hp;absorb.unit, 3,400 22' More then 4-per outlet(each)
1-1.75 mil.BTU 1.00
>50 hp;absorb.unit, �- 5.725 Minimum Permit Fee$72.50 SUBTOTAL:
>1.75 ml!.BTU $
Air handling unit to 10 000 ctm 658 - _ B°/.State Surcharge $
Air handling unit>10,000 cfm _ 1,170
Non-portable evarorate cooler 65t3 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connecter)to a sin duct 448
Vent system not Included In 656
appliance permit---- _ _ ----- --
Hood served by mechanical exhaust 656- Other Inspections and Fees:
Domestic Indnerator _ 1,170 1 Inspections outside of normal business hours(nunimum charge-two hours)
$62 50 per hour
Commercial or industrial Incinerator 4,590 2 Inspections for which no fee Is specifically Indicated (ei nimum charge-half hour)
Other unit,Including woad stoves, 856 $62 50 per hour
Inserts,etc. JM - 3 Additional plan review required by changes,additions or revisions to plena(minimum
Gas piping 14 outlets 360 charge-cne-half hour)$62 50 per hour
Each additional;utlet 63
'-'-- - - '91a1e Contractor Boller C;rtlfiutlen required for units>200k BTU.
TOTAL C-nm MEKCIAL $ "Residential AtC requires site plan.�nwinn placement of unit.
VALUATION: All New Commercial Buildings require 2 sets of plans.
IAdslsVonnsVT;ech-feet doc 02/11/02
i
s:
Mechanical Permit Application
Date receivedi J Permit no.:
f City of 'Figard Prgject/appl.no.: Expire date: I
City ofTigard Address: 13125 SW Hai: Blvd,Tigard,OR 97223 Date issued: By:tp I Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 / \ :� Case file no.: Payment type: __-
Land use approval: Building permit no.:
TYPE OF PERNfIT �I
JA1 &2 family dwelling or accessory U CommercialAndustrial J MUIU I,ii,iik U Tenant improvement
L]New construction U Addition/alteration/replacement U Oth<:r:
JOB SITE { 1 1 1 SCHEDULE
Joh address,` 0 !". .) R ,h e ( Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/to lot/account no.: profit.Value$
Lot: Block: Subdivision: 'See checklist for important application information and
Po jcct name: jurisdiction's fee schedule for residential permit fee
City/county: .i.i ZIP: DWELLING PERMITSCHEDULE
Description and to ation of work on prLmiscs:S • 'ate 7—sting
' 1 ° 1
Est.date of complrtion/inspection: Ueuriptioo Qty. Rec.onl Res.onl
Tenant improvemen!or change of use:existing space heated or cond'tioned?U Yrs U No unixingt::ilcplanrequirecxislinr(spacr insulated?U Yes U No eziI A system _
Boller/compressors
Isri.tt+ `tali +` State boiler permit HP Tons BTU/11
1tIdre,ss: l`�'?W`� S.�.�`I' ytc 1LIc+u Fir smo c amper u c t smo a etcctors
City: ot�r t State:QVI,- ZIP: „ rj cat pi mp(arts p an require )
Phone: o �+ Fax:(07 pvi E-mail: n1 sla 'ep acc furnace urner
CCB no.: In . I=) �,�— Including duetwork/vcnt liner U Yes U No
Hata r,�n nc rc ocate eaters-susf.en c ,
City/metro lic.no.: _ ?.1l'? 7,,r. ! _ wall,or floor mounted
Name(please print): f r e, (I. cam— vent f u;+ ,lance of er an furnace
1
Refrigeration:
Absorption units^_ BTUAI
Name: Chillers_____ HI'
Address: Com ""ors____ � IIP
— nr ronmenta ex aunt an vent al on:
City: State: ZIP: Apphancevent
E-mail nryercx aust -----
1
Hoods,Type rer.kitchen/hazmat
hood fire suppressiot.system
Name: IVk l''q pl Exhautit ran with single duct(hath fans)
Mailing address: t•) t g L SZ,j c1S`" c + .x at NI.systema art from headn or C
City' Statc: 1 ZIP: Fuelpiping an st ul on(up to out c.s)
Type: ITT
PhoneFax E-mail: ' N3 oil
cacti it ona mer outlets
_
IF Processpiping(schematic requucd)
Number of outlets _
Name: _ ter st appliance or equipment:
Address: Decorative fireplace Cr•`'
City: State: ZIP; nsert-type
Phone: E-mail: oo slot/ pe et stove - - - - -
Other:
Applicant's signatu —
Name(print): �\ r a :0�,)6 '
Not all judidietlons accep+ciedh cwds,please call Jwim0cth,n I'm more inrunnnncxt Permit fee....................$ _
U Visa U Master( rd Notice:This permit application Minimum fee................$ _
Cmdn card number:__ T—�_— _ ____ expires if a permit is not obtained Plan review(at
.apse, within within ISO days after it has been State surcharge(ARF)....$
Name c to r"shown rM c itreT cswd $ accepted as complete. '
TOTAL .......................$ r l0
Cwdholder signature Amount 440-4617(6W(70M)
CITY OF TIGARD 24-Hour _
WILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171MST
J
Received rr Date Requested– � �" AM1_� — BLIPyI�v G r r� _ _
Location PM BUP—
Contact Person 005,01
_ — _ Ph� )
Contractor__.- _—__---- _-- -- Ph(— ) —
PLM
ByVR
r
UILDING Tenant/Owner —_..___
oting ELCundationELCg Drain Access:awl Drain ELR
Slah Inspection Note;;: SIT
Post&Beam _ _
Shear Anchors
Ext Sheath/Shoar --
Int Sheath/Shear _
Framing _—
Insulation
Drywall flailing —
Firewal! --— ------
Fire Spr;nkler
Fire Alan 1 —�—
Susp'd GAIng --_ -- - - - ------ ` ! t
Roof
Other:
Final -- -- — -.
PASS PART FAIL --- —
_ ---
Post&Beam _-_-__--
Under Slab — i --
Rough-In — —_— -- ----
Water Service
Sanitary Sewer ----- — - --- -----__ _
Rain Drains
Catch Basin/Manhole --- —
Storm Drain --------..—-.___-- -------_ —--
Shower Pan - - - -- - ----_�
Other: -- ----- -
Final -. ---
PASS PART FAIL --" - -
Post
Rou h-In
L _
Damparii;0�
_WS ART FAIL
TRICAL ----
Service
Rough-In —
UG/Slab —
Low Voltage
Fire Alarm -- ----- ---- _— _
Final
PASS ,PART FAIL Reinspection fee of$ required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd
SITE — Please call for reinspection RE:
Fire Supply Line --- -- [] Unable to inspect-no access
ADA
Approach/Sidewalk Date
Other:
Final DO NOT REMOVE this Inspectlon record from the job site.
PASS PART FAIL