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14260 SW McFarland Blvd
CITY OF TIGARD BUILDING INSPECTION DIVISION 11„ST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171, 13UP
--Date Requested l �� i -� __AM� .PM �_ BLD
Location_ `-I "Z L c, 1T., c- Suite _LJ:L&,�zj — MEC'}aGc GG 3CP_3
Contact Person Ph �_� ( PLM
Contractor Ph SWR
BUILDING �— Tenant/Ownel ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS
Ft9 Drain
Crawl Drain Inspection Notes f/ SGN —
Slab 1 �,rt V%Lt:T(� SIT
Post&Beam
Ext Sheath/Shear so
Int Sheath/Shear
Framing
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler — --- -- -
Fire Alarm
Susp'd Ceiling -----
Roof
Misc: —
Final
PASS PART FAIL — -- --
PLUMBING
Post&Beam
Under Slab _ ,—
'rnp out
Water Service
Sanitary Sewer —
Rain Drains
Final
PASS PAPT FAIL
aN
Post&Beam -
Rough In
d Gas Line —
Smoke Dan.pers
-
-PART FAIL
ELECTRICAL _Service
Rough
v —
Rough In
UG/Slab ----
l_ow Voltage
Fire Alarm
Final
PASS PART FAILSITE
Backfill/Grading --"---
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I ]please call for reinspection RE: — [ ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Ext
7 C� / Inspector
Other
Date lL'" __-_ u _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYOF TIGAR —_MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2000363
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2511 01
PARCEL: 0BA-05900
SITE ADDRESS: 14260 SW Mi,FARLAND BLVD
`,UBDIVISION: SHADOW HILLS NO2 ZONING: R-2
BLOCK: LOT: 042 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES 0 3 HP: DOMES. INCIN:
LPG — — 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 30 HF REPAIR UNITS:
FIRL CAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITS - OTHER UNITS: 1
FURN >=100K BTU: <= 10000 cfm: GAS OUTLE'rS: 1
> 10000 cfm:
Remarks: Install gas piping/outlet and NG insert.
Owner`— --- -- _ FEES
KELLY, MARK B +GAIL E Type By —__ Date_ Amount Receipt -
14260 SW MCFARLAND BLVD PRMT CTP, 10/16/01 $72.50 272001000C
TIGAR OR 97223 5PCT CTR 10/16/01 $5.80 272001000C
Total' $78.30 -
Phone: -"� —"
Contractor: —_—
T + K MECHANICAL
11525 SW CANYON
BEAVERTON, OR 97005 REQUIRED INSPECTIONS_______-__
Gas Line Insp
Phone: 503-626-4652 Mechanical Insp
Reg #:LIC 121165 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will he done in accordance wi}h approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires yoLI to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-OU i-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling
Issue By: Permittee Signature-�--,
7:00 P.M. for inspections needed the next business d'ay
Call (503) 639-4175 by p
Mechanical Permit Application
Date receives! j t ` Permit no
City of Tigard Project/appl.no.: Expire date. _
Cit o Tigard Address: 13125 SW Hall Blvd,Tig 7223 f `—
y ! Phone: (503) 639-4171 /('(` ' Date issued: _ By:Q,i ) Receipt no.;
Fax: (503) 598-1960 / Case file no.: payment type:
Land use approval: Building permit no.:
1
1 &2 family dwelling or accessory U Conunciccdl/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Other:.11ol SITE -
1VALUATION
Job address: t QQ 5(,-) 0 ) (-Fa , &)Id Indicate equipment quantiut . to buy, helow. Indicate the dollar
Bldg.no.: _ Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
IA —Block: Subdivision: "See checklist for important application information and
Project name: jurisdiction's Ice schedule for residential permit fee.
C'ily/county 7J i oor d U x'9 h '1,Ip: q`I a 5_1 __I
t
Description and to tion of work on premises: Il U% \i nit t 1 1
exo,S i `-,5+.'r'+ - I ee(ea.)I lolal
Est.dale of completion/inspection: 11kurilNian qt It_r nl� Res.only
Tenant improvement or change of use:
Air handling unit _ _CFM__
Is existing space heated or conditioned'!4Yes U N(' Air conditioning(site plan require ) _
Is existing space insulated'?a Yes U No I Alternlion of existing HVAC system _
oiler/compressors
Business name: State boiler permit no.:
_ 1- K f`0 e CVx�n cc,I HP Tons BTU/H
Ad-!ress: y o S- Le Li,J T V t{w 4 '# 10 _ Fir•smo a ampers/duct smoke detectors
Cit� I(_ I State:0y-f)- ZIP: 9-1oo(D Heat pump(Ute plan require ) _
Phone: 3e •qu1 Fax: qad-Si IS E-mail: Insta I/rep ace urnac utner
- Including ductwork/vent liner U Yes U No
CCB no.: ►1( f k5- Install/replace/relocate eaters-suspen ed,
City/metro lic.no.: wall,or floor mounted
Name(please print). cat for appliance of cr than furnace ._
Refrigeration:
Absorption units_ BTU/H
Name: A , y l rJ�,n n fL _- Chillers __u lip
Address: 7- U- 5 L- TU h U-'' ' 3U(o C'rm tressors__
,nv ronmenta ex^ ust an vent I list on:
City: IA IohCL, State:UU ZIP: r100 Appliance vent ---, _-
Phone: -S l '(4('j Fax: 'IliI `?tS-1 I E-mail: )ryeaunt
Hoods.Type /I I/res.kitchen azmat
hood fire suppression system -�
Name: 0. Q �'_ j U _ lsxhaust fan with single duct(bath fans) _
Mailing address: I c(a V 01I ur f31 u I-xhaust system a ari Froin heating or AC
— Fuelpiping andistribution(up to outlets)
City: State: �� ZIP: ( �c,t of Type: v,LPCi I NG Oil _
Phone: U, Fax: E-mail: Fuel piping each adaitional over 4 out cis
roeesi piping(sc sematic required i --
Number of outlets
or eq-Tent:
Add Decorative fireplace
City: State: _ Zip: Insert-type _ ry _
oostove/peet
phone: -- Fax_.__ Email: stove
_
Applicant's signature: Date: 10 It, ter:
Nance (print): A i - -
Not all jurisdictions acceM credit curds,pleasecall jurisdiction lar nuxe inr malinn. Permit No.....................$
U Visa U MasterCard Notice:This permit application Minimum fee................$
expires if a pennit is not obtained plan n view(at .— %) $
Credit card number:._-_ -- ---•L—�-- within 190 days after it has been —
I'.spdres >' State surcharge(896)....$ c`71
Nameorchar of as shostnt on credit card —- s accepted as complete.
('ardholder signature u — —Awunt 4/04617(6MCOM)
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 Oty (Ea) Arnt
$5,0 0 f 1(1 to$10000.00 $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 8 vents _ 17.40
$10 25,
,001.00 to$ 000.00 $148.50 for the first$10,000.OJ and 3) Floor Furnace
$1.54 for 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 ^
325,001.00 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 apply: Boller Heat Air
$1.20 for each additional$100.00 or For Items 7.11,see or bump Cond
_ fraction thereof. footnotes below. Comp •'
Minimum Permit Pee$72.50 SUBTOTALS to 100K 7)100K absorb unit
BTU 14.00
8•/s State Surcharge $ 8)3-15 HP;absorb 25.60
unit 100k to 500k BTU
25%Plan Review Fee(of subtotal) a 9)15-30 HP;absorb 35.00
Required for ALL commercial permlts onl�r urdt.5-1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 30.. absorb
unit 1-1.75 mmil BTU 52.20
unit
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: Qt (Ea)_ Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts$vents 10.00
Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a single duct
ducts&vents 6.80 1 _
Floor furnace Including vent_ 955 16)Ventilation system not included In
Suspended heater,wall heater cr 955 appliance permit 10.00
floor mounted heater - 17)Hood served by mechanical exhaust
Vent not included In applicance 445 _ 1000 _
hermit -- 18)Domestic incinerators
Repair units _ 805 17.40
<3 hp;absorb.unit, 955 19)Commercial or industrial type incinerator
to 100k BTU 69.95
3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves
101k to 500k BTU _ 10.00
15-30 hp;absorb.unit,501k ll0 1 2,310 21)Gas piping one to four outlets
mll,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$72.50 SUBTOTAL: $
>1.75 mil.BTU _
Air handling unit to 10,000 cfm 658 --
Air handlin unit>10,000 cfm
_____,1170 8%State Surcnarge $
Non portable eva orate cooler 858 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a sin leduct 8 _
Vent system not Included In 656 -
appliance permit Qth r Inspections and Fees:
Hood served b mechanical exhaust 656
Y- _ 1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic incinerator 1,170 $72 50 per hour
_Commercial or Industrial Incinerator _4,590 _ 2 Inspections for which no foe is specifically indicated (minimum charge-hall hour)
Other unit,including wood stoves, 656 $72 50 per hour
Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum
Gas piping 1-4 outlets -_� 360 _ charge-one-half hour)572.50 per hour
Each additional ri,Wet 63 'Slate Contractor Scller Certification required for units>200k BTU.
TOTAL COMMEP.CIAL. $ '"Residential AIC requires site plan showing placement of unit.
VALUATION: All New Commercial Buildings require 2 sets of plans.
IL L\d9ts\forrns\mech-fees.doc 08/29/01