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9675 S\% McDonald tit
CITY OF TIGARd MECHANICAL PERMIT
PERMIT#: MF_C20Q2 00727
DEVELOPMENT SERVICES
DATE ISSUED: 4/2102
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102CD-02613
SITE ADDRESS: 09675 SW MCDONPLD ST
SUBDIVISION: TWAI_ITY HILL ZONING: R 4.5
BLOCK: LOT: 013 JURISDICTION: TIG
CLASS OF WORK: ALT �— FLOOR FURN: — EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS- VENT FANS:
OCCUPANCY GRP: VENTS W/O APPI.: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS_ _ HOODS:
FUEL TYPES 0 3 HP: DOMES, INCIN:
4"T— ---- 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 BTU: 1 i_AIR HAN!)LING UNITS —_ OTHER UNITS-
FURN >=100K BTU: <= 10000 cfm GAS OUTLETS:
> 10000 cfm:
Remarks. Replace furnace
Owner: --- — FEES------- —
NICHOLSON,VICKI L Type By Date Amount Receipt
9675 SW MCDONALD PRMJ CTR 4/2/02 $72.50 272002000C
TIGARD, OR 97224 5PCT CTR 4/2102 $5.80 272002000C
Total —a— $78.30
Phone:503-620-6197 -
Contractor:
THE HEATING SPECIALIST
9300 NE HALSEY
PORTLAND, OR 97220 REQUIRED INSPECTIONS
Mechanical Insp
Phone:257-7000 Duct Inspection
Reg #:LIC 56628 Final Inspection
PLM 26"494PB
This permit is issued subject to the regulations containea in the Tigard Municipal Code. State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 clays. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those n.tles are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies o" these rules or direct questions to OUNC by ca!ling
rcn•i17dr,_U1 RU
Issue By: ���- Permittee Signatr re: L, �C
---� —.
Call (503) 63.,-4175 by 7.00 P.M. for inspections needed the next si ess day
Mechanical Permit A lication
Date received: Permit n�1t1!LJ,elOZ ADi t7
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard)( t 97,2�,a j j pate issued: By: Receipt no.:
Phone: (503) 639-4171 1.
Fax: (503) 598.1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval: PLANNINQ/ENQINEERI uilding permit no.:
!� 1 &2 family dwelling or accessory U Commerrial/industrial U Multi-family U'fenant improvement
U New construction U Ad(lition/alteration/ieplacement U Other:
Job address: "14, -1-:�, ft_.� ,A � �� � Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: *Sec checklist Im important application information and
Project name: N is he)15,n jurisdiction's fee schedule for residential permit fee.
III No MANI I
City/county: -T-
Description
TDescription and location of work on premises:.- _
ki- ('4_c.. 4. Fee(en.) Total
Est.date of eompletlon/inspeclion: � Descri ion Qty. Res.only Res.onl
Tenant improvement or change of use:
spare heated or conditioned'?U Yes U No Air handling unit ----CFT1
Is existing�P Air con nioning(site plan require ) _
Is existing space insulated?U Yes U No I Alteration o existing UVAC system
Boiler/compressors —
�— S_tate hoiler pe
rmit no.:
Business name:,Jfta. A&Ape",ALe az� Ill,
— Tons-. HTU/H
Address: c)„'r u> 'i-F irc7smoke dampers/duct smoke detectors --- —
City: / k A old. Stater C 7.IP: )7.?a. Feat pump(site plan required)
Phone: `) . 57 oo� Fwx,3-251 711, L-mail: nsta rep ace Trnacciburnerl
Including ductwork/vent liner W Yes U No 1 '. , Y•s-s
CCB no,: �4�(p.> K losla rep ace/relocate heaters-suspenced,
City/metro lic.no.: I_3 c% -, will,or nuor mounted
Name(please print): c,a V III Vent for tante other than furnace
e genal on:
Absorption unitsHTUAI _
Name: Chillers_____ HP
Address: l..b• Com ressors_�
_ — nv ronmeata exhaust an vent at on:
City_- Slate: ZIP: Appliance vent -
Phont: Fax: E-mail: )ryT erexFiaust
floods, Type res. itc ten76namat
hood fire suppression system
7Mailing
Nt C_6 V J`c>r) Exhaust fan with sing;,duct(bail,fans)
s: f Sv Cr: r �c 1t i• 1 r� ;xfiaust s ststem a art from heatin oC States rt. ZIP:,j > > , ue p p ng a stn ut on(up to outlets)
TypeLPG NO Oil _
Phone: L�. cl - il-17 Fax: E-mail: Fuelpiping each additional over out ets
rocesspiping(sc ematicrequired)
Number of outlets
Name: i er list 'app ince or equipment:--
Address: _—__ Decorative fireplace
City: _ State: ZIP:
Phone: ax E-mail: o stove/peod et stove
Other:
Applicant's signature:_.- r_. o..,_<. Date:_1 :. ,. — ler. -
Name (print):
Not all Jurisdictions accept reedit cards,please call jurisdiction ror mae Information. Permit fee.....................$ %a+'
(]Visa U MasterCard Notice:This permit application Minimum fee................$
expires if a permit is not obtained plan review(al %) $
Credit card number_^ _--....___�- _�_��- within 1g0 days after it has been
Expire Y State surcharge(8%)....$
----- --� accepted as complete.
Name d cardholder u shown otm credit card i
= TOTAL .......................$ _.1A��
Cordholdef signature —�- -- Amotatt 1144617(6MCOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
UATION: FEE: Description: Price
TOTAL VAL
Total
31 OU tri AL U0 � Minimum fee$72,50 Table 1A Mechanical Code QtY (Ea) Amt
--- --- 1) Furnace to 100,000 BTU
$5,001.00 to$10,000 00 $72.50 for the first$5,000.00 and Includingducts&vents 14 00 _
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
fraction thereof,to and Including 17 AU
$10,0()0.00. Includingducts&vents
---- - - --- --- ---- 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
_ $25,000.00. or floor mounted heater 14
$25,001.00 to$50,000.00 $379.50 for the first$25,1100.00 and 5) Vent not Included in appliance permit
$1.45 for each additional$100.00 or 6 PO
fraction thereol,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: Boiler Heat P,ir
$1.20 for each additional$100.00 or For Items 7-11,soe or Pump Cond
fraction thereof. footnotes below. Comp*
-�-- - J� -- -�- 7)<3HP;absorb unit 14 00
ASSUMED VALUATIONS PER APPLIANCE: to IOOK BTU
_--.-- _ 6)5-15 HP;.al»oib
Value Total unit 100k to 500k BTU 25.60
Description: Q (Ea)_ Amount 9)15-30 HP;absorb
Furnace to 100,000 BTU,Including 555 _ unit.5-1 mli BTU 35.00
ducts&vents 10)30-50 HP;absorb
Fumace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU _ 52.20 _
ducts&vents 11)>50HP:absorb
Floor furnace including vent 055 unit>1.75 roil BTU 87.20
Suspended healer,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater_ 10.00
Vent not Included In applicance 445 13)Air handling unit 10,000�'FM+
_permit___ -- _ - -17_20 -�
Repair units 805 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 1000
to 100k BTU 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 6.60
101k to 500k BTU 16)lentilation system not Included In
15-30 hp;,absorb.unit,501k to 1 2,310 a liance permit 1000
mil,BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00
1-1.75 mil.BTU 18)Domestic incinerators _
>50 hp,absorb.unit, 5,725 17.40 _
>1.75 mil.BTU 19)Commercial or Industrial type Incinerator
Air handling unit k. 10,000 dm 656 69.95
Air handling unit>10,000 cfm 1,170 20)Other units,Including wood stoves
Non ortable evaporate cooler 656 _ 10.n0
Vent fan connected to a single duct 446 21)Gas piping one to four outlets
Vent system not included In 656 5.40
a Ilance permit 22)More than 4-per outlet(each)
Hood aerved by iTtHG ranical exhaust 656 1.00
Domestic Indnerator _ 1,170 Minimum Permit Fee$72.50 SUBTOTAL: $
Commercial or Industrial Incinerator 4,590 _
Other unit,Including woad stoves, 656 8%State Surcharge $
InsertsLe tc
Gas pf ip ng 1 4 outlets 360 25%Plan Review Fee lot subtotal) a
Each additional outlet _ _ 63 Required for ALL commercial permits on,y
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: , 5 VALUATION:
_ _ her Inspections and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72.50 per how.
2 Inspections for which no fee is specifically Indicated (minimum charge-half hour)
$72.50 per hour
3 Additional plan review required by changes,additions or revisians to plans(minimum
chnrgeone-half hour)$72 50 per hour
`State Contractor Boiler Certification required for units 400k BTU.
"Residential A/C requires site plan showing placement of unit.
I.ldstsVomrs\mech-fees.doc 1101'"',I
CITY OF TIGAsRD 24-Hour
13UILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BUP —
Received - Date""quested_ -- AM__ PM BUP
Location --_-- __ 7 C. Qdsuite MECADCJ�Z
Contact Person __-- -- Ph(—) --_- _ PLM __--
Contractor ph( ) cam--5 7 7 000 SWR
BUILDING 'TenanUOwner ___--_ _ ___ ELC
Footing ._ ELC
Foundation cces
Fig Drainf' ELR
Crawl Drain
slat, Inspect n Notes: SIT
Post&Beam _ --�;�� — -
Shear Anchors �C
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation _
Drywall Nailing -
Firewall
Fire Sprinkler — — - --
Fire Alarm
Susp'd Ceiling —._ -- - -- - -- - - -
Roof
Other
Final
PASS PART FAIL
PLUMBING -- - - -
Post&Beam
. n er Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
! Storm Drain
Shower Pan
Other'
Final
T FAIL
MECHANICAL ----- - -----
Rough-In am ��1%�I -
Gas Line `
Smoke Dampers
-_AS PART -FAIL --- -
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage -- - — - -----
Fire Alarm
Final 0 Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS —
PART FAIT-
- c- - ---T - -
SITE Please all for reinspection RE: _— [ Unable to inspect -no access
Fire Supply Line
ADA Date �—__ Inspector _ Ext Approach/Sidewalk
Other:
Final — DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL