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10940 Summer Lake Dr
CITYOF T I G,A R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00113
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE. iSS:IED: 3/20/02
PARCEL: 1 S133AD-04600
SITE ADD,'•tESS: 10940 SW SUMMER LAKE DR
SUBDIVISION: AM/NT SUMMERLAKE ZONING: R-7
BLOCK: LOT: O'-,'0 JURISDICTION: TIG
CLASS OF WORE. f.LT FLOOR FIJRN: EVAP COOI.ERS:
TYPE OF USE: SF UNIT HEATERS. VENT . AS:
OCCUPANCY GRP: R3 VENTS WiO APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES - ---- 0 3 HP: - - DOMES INCIN:
LPG u 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
ODSTOVF_S:
GAS PRESSURE: 50 + HP. CLO DRYERS:
FURN < 100K BTIJ: 1 AIR HANDLING_ UNITS OT�C
FIJRN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
UNITS:
OUTLETS: 1
> 10000 cfm:
Remarks: Replacing existing gas furnace laps pack)and ducting, 1 outlet.
Owner: FEES
RON DENTAL Type By Date Amount Receipt
1107"SUMMER LAKE PRIvIT CTR 3/20/02 $72.50 272002000C
5PCT CTR 3/20/02 $5.80 2720020000
Total $7b 30
Phone: 503-59C-2704 -- —— --
Contractor:
COLUMBIA HEATING+ COOLING INC
8900 SW BURNHAM
TIGARD, OR 97223 _ REQUIRED INSPi:CTIONS
Oas Line Insp
Phone:624-2704 Mechanical Insp
Reg a:LIC 76359 Final Inspection
PLM 34-175
This permit is isE ued subject to the regulati,Dris contained in the Tigard Municipal Code, State of Or,-.
Specialty Codes and all other applicable laws. All work will be done in accordance :•:Ith approved
plans. This permit will expire if work is not started within 180 days of issuance, or if wcrlc is suspended
for more than 180 days. ATTENTION- Oregon law requires you to follow n lies adopted in the Oreqon
Utility Notification Center. Those roes are sept forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling
/C,rlIWAS-11 ff
Issue By: Permittee Sidnature:'�L;
Call (503) 639-4175 by 7:00 P M. for inspections needed the next business day
S
Mechanical Permit Application ,
-_ Date received:�/;o T" Permit no.: ► ,�cYl)-GZ'? j
City of Tigard Project/appl.no.: Expire date:
Addre?At: 13125 SW Hall Blvd,Tigard,OR 97223 1
City of Tigard Fate issued: Hy: Receipt no.:
Phone: (503) 4139-4171 Payment Fax: (503) 598-1960 Case file no.: Pa Y YPc
building permit no..
Land use t.pproval: —
t
tQN &2 family dwelling or accessory U Commercial/industnU Multi-family Y J Tenant im, vement
New nns11•11clitm AKAddition/altrration/replacement U Other: -
i1 1 1 I
Indicate equipment quantities in boxes below. Indican.the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
- profit.Value$
Tax map/tax lot/account no.: _ ___
_ Blrx:k: Subdivision: _ `See checklist for important application information and
Lot:Lot: ;- jurisdiction fee schedule for residential permit fee.
Prujw name:
City/county: ZIP: -
Description and Ion of work on premises:_ _�_
}�1i�e-n r V- e�t t! — Itr(tyr.) lulnl
Description
Qt lies.onl Res.onl
Est.dale of comple ion/inspection: I --
Tenant improvement or chang,of use: Air handling unit —____CFM_
Is existing space heated or conditioned'?U Yes LI Nu All con Mooning(site p an requ re )
Is exislirg spa(c insulated?U Yes U No, Alteration of extsong HVAC system
Wo er compressors
Str.tc boiler permit no.:
Business nam(: I (pipes L '1 two+-*-(-0 it^ __ _ Hp Tons HTU/H
Address: ��s
Yt� 1 Ir smo"F aml,er-7s uct smo a electors
Cit--�011tate ZIP: 2,, pan requ r-0—
City:
1
Y' ns /rc a ' rnac burner_._
Phone: mu+I: - Inc timp iuctwork/vent lino L Yes U No
CCB no.: nc'a r�plAL relocate eaters-susp n e .
City/metro lie.no.: '�� wall,or floor mounted
-i�
Vent or ap Mance ot(ier t mn urn,
Name(please,print): + C'/ r �e ration:
Absorption units B'I'U/I1 -
Chillers__ _ 111'
Name: (/ Com ressors_, III'
Address: .nv romnentm exhaust and tr•nl at on:
City: — Slate: ZIP: —_ Appliancev::nt _
C`hr�nc: .Z7 l Fax: E-mail: )rverux oust ----
1 _IT4W,Type res.kitcFo taimat
hood f ire suppression system
Name: p►-N
. �1 Ix
fan with sin Ic duct(bath fans)
Mailin address: / sx oust slrstem apart from heatingor AC
g _ uep ng an st ut on',up'o 4 uul eLa)
Ci . �� -� Slate: ZIP: Type: LI'r .� NC) _ _ Oil -- -
I'I mc: `- --- 14tx E-rnail. Fucipipingeacha ioonaToverTout'ets
rocaspiping(sc sematic required) -
Number of outlets _
Nan_tc: _ __.-- t er App once orequput
Adder s: _ Decoiativeiire lace -
Cil ZIP: nsert-ty c -
Y ---- o stogy pe ct stove _
E
Phone: — Fax: -.nail: (xtcr: _
Aprlicant's si Hato Date: C Z t iy:_-�
Nanree((trint): L — -
__ R:rmit fee.....................$Not all accq m credit cards,pkase c II b:nsdlc Ion ax,rv.e Inramatlrn,. Notice:This permit application Minimum fee................$
:i Visa U MaatetCnrd expires if a permit is not obtained Plan review(at — %) $ __—
Credit card rummer:___ --- —'PAp�- withit,180 days after it has been State surcharge(8%)....$
Near of ca, „der u-sT n- c t tura
accepted as Complete. $ -,t�' r 1
S TUTAI. ....................... —
CiW1 n!derii`nature Amount 4'14617 INUlf('OM
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 foe$72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to$10,000.00 $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&vents 17.40
$10 J01.00 to$25,000.00 $148 50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100,00 or includingvent 1 •.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&nd 5) Vent not included In applian;e 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 dno Check all that apply: Boller Heat Air
$1.20 for each additlunal$100.00 or For Items 7-11,see or PuiT,p Co,d
_ fraction thereof. footnotes below. C0mp
Minimum Permit Fee$72.50 1
t0 100K SUBTOTAL: $ 7) 00K absorb unit
BTU 14,00 1
8%State Surcharge a 8)3-15 HP;absorb 25.80
unit 100k to 500k BTU
25",�°Plan Review Fee(of subtotal) $ 9)15-30 HP,absorb 35.00
Re wired for ALL commercial permits onl unit.5-1 mil BTU
� ..___ __ _. _ .. P_-- _ _Y._ _- 10)30-50 HP;absorb -
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20
_- - - - - - 11)>50HP;absorb
unit>1,75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: -1 12)Air handling unit to 10,000 CFM 10.00 J
Value Tc,ta1 13)Air handling unit 10,000 CFM+
Descriptlor: City (Ea) Amount 1720
Furnace l0 100,000 BTU,including t 955 14)Min-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
Floor furnace Including vent 955 16)Ventilation system not included in
Suspended heater,wall heater or 955 appliance permit 10.00 -
floor mounted heater 17)Houd served by me^hanical exhaust
Vent not Included In applicance 445 10.00
ermit _- - _805 -- 18)Domestic Incinerators 17.40
Repair units
c 3 hp;absorb.unit, 955 - 19)Commercial or!lidustrial type incinerator
to 100k BTU WWI-, _
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101k to 500k BTU _ �. 10.00 _
15-3C np;absorb.unit,501k to 1 2,310 21)Gas piping one to four cutlets
mil.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 MI iimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU
Air handling unit to 10,000 cfm 6588°/.State Surcharge $
.Air handling unit>10 000 cfm __ 1,170 _
904--Iortable evaporate�eler _ 656 TOTAL RESIDENTIAL PERMIT FEE: $
Ver!tan oonnected to a single duct 446
V9n:sy�tHrn incl included In 656
eppllance permit Other Inspectlonq and Feer.
Hood 5st Ived by mechanical exhaust 856 t Inspections outside of normal business hours(minimum charge-two hours)
Doraasuc.InCnerator _ _1,170 $82 50 per hour
Condrtarclal or Industrial Ir.Jneratt)r 4,590 2. Inspec ions for which no fee is specirically indicated (minimum charge-calf hour)
Other unit,litduding wi i stoves, 656 $62 50 3 Additional alrplanrreview required by changes,additions or revisions to plans(minimum
Inserts etc.
Gas I in 1-4 outlets 360
charge-one-half hour)$82 50 per hour
Each additional outlet g3_ *state C :raconr 801107 Ctrtificallon required for units>200k BTU.
TOTAL CiOMMERCIAL "Residei,iial AIC requires site plan showing placement of unit.
VALUATION: __. All New Commercial Bulirlings require 2 sets of plans
lAd,tsdcrmsUmech-fees.doc 12/26/01