9630 SW SERENA WAY N
N
7
9630 SW Serena Way
CITY
OF TIG AR D MECHANIC AL PERMIT
DEVELOPMENT SERVICES PERMIT#: PAEC2002-00429
13125 SW Mall Blvd., Tigard, OR 97223 (5C 1) 639-4171 DATE ISSUED: 10/4/02
PARCEL 2S114EiA-03200
SITE ADDRESS: 09630 SSV Sir^ENA WAY
SUBDIVISION: PICKS LANDING 1`0.2 ZONING: R-4.5
BLOCK: LOT. 07 JURISDICTION: 'FIG
CLAS3 OF WORK: 01R FLOOR FURN: EVAP COOLERS:
Ti'.`_ OF USE.: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS_ HOODS:
_ FUEL TYPES0 - 3 HP: J DOMES. INCIN:
LPG ---._A_—___�_ 3 - 15 HP: COMML. INCIN:
MIAX !NPUT: B rU '.5 - 30 HP: UNITS:
FIRE DAMPERS?: 30 REPAIR
50 HP: WOODUNITS:
GAS PRESSURE: 504- HP: CLO DRYERS:
FURN < 100K BTU- AiR_HANDLING UNITSOTHER UNITS:
FURN >=100K ETU. <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of(2)gas fireplaces and gas piping for(2)outlets.
_Owner: �Y FEES _
RICK DAY Description Date Amount
9630 SW SERENA WAY $72.50
TlGARD, OR 97224 [ML( I I i I'crnui I cc 10/4/02
[MECII] fermi' Fee 10/4/02 $0.00
[TAX] 81%)StateT'as 10/4/02 $5.80
Phone: [TAX]81%,State'Fa\ 10/4/02 $0.00
Contractor: _ _Total $78.30
FIRELIGHT LLC
17690 NE HILLSBORO HWY
NEWBERG, OR 97132 _ REQUIRF-D INSPECTIONSInsp _
Phone: 503-554-0891 Gas Line
Misc. Inspection
Reg#: 148689 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, St&tc of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more tf,an 160 days. ATTENTION: Oregon law
requires you to follow rales adopted in the Oregon Utility Notification Center. The se rules are set forth in OAR 952-001-00
irljIssU d By: _ Permittee Signature:
t, Cali (50 639-4175 by 7:00 P.M. For inspections needed.6e next bushuass day
Mechanical Permit Application
--- ----- "Dateceived:/0 1y,09 Permit
City Of Tigard Project/appl.no.: ep' edate_ _—
City fufTigurd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued:_ BA,;b Receipt no.:
^
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: - Buitaing permit no.:
�1 72farrily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvcm.nt
U Nuction 'J Addition/alteration/replacement U 01I.. --
Job address: c-jr<- 1 moi;1(/—� %u Indicate equipment quantities in boxes belovi. Indicate the dollar
Bldg. no.: — Suite no.: value of all mechanical materials,equipment,labor,overhead, I
Tax map/tax lot/account no.: profit,Value$ _
Tat; Bock: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: TJ R'' �+,_A ZIP: �!7 Z2.
Dcscriptton n I Icxation of wo on premises:
ik 1411 hoe, CXk'A1107 Icr(ea.) I'o1a)
Est.date of completionihnspection:
D wcri Ion "y. Res.onl Rcw.mill
Tenant improvement or change of use: A!ircon
ing unit , —CFM
Is existing space healed or conditioned?t�5'es U No tionine(s to p an require ) _ __
Is existing space insulated?*FYes U No Alteration of existin—g-IIVAC system -
Boi er compressors
State boiler permit no.:
Business name: F err/0h h ►- L= HP Tons—_—BTU/H --
Address. t'7 Q O /✓� S G !�� __ it smo a amper uct smo-Tec etectorx
City: /�{✓i State: d ZIP: /713 Z-- mat ump(siteplanrequirec)
1 Fax: S?84 71, E-mail: nate rep ace urnac urncr13�
Phone: 5 S c/( Including ductwork/vent liner U Yes U No
CCB no.: c71 F el Instalrep ac re ocatc eaters-sus p-rn3 .
City/metro lic.no.: 4 r/ 3 Z-- r wall,or floor mounted _—
Name(plertse print): i e t Vent for applion furnace
Refrigeration.
Absorptionut�ics _ BTI1/H —
Chillera HI'
Name: 1.c ' -`00 f Compressors- __ Hi'
Address: / /�r //�//�G�>�4. L� ci nv ronmenta ex tial an vent at on:
FR;N-,o,
y: cep/x ;! _— State: _ZIP: a if{- Applianceveni —
nc. 6'� _ ax.C-( J. F ( s' 1Q/[b 1: moil: I)ryerextl—gust —
Hoods,TypeTlTrFres ttchcn azmat
hood fire suppression system
Name: i k Oe~U Exhaust fan with single duct(bath fans) _
Mailing address: q b ` C r ' 6✓� x taust system a ar, rom eating or 4�`
Fuelpiping an nitiuii'on tup to 4out it
Cit �1'c , l► �1state 2 7.tP: cy f.�; NG oil Z
City: s:.:2_ 1��—._. ryp� —
Phone:
-- I ;,r F_.-mail: •'ue piping each Raditional over 4 outlet
Process p p ne(schematic required)
Number of outsets
Name: _ ter WdR appliance or equ pmt at:
Address: _ Decorativeftrrplacc 2,
— n- I- -t e
0o atov 1'e et stove
Phone: Fax: E-mail: ( er:
AppN�ant'a signature: :. �. / Date: &�° Z_ _ Other:
Name (print) .
Permit fee.....................$ --5--_
Dia all Jurim; nna w<ccM credit cant.please call jurlydicarm fur mme inlorrruti(m. Notice:This permit application Minimunt fee................$
Ll Visa expires if a perrttt+.is not obtained Plan review(at — %) $ —
Credit card rn r �. �6 within I80 days After it has been State surcharge(8%)....$ —3.�--
carne of cardholder
accepted as complete. TOTAL .......................ue ownar. It cud -7 g,
$
440J617(tyOQCr1Ml
uwdholdet signature _� — Am _
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
Ir'TOTAL VALUATION: PERMIT FEF_: � Description: L14.00
Total
Table 1A Mechanical uodu Qty Amt
$1.00 to$5,000.00 _ Minimum fee$72.50 1) Furnaco to 166,566B10
$5,001 00 to$10,000 o $72.50 for the first$5,000.00 and includinb duds&vents$1,52 for each additional$i00.00 or 2) Furnace 100,000 BTJ+
fraction thereof,to and includin0 F rnac ducts 0 vents
__
$10.200.00. _
10,001.00 to$''.5,000 00 $148.50 for the first$10,�U0.00 and 3) Floor Furnace
including vent 1400
$1.54 for each additional$100.00 or -
fraction thereof,to and including 4) Suspended haater,wall heater 14 On
_ _ $25,000.00. _ or floor mounted heater
25,001,00 to 15J,000.00 $379.50 for the first$25,000.00 and u) Vent not Included in appliance permit
G.80
$1.45 for each additional$100.00 or
fraction thereof,to and including 6) Repair urAs
1'.15
-up----
$50,000.00.
Lf1
$50,000 and up-- $742.00 for the first$50,000.0)end Check all that apply: Holler m Air
$1.20 for each additional$100.00 or For items 7-11,sue or Pump Cond
fraction thereof. footnotes below.
' Co�.p
- -- 7)<' 1F,absorb unit
Minimum Permit Fee$7R.S0 SUBTOTAL: $ tc ,OOK 8 rU 14.00 -
--'-` .. '--_ '/.sStele Surcharge � 8;3-15 HF absorb 25.60 -
unit 100k It 50%BTU _ _�- -(
9)1 F 7C:(P;absorb f
25%Man Review Fee(of subtotal) $ - -
unit.5-1 mC ''t I 35.00
il
_R_equired for ALL commercial permits onl _ 10),30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1,i5 mil BTU 52.20
11)>501-1131;absorb
whit>1.75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: Y 2)Air handling unit to 10,000 CFM
tO.OL t
Value Total --IT)Air handling unit 10,000 CFM+
Description: Ot EI a) Amount - 17.20
Furnace to 100,000 BTU,including 955 14)Non-portable evaporE to cooler
ducts&vents
10.00
Fumare>100,000 BTU including 1,170 15)Vent fan connoctad .o a single duct
ducts&_vents
Flfur -6-6
8.110 -
nor nace Including vent 955 - 16)Ventlk tion system not included in
Suspended healer,wall heater or 955 appliance permit 10.00
ffoo, mounted heater 17)Hood served by mechanical a(haust
Vont nal Included in applicanca 445 10.00
permit _- _ 805 17.40
_ - 18)Domestic incinerators
Re air units
e 3 hp;absorb.unit, 955 19)Commercial or Industrial type incinerator
to 100k BTU _ 89.95
3-15 hp;absorb.unit, W 1,700 20)Other units,Including wood stoves 'L low 70 .r
101k to 500k BTU_ -- - -
15-30 hp;absorb.unit,501 k to 1 2,310 21)Gas piping one to four outlets
hill.BT'J _ _... Z- 5.40 J
�
30-50 hp;absorb,unit, 3,400 22)More than 4-per outlet(each)
1.1.75 mil.BTU -
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 sUBTOTAL $
*1.75 mil.BTU _ ----- -
ii&handling u,At to 111,000 cfm 658 - "-- 8%state surcharge 4 $
AIr handling tura>10,000 dm 11170 _ _ --_
Non-portable ev�rate cooler_ 858 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446 -
Vent system not Included in 656 -----
a Q�hgr Inspections and Fees
Hood served by mechanical exhaust -656 t Inspections outside of normal business hours(minimum charge-two hours)
Dome3th Incinerator 1,170 - $62 so per hour
Comniorclal or Industrial indneraito_r 4,590 2 Inspections lot which no to
is specifically Ineicsted (minimum,harge•tieU hour)
Other unit,including wood stoves, 656 $62 50 per nour
Inserts,etc, _ _ 3 Additional plan review required by changes,additions or revisions to plans(minimum
C3aa I my i-4 oullet�
3E J charge-one-half hour)$62 50 per hour
Erich additional outIvt _ 63 'State contractor Boller Certification required for uni"s>,200k BTU.
_ 'Residential AIC rett,cires site pian showing placemert of unit.
TOTAL COMMERCIAL
VALUATION' _-- All flew Commercial Builrtt qs require. Gels Of plans.
I:\dstsVorms\mech-fsc+s.00c 12/28!01
CI rY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
Received _ _n^te Requosted�_/_G Z� BUP
Aft PUP
Location Suitti - -__-- MEC _ c�
Contact Person _ _ Ph __ ) PLM
Contractor— Ph(---) �SCr' SWR _
BUILDING TorianlJOwner —ff�j�'i _. D y ELC
Footing
Foundation Access: i.LC
Ftg Drain
Crawl Dram cLR
Slab Inspection Notes: —- SIT
Post&Beam
Shear Anchors ---
Ext Sheath/Shear
Int Sheath/Shear
Framing —
Insulation
Drywall Nallin
Firewall
Fire Sprinkler -_
Fire Alarm
Susp'd Calling _--
Roof
Other: —
Final
PASS Pb RT FAIL -- -- ------
PLUMBING
Post&Beam -----
Under Slab _
Rough-In -
Water Service
Sanitary Sewer — —� -
Rain Drains
Cbtch Basin/Manhole —
Storm Drain ---- _
Shower Pai i
Other:
Final — — —
PASS PART FAIL
MECHANICAL —
Post&Beam
Aou h-hj- _
Sm9,IiiQ Dampers -- —_. _----__--_
') PAR; FAIL
_ RICAL —
Sr!lvice --"—.__ --- —
Rough-In
U4/Slab -
Low Voltage
Fire Alarm — ---
Final El Rei►-spection fee of$_ required before next inspection. Pay at City Hail, 13125 SW Nall BlvJ
PASS PARTFAIL
t31TE __ [] Please call for reinspection RE:— n Unable to inspect - no access
clre Supply Line
ADA
Approach/Sidewalk Gafto-� � � -- InsPectar '� Ext
Other _...--
FlnnI DO NOT REMOVE this 141:spectlunr recorcl from they Jeiib site.
PASS PART- FAIrI J
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST -- — -
INSPECTION DIVISION Business Line: (503)639-4171
Received Date Reque#d
AM . PM BUP -
Location Suite -- MEC - ---�
P
Contact Person , -- _ Ph L�it
Contractor - -•-
___ Ph(_ ) SWR _
BUILDING Tenant/Owner - ELC
Footing ELC
Foundation Access: ELR _
Ftg Drain
Crawl Drain - SIT
Slab inspection Notes:
Post&Beam -------- ----- -
Shear Anchors _
Ext Sheath/Shear - --�
Int Sheath/Shear -
Framing - ---_ ----- -
insuletior
Drywall Wailing ------- ----- -.---._---
Firewall
Fire Sprinkler --�--� -
Fire Alarm -
Sus-)'d Ceiling ------- -'
Roof -
Other:_---. ------. �-1
Final _ ... -_V Q -
PAS6_PART FAIL
PLUMBING �--- - ------
Post&Bearn
Under Slab ------
Rough-In
Water Service - -
Sanitary Sewer
Rain Drains --_-- - -- - -
Catch Basin/Manhole
Sturm Drain
Shuwei Pan ---
Other: ----------
Final
PASS PART_ FAIL ------
MEt AANICAL-_ -- ---.------ _
Post&Beam -
Rough-In
-
Smoke Dampers - -- `-
Final ------------
PASS _FART FAIL -" J---�
ELECTRICAL - _----- ------ _ �-__ - --.-_
Service
Rough-In ------
UG/Slab -_
Low Voltage ---
Fire Alarm
Final 0Relnspectlon fee rrf$__- r uired before noxi I ispoction, [,ay at City Hall, 1, �5 SW Hall Bl id.
pASS PART FAIL
Please call for reinspection RE:..--..._ _ ('_'__.___--.-_-._-- �� Unable to irspec;-no accr3r,
Fire Supply LineEst
`/"_._
ADA ,A
Approach/Sidewalk
Other.
Final Do F0,,11`F FIEMOVE this 111spection r4igord froMMo the job eke-
PASS PART FAIL