Permit A , CITY OF TIGARD MECHANICAL PERMIT
l 1 DEVELOPMENT SERVICES PERMIT #: MEC2001 -00088
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/12/01
PARCEL: 1 S136AD -02501
SITE ADDRESS: 10570 SW 71ST AVE
SUBDIVISION: VILLA RIDGE ZONING: R -4.5
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace furnace
Owner: FEES
MARTIN, WALLACE D AND BETTY J Type By Date Amount Receipt
10570 SW 71ST AVE PRMT CTR 3/12/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 3/12/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
SKY HEATING + AIR CONDITIONING
1637 SE NEHALEM
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 235 -9083 Final Inspection
Reg #: LIC 00050244
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 started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set 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 (50 -9189.
Issue By: 1 4-0-4'Yl� Permittee Signature:
Call (50 639 -4175 by 7:00 P.M. for inspections needed the next business day
03/07/01 WED 09:25 FAX 503 598 1980 CITY OF TIGARD fiJ002
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Mechanical Permit . - pplication
HIE C'�'" 1 .. Date received: Permit no.://b/c, $
N $
lj:':41! City of Tigard Project/appl.no.: Expire date:
CityofTigard Address: 13125 SW Hall Blvd, Tiganls �� OR 971x23 8 (r fi�
t
Phone: (503) 639 - 4171 ;'" (u Date issued: By: Receipt no.:
' Fax: (503) 598 - 1960 Case file no.: Payrnenttype:
COMMUNITY DEVtlu:
Land use approval: Building permit no.:
TYPE OF PERMIT
1 & 2 family dwelling or accessory 0 mi:rcial/industrial 0 Multi - family 0 Tenant improvement
New construction v Additic n/alteration/replacement 0 Other:
Jolt SITE ln' (:OMMI:RCL %L VALUATION SCIICDULE
Job address: 1 05711 5 fJ q - Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $ .
Lot: (Block (Subdivision: *See checklist for important application information and
Project name: 1 jurisdiction's fee schedule for residential permit fee.
City /county! Tpai d !ZIP: •1 1 & 2 FAMILY DWELLING PI:RMI1' HT SCHEDULE
Description and °cation of work on premises: :".a 1 r .1ND COMMERICAL IINDI`STRIAL LQU11'MI:N I SCIIEDIiLF,
,t'YY)QZ Fee(ea.) Total
Est date of completionlinspection: 31Q1Q( Description Qty. Res. only Res. only
Tenant improvement or change of use:
t �
•
Is existing space heated or conditioned? LI Ye; 0 No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
• MECI IANICAI; CON] RAC! 01 o►er compressors
Business name: 9 IJ /al C _ State boiler permit no.:
HP Tons BTU/H
Address: • : t ti'T AA - Fire /smoke damptrs/duct smoke detectors
1 City: JJ - Ctn. State: CJ 4 2,IP: (11802 Heat pump (site plan requ'R
Phone: 2a5,Q• to Fax'QJj•I' _ E -mail: Install/replace furnace /btuner„jLt.L<BT /H
Including ductwork/ vent liner O YesNo ( 14 l4, O6
' • no.: 0' ri ins tall /replace/relocateheaters - suspended,
t)
City/metro lic. no.: ( - 7 wall, or floor mounted
Name (please print): ► (d - $ r on - nt appliance other than fumace
CONTACT PERSON Absorpttiio ETU/}(
Name: Chillers HP
Address: Compressors_ HP
Environmental exhaust and ventilation:
City: I State: I %-IP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust l 1
OW' lilt Hoods, Type Enures. kdtchen/hazmat
N ame 1 ^ rn'' (J (J Exhaust fire suppression with duct V Vu.L n Exhaust fan with single duct bath fans )
Mailing address: 0,0 0 t!., ' St ' 1. , Exhaust system apart from heating or AC
State: Q' ::IP: Q Fuel piping and distribution (up to 4 outlets)
/ „(,Li Type: LPG NG Oil
Phone: ' -�iia Fax: E-mail: Fuel piping each additional over 4 outlets
ENG IN II It Process piping (schematic requited)
Number of outlets
Name: Ni A Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I;:IP: Insen -type
Phone: I Fax: (E -mail Woodstove/pelletstove
Other:
Applicant's signature: A• /�/ >/ / Date: 1 Other:
Name (print): j) ((�'r If - a --I— ,
Noe all Jurisdictions accept aedit at*. please call jurisdiction ►ar more inf xtraua Permit fee $ 77 0 - -
O Yso ❑MasterCard Notice: This permit appiiaition Minimum fee $ 2(
/ expires if a permit is not obtained
Coedit card Plan review (at %) $
number within 180 da days after it has been
r �a y State surcharge (8%) .... $ 5 .S0
Nampa or cardholder as shown ea credit said : accepted as complete. TOTAL $ g' ao
Cardholder eignalme Am wet 440.4617 (6/00/COM)
03/07/01 WED 09:26 FAX 503 598 1960 CITY OF TIGARD IZ 003
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
$1.00 to 35,000.00 Minimum fee 372.50 Table 1A Mechanical Code Qty la; Amt
$5,00.00 to 310,000.00 $72.50 for the first 55.000.00 and 1) Furnace to 100,000 8TU 14.00 �°
31.52 for each additions $100.00 or Including duds & vents ; �
fraction thereof, to and Iiicluding 2) Furnace 100,000 BTU+
$10,000.00. including duds & vents 17.40
310,001.00 to $25,000.00 3148.50 for the first $10 000.00 and 3) Floor Furnace
31.54 for each additiona $100.00 or i f including vent 14.00
fraction thereof, to and including I 4) Suspended heater, wall heater
• 325,000.00. or floor mounted heater 14.00
325,001.00 to 350,000.00 $379.50 for the first $25 000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.30
fraction thereof, to and ii :cluding 6) Repair units
$50,000.00. , 12.15
350,001.00 and up 3742.00 for the first $50 000.00 and . Check.3lI.that applY %Boiler. Heat Alt .
31.20 foreach additional $100.00 or For items pi 1, see 1 .or • . Pump Cond_
fraction thereof. footnotes'below.. • , .: Comp' N
7) c3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU _ 14.00
8) 3.15 HP: absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9)15.30 HP; absorb
Furnace to 100,000 BTU, Including 955 unit .5-1 mil BTU _ 35.00
ducts 8 vents 10) 30-50 HP; absorb
Furnace > 100,000 BTU indudillg - 1,170 unit 1 -1.75 mil BTU , 52.20
dues &vents 11) >50HP: absorb
Floor furnace Including vent ' 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit tti 10,000 CFM
floor mounted heater 10.00
Vent not Included In applicance 445 13) Alr handling unit 10,000 CFM+
permit T- 17.20
Repair units 805 _ 14) Non - portable evaporate cooler
c 3 hp; absob. unit, 955 10.00
to 100k BTU _
15) Vent fan connected to a single duct
3-15 hp; absorb. unit, 1,700 8.80
101k to 500k BTU 16) Ventilation system not inducted In
15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10
mil. BTU .
- 17) Hood served by mechanical exhaust
30-50 hp; absorb. unit 1 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 handing unk b 10,000 dm 656 69.95
Air handling unit >10,000 cfrn _ 1,170 20) Other units, including wood stoves
Non- portable evaporate cooler 656 • 10.00,
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not Included In 658 5.40
appliance permit 22) More than 4-per outlet teach)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator _ 1,170 Minimum Permit Fee $72.50 SUBTOTAL: n ` �50
Commercial or industrial incinerator 4,590 $
Other unit, Including wood stoves, 656
8% State Surcharge $ S t d o
inserts, etc. _ O
Gas piping 1-4 outlets - 360 25% Plan Review Fee (of subtotal) • I $
Each additional outlet _ Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $ ,ig t 60
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VALUATION:
Other Inspections and Fees:
1. Inspeclions outside of normal business hours (minimum charge-two hours)
372.50 per hour.
2. Inspections for which no fee is specifically Indicated (minimum charge -half hour)
372.50 per hour
3. Additional Flan review required by changes, additions or revisions to piens (minimum
charge - one-half hour) 372.50 per hour
`State Contractor Boller Certification required for units'200k BTU
• "Residential A/C requires site plan showing placement of unit
I :ldstslformS medl- fees.doc 10/11 /00
goon
`CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 6 4171 MST
BUP
Date Requested - AM PM BLD
Location / .3 w 7/ $ Suite MEC S /-
Contact Person Ph Z 3Sy l/ t3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall • ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath/Shear
Int Sheath /Shear
Framing r— ('.i,e z.",-.(z (
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm -
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
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Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS —ART FAIL
Post & Beam
Rough In
Gas Line
S like kei ke Dampers
.410, - • RT FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm •
Final •
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ J Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date Ll / / — DI Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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