Permit . 1
CITY TIGARD � MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2001 -00454
A' L311F. '" - - 1312 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/14/01
PARCEL: 2 S 112 D C -01500
SITE ADDRESS: 15615 SW 74TH AVE 100
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 006 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: 1 VENT FANS:
OCCUPANCY GRP: M 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 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Add unit heater, side wall vented and gas pipe.
Owner: FEES
74TH AVENUE INDUSTRIAL PARK LL Type By Date Amount Receipt
8100 SW DURHAM RD PRMT CTR 12/14/01 $72.50 2720010000
TIGARD, OR 97224 5PCT CTR 12/14/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
HANSON HEATING
1916 SE 148TH
PORTLAND, OR '97233 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 503- 891 -9138 Mechanical Insp
Reg #: LIC 142382 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 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 pies of these les or direct questions to OUNC by calling (503)246 -9189.
Si
Issue By: LAd,7,677z/r___) P ermittee Signature:
/17'1 0.6 Lal r /Y�J
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
s MechanicalP • .i..1 cat
Date received: a /3 d Permit ri .. , DD /.,ODL�j�' -
AA II? Cit of Tigard
� _„ ,1 b Projecdappl. no.: Expire dat e:
City of Tigard Address: 13125 SW Hall Blvd, • ard O t *7223 Date issued: By: Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: Building permit no.:
❑ 1 & 2 family dwelling or accessory lg Commercial /industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION .•. ,, • COMMERCIAL VALUATION SCHEDULE •
Job address: 5 , i5 4 Au e Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: b 0 value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ $�� -
-1- Lot: Block: Subdivision: *See checklist for important application information and
Project name: // �� , jurisdiction's fee. schedule for residential permit fee.
City /county: ZIP: r c 2 . ,y a 1' & -2 "FAMILY DWELLING PERMIT FEE SCHEDULE,:
' .Description and ocation of work on premises: fldd twr AND COMMERICAL /INDUSTRIALEQUIPMENTSCIIEDULE
-i �;,l''i a vu -ti la ' `�c.: i - S 4+ a Fee(ea.) Total
Est. date of completion/inspection: 11 / Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air handling unit CFM
C Is existing space heated or conditioned? la'Yes ❑ No
Airconditioning (site plan required)- -
Is existing space insulated? d Yes ❑ No Alteration of existing HVAC system- -
MECHANICAL CONTRACTOR Boiler /compressors
Business name: State boiler permit no.: I■■ ME
MN
ii Sr1A� ' HP Tons ' BTU /H
Address: Fire /smoke dampers /duct smoke detectors - --
City: l'o rt lei -nr0 State6 R ZIP: el 7 A 3 3 Heat pump (site plan required) _ -- -'
Phone:se3 8 l- q/,3$' Fax:7. • -5596 E -mail: InstalUreplace furnace /burner BTU /H 11
Including ductwork /vent liner ❑ Yes ❑ No
CCB no.: / 3g ^1 -o a— Install/replace /relocate heaters- suspended,
City /metro lic. no.: 6 0 wall, or floor mounted �--
Name (please print): * AM. • 0 , r f}-A1 SO Vent for appliance other than furnace —
CONTACT PERSON Refrigeration: ■
1 Absorption units BTU /H
Chillers HP S
Address: 5 - 6 l - 5 w f a. V E' Compressors HP ME
Environmental exhaust and ventilation: ■--
M State: D 2 ZIP: • 1 7 , Appliance vent
Phone: 5 ,I; - TS Fax: 598- : 3 E -mail: Dryer exhaust _
' OWNER *. , . - • - .:, ' ! ,••• • Hoods, Type l/ II/res. kitchen/hazmat ■__
' hood fire suppression system
• Name: Exhaust fan with single duct (bath fans) -
Mailing address:
Exhaust system apart from heating or AC _
City: State: ZIP: Fuel piping and distribution (up to 4 outlets) ■--
Type: LPG NG Oil
Phone: Fax: E - mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required) I
Name: Number of outlets
Other listed appliance or equipment: . -
Address: Decorative fireplace
City: State: ZIP: Insert - type =
Phone: — .1.a = E -mail: Woodstove/pellet stove —
Other: IMi
Applicant's signatu ji A I MI Date: Aillot Other: M
Name (print): �- '�
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
❑ Visa 0 MasterCard Notice: This permit application Minimum fee $ 707- -,5
Credit card number: expires if a permit is not obtained Plan review (at %) $ -
Expires within 180 days after it has been State surcharge (8 %) .... $ �10 • . .€ � J
Name of cardholder as shown on credit card accepted as complete. TOTAL $ / O
. $
Cardholder signature Amount 440 -4617 (6/00 /COM)
•
.'--,
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL PERMIT:FEE ;.& .' x : Description . • V ; Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A,Mechanical Code „= - (t' (Ea) ' ` Arnt
$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
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
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 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 ly: < , Boiler Heat ' `Air .
$1.20 for each additional $100.00 or For items 7 -11 app or P ump Con . l'
fraction thereof. - footnotes below CO m p ,',
7) <3HP;
Minimum.Permit Fee $72.50 SUBTOTAL: $ 4 to 100K BTU absorb unit 14.00 •
8% State Surcharge $ 8) 3 -15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9) 15 -30 HP; absorb 35.00
Required for ALL commercial permits only unit .5 -1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU
11) >50HP; absorb
unit >1.75 mil BTU 87.20 .
;ASS.UMED VALUATIONS PER APPLIAN . . s - 12) Air handling unit to 10,000 CFM 10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (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
Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater
Vent not included in applicance 445 17) Hood served by mechanical exhaust 10.00
permit
Repair units 805 18) Domestic incinerators 17.40
< 3 hp; absorb. unit, 955
to 100k BTU 19) Commercial or industrial type incinerator
69.95
3 -15 hp; absorb. unit, 1,700
101 k to 500k BTU 20) Other units, including wood stoves
10.00
15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
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
>1.75 mil. BTU Minimum Permit Fee $72.50 SUBTOTAL: ,
Air handling unit to 10,000 cfm 656 $
Air handling unit >10,000 cfm 1,170 8% State Surcharge , .- .
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not included in 656
appliance permit
Hood served by mechanical exhaust 656 Other Inspections and Fees:
Domestic incinerator 1,170 1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge -half 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) $72.50 per hour
Each additional outlet 63
*State Contractor Boiler Certification required for units >200k BTU.
**
TOTAL COMMERCIAL _' $ Residential A/C requires site plan showing placement of unit.
VALUATION: ,. '.,.. . t,, All New Commercial Buildings require 2 sets of plans.
is \dsts \forms\mech - fees.doc 08/29/01
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: Business Line: 639 -4171 MST
BUp
Date Requested /b AM PM BLD
Location 1 / ,c6, /5 11--1)'e- Suite ! o C�.) MEC ell% i 2 G 4 .7(s C 7 /
Contact Person i y , ✓� Ph 6 �/S- PLM
Contractor Ph "Z /_g' J 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: •
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
- Post & Beam
oug
as in
S • ke Dampers
PART FAIL
RICAL "
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date i — ) `''" C ' Ext
Other
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job. site.
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