Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00186
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/16/03
PARCEL: 2S 113AB -00800
SITE ADDRESS: 15995 SW 74TH AVE 150
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B 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 OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 3
> 10000 cfm:
Remarks: Run 71' - 1" pipe and 100' - 3/4 ". (3) outlets. Value: $3000.00
Owner: FEES
DUNCAN, JOHN A AND Description Date Amount
JANICE LEE [MECH] Permit Fee 4/11/03 $72.50
7060 SW PALMER WAY
BEAVERTON, OR 97007 [TAX] 8% StateTax 4/11/03 $5.80
[MECPLN] Plan Rev 4/16/03 $18.13
Phone: Total $96.43
Contractor:
POWER PLUMBING CO
PO BOX 23144
TIGARD, OR 97281 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 244
Mechanical Insp
Reg #: LIC 52378 Final Inspection
I
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
requir- _ e _ • follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
ued By: - : ; ��;ji� - Of Permittee Signature: A lc, 4
Call (503 639 -4175 by 7:00 P.M. for inspections needed the next business day
1
Mechanical Permit Application FOR OFFICE USE ONLY . ' .
Received Mechanical ` /
Date/By: z/-/ (-C)3 1313 PermitNo.: �� C (}S' O Tsv
City of Ti and Planning Approval Building
y g Date /By: Permit No.: 'DU �J —00 /O7
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
ti „ ' 10, Date /By: Case No.:
i Internet: www.ci.tigard.or.us e .j 11 Contact Ju ® Sec Page 2 for
m 24-hour Inspection Request: 503- 639 -4175 'M.. W Name /Method: l Supplemental Information.
r'. : - , :TYPE. OFVORK% ,- =.: COMMERCIAL FEE* •SCHEDULE= USE;.CHECKLIST, , ;
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
,rAdditio ratlon%iyplacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
x .', ; W.;f :'CIATE _ GORY OF CONSTRUCTION 'w � mechanical materials, equipment, labor, overhead and profit.
CATE
El 1 & 2- Family dwelling 0 Commercial /Industrial Value: $ ,3' OD - See Page 2 for Fee Schedule
❑ Accessory Building • Multi- Family 'aRESIDENTIAL'EQUIPMENT %SYSTEMS FEE*. a SCHEDULE,.., '
Description 1 Qty 1 Fee(ea.) Total
❑ Master Builder ❑ Other: Heating/Cooling
;:JOB_SITE IN.IO _ T.IO andLOOATION .. ` Furnace - add -on air conditioning ** 14.00
Job site add ress: / 669 O 7 _72L 1 Gas heat pump 14.00
Suite #: ( 5O Bldg(E.. = = Duct work 14.00
Project Name: 54 ORT } i r\J je]j Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12.15
OtherFuel Appliances ,
Tax map /parcel #: Water heater 10.00
': WORK' '`n s '°
, ' Gas fireplace 10.00
/ 7 / !C ''��' ?
0.. �:,
„�.,; Flue vent (water heater /gas fireplace) 10.00
i Log lighter (gas) 10.00
+' ( 1 Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
_ - Other: 10.00
r ❑�P �❑ TENANT _,
Name: Environmental :Exhaust &Ventilation
Range hood/other kitchen equipment 10.00
Address: Clothes dryer exhaust 10.00
City /State /Zip: Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
❑,APPLICANT F❑ CONTACT PERSON ''4 utility rooms) 6.80
Name: Attic /crawl space fans 10.00
Other: 10.00
Address: , 'Fuel Piping '
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Furnace, etc. **
Phone: Fax: Gas heat pump ** •
E- mail: Wall /suspended/unit heater **
,'',,,,•:;.:_:-.. .CONTRACTOR., ; • , . _ Water heater **
Business Name: Po ti-e/ Pk/+ ,,, Fireplace **
**
Address: /Pip /� SGv 77?u.� i Range
BBQ **
City /State /Zip: ODA 99 Z R 3 Clothes dryer (gas) **
Phone: 5 -c f. / 9O Fax: Other: -A (9-�t -C , S 3 **
CCB Lic. #: S'A ,,,s/ Total:
Mechanical Permit,Fees* • .
Authorized Y -�1 Subtotal: $
Signature: C /� � e: Minimum Permit Fee $72.50 $ ''79,.5
/2 -,,, ,2�d4 Plan Review Fee (25% of Permit Fee) $ g'/
(Please print name) State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $ 1 & 3
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Boar .
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 I'
To `Ai• dill'
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: 'Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
Assumed Valuations Per" Appliance:
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace> 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc. •
Gas piping 1 -4 outlets f 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
i:\Dsts\Permit Forms \MecPermitAppPg2.doc 01/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVfi'3ION Business Line: (503) 639 -4171 MST
•
BUP
L�
Received Date Requested < l AM PM BUP
Location / S / S 7 '`- /4--ti Suite / Ste. MEC 3 -6 / ?,
Contact Person 06/) Ph ( ) 9362 - SS r PLM
Contractor Ph ( � ) SWR
BUILDING Tenant/Owner i� ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
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
Under Slab
Rough -In
Water Service
Sanitary Sewer /`
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS FAIL
ECHANIC
Rough -In
s irie
- Smoke Dampers
Final
•S APART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage .
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / v Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site. •
PASS PART FAIL