Permit CITY OF TIGARD
A.dh MECHANICAL PERMIT
r DEVELOPMENT SERVICES PERMIT #: MEC2002 -00334
.,f II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/26/02
PARCEL: 1 S136CB -02700
SITE ADDRESS: 11070 SW 82ND AVE
SUBDIVISION: RANCH VALLEY ZONING: R -4.5
BLOCK: LOT: 008 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: 1
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace furnace and install exterior NC unit. Do not install within the required setback
Owner: FEES
VAUGHN, MARVIN WESLEY + BETTY Type By Date Amount Receipt
11070 SW 82ND PRMT CTR 7/26/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 7/26/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
ABLE HEATING + COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 579 -2250 Duct Inspection
Reg #: LIC 00108535 Final Inspection
EXPIRED
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 -0 -0010 thr• • OAR
952 - 001 -0080. You may obtain copies of these rules or direct • = tio• - o OU■ _ ay
(RM124R -Q1RQ
Issue By: _1,2_, Permittee Signature: �
Call (503/639-4175 by 7:00 P.M. for inspections needed the next business day
_ rii Et✓, 00)-i ) 331
.. Mechanical Permit Application
Date received: Permit no : 4, tt i ,
. - j-- I'I`I City of Tigard . Project/appl.no.: Expire date:
Ciry ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receiptno.:
Fax: (503) 598 -1960 Case file no.: Payment type: ,
Land use approval: Building permit no.:
TYPE OF PERMIT
1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family . 0 Tenant improvement
New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: I \ n'b 6 - • _ n Indicate equipment quantities in boxes below. Indicate the dollar _
- Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, .
. Tax map /tax lot/account no.: , profit. Value $ . - ,
Lot: Block: I Subdivision: *See checklist for important application information and .
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: - ra o .,)\ h, ZIP: C3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRLAL EQUIPMENT SCHEDULE
• Fee(ea.) Total
Est. date of completion/inspection: 1 /30 - S /o'Z, Description Qty. Res. only Res. only
Tenant improvement or- change of use: HVAC:
' Is existing space heated or conditioned? 0 Yes 0 No • Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system •
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MECHANICAL CONTRACTOR Boiler /compressors
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Business name: 4 )0\9 Q ile ,r ; � HP Tons BTU/H
State boiler permit no.:
Address: Xt� \2 Cv,,,3 60, .fir Fire/smoke dampers/duct smoke detectors .
w " r JC / L Heat um ite lan re uired
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City: 7 - 3 � State g1 pump P q
J SA -2 SU I 5ST OR -91o4I lnstaWreplacefurnace/burner 7S TU /H I
Phone: Z Fax: E -mail: �' •
Including ductwork /vent liner 1;Yes 0 No
CCB no.: j cfg S35 Install/replace/relocate heaters - suspended,
• City /metro lic. no.: - ' wall, or floor mounted '
Name (please print): r p! Vent for appliance other than furnace
CONTACT PERSON Refrigeration: .l
Absorption units 2- `4 BTU /H , •
Name: .7 G Chillers HP
Address:. - V Compressors HP .
Environmental exhaust and ventilation:
City:. • I State: I ZIP: • Appliance vent
Phone:0i •') - H Fax: E - mail: Dryer exhaust ,
OWNER Hoods, Type 1/ IVres. kitchen/hazmat
hood fire suppression system
Name: W CS Uo jQ\-, n Exhaust fan with single duct (bath fans)
Mailing address: \ \o) 7 $ Z,,_ Exhaust system apart from heating or AC • ,
` Fuel piping and distribution (up to 4 outlets) •
City: 1 ;-8 I State:C(L I ZIP: Ck Type: LPG NG Oil —
Phone: - 0 1- ltd Fax: E -mail: Fuel piping each additional over 4 outlets _
Process piping (schematic required) '
Number of outlets
Name: Other listed appliance or equipment: ,
Address: Decorative fireplace
City: • I State: I ZIP: Insert - type
Phone: / . • I E -mail: Woodstove/pelletstove
Other:
.
Applicant's signature: I Date: 1 /2,6 Other.
Name (print): VA-- C,,,a`-t'S - . / .
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee - $ ✓
CI ❑MasterCard Notice: This permit application Minimum fee $ S O
Credit card number: / 1 expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %)...,. $ ^
Name of cardholder as shown on credit card $ accepted as complete. a TOTAL $ - �` `� a
Cardholder signature . Amount EX P 1 R E ® 440 -4617 (6/00/COM)
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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 fee $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 I 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 apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see Pump Cond
Comp fraction thereof. footnotes below. p ••
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Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit
to 100K BTU - 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
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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
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ASSUMED VALUATIONS PER APPLIANCE: 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 t 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 17) Hood served by mechanical exhaust
Vent not included in appliance 445 10.00
permit 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101k to 500k BTU 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 Minimum Permit Fee $72.50 SUBTOTAL: $
>1.1. 75 mil. BTU
Air handling unit to 10,000 cfm `656 8% State Surcharge $
Air handling unit >10,000 cfm 1,170 '
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)
$62.50 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 $62.50 per hour
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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) $62.50 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: All New Commercial Buildings require 2 sets of plans.
- is \dsts\forms\mech - fees.doc 02/11/02
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