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Permit CITY TIGARD MECHANICAL PERMIT PERMIT #: MEC2001 -00169 • - �I DEVELOPMENT H B r SERVICES Tigard, 639 -4171 DATE ISSUED: 5/17/01 PARCEL: 2S111 BA -04200 SITE ADDRESS: 14040 SW 98TH AVE SUBDIVISION: MCDONALD ACRES ZONING: R -4.5 BLOCK: LOT: 017 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1 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: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Installation of gas cooktop vent. Owner: FEES MCMILLAN, ROBERT LAND Type By Date Amount Receipt MARGARET R PRMT CTR 5/17/01 $72.50 2720010000 14040 SW 98TH AVE 5PCT CTR 5/17/01 $5.80 2720010000 TIGARD, OR 97223 Total $78.30 Phone: Contractor: CENTER POINTE CONSTRUCTION 8620 NW ASH PORTLAND, OR 97229 REQUIRED INSPECTIONS Mechanical Insp Phone: 503 - 381 -3896 Final Inspection Reg #: LIC 127655 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 obtai co..- of these rules or direct questions to OUNC by calling (503)246 -9189. � Issue By: _�' / - Permittee Signature: r A QI--' Call (503) 639 -4175 by 7:00 P.M. for inspections needed the business day . Mechanical Permit Application Date received: - /' 71. . / Permit no.:/` no.:/lb 04,7 " "' k j ' � � l City of Tigard . _ ty g Project/appl. no.: Expire date: i and Address: 13125 SW Hall Blvd Ti OR 97223 ��, 8 Date issued: .4ivAj ' • ece City of Tigard no.: Phone: (503) 639 -4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT . 1SCl & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction Addition /alteration/replacement ❑ Other: JOB SITE INFORMATION ('OMMERCIAL VALUATION SCHEDULE Job address: / yv c/ ) j , L.,_,t. q Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, profit. Tax map /tax lot/account no.: pro Value $ ' Lot: (Block: I Subdivision: *See checklist for important application information and Project name: /1 cPi , r4 jurisdiction's fee schedule for residential permit fee. City /county: , n•S/ ,''1 ?t''9j? I ZIP: 91. 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: i- A. I / AND COMMERICAL /INDUSTRIAL EQUIPMENT SCHEDULE S/V ✓! ✓ali fi gi l-< Fee(ea.) Total Est. date of completion/inspection: ,5/Z//o,/ Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air handling unit CFM Is existing space heated or conditioned? s ❑ No Air conditioning (site plan required) Is existing space insulated ?WYes ❑ No Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: (�(�,�, /�0 ,'••.ii- �j >� r fry IN Op-. State boiler permit no.: HP Tons BTU /H Address: Se6 2_0 /l. rest.) AI j /4. Fire/smoke dampers/duct smoke detectors City: f Q I State / z I ZIP:' '72Z7 Heat pump (site plan required) Phone: 3 d - .. F . Fax I E - mail: Install/replace furnace/burner BTU/H Including ductwork/vent liner ❑ Yes ❑ No CCB no.: I Z 6 S.r Install/replace/relocate heaters - suspended, City/metro lic. no.: wall, or floor mounted Vent for appliance other than furnace Name (please print): V 2 t� jf S7F Refrigeration: CONTACT PERSON Absorption units BTU/H Name: V v C / it (- 3 / Chillers HP ,r/6 2 . J /V , A d- Compressors HP Address: 1 Envuromnental exhaust and ventilation: City: ( ° U / I State0 ^ I ZIP: q - 2 a Z ? Appliance vent I Phone: Fax: E - mail: Dryer exhaust OWNER Hoods, Type I/ IUres. kitchen/hazmat /� hood fire suppression system Name: ' J (> j .L "— *-i 5 re i iy , C, ,' / / 9 I Exhaust fan with single duct (bath fans) Mailing address: /L /O Li (mot/, 9 '1 Exhaust system apart from heating or AC City: j I Sin. !f State: >' ZIP: Gj Fuel Pi and distribution (up to 4 outlets) LPG NG Oil Phone: 20 -, t- L l' 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 Fax: I E -mail: Woodstove/pelletstove Other: Applicant's signature: \ (2,6g..,...1 I Date: 57/ - 2 /01 Other: Name (print): 00 /2 rL W S a Not all jurisdictions accept credit caIt jurisdiction for mote information. Permit fee $ �a i -SO ❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $ expires if a permit is not obtained Plan review (at % Credit card number: J / ( %) $ Expires within 180 days after it has been State surcharge (8%) of cardholder as shown on credit card accepted as complete. g ( ) "' $ mil, '. 3 o Cardholder signature Amount , 440-4617 (6I00tCOM) MECHANICAL PERMIT FEES K COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total Table 1A Mechanical Code QtY (Ea) Amt $1.00 to $5,000.00 Minimum fee $72.50 1) Furnace to 100,000 BTU $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and including ducts & vents 14.00 $1.52 for each additional $100.00 or 2) Furnace 100,000 BTU+ fraction thereof, to and including $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 or Pump Cond _ fraction thereof. footnotes below. Comp* ** 7) <3HP;absorb unit to 100K BTU 14.00 ASSUMED VALUATIONS PER APPLIANCE: 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 & vents 10) 30 -50 HP; absorb Fumace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20 ducts & 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 to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 13) Air handling unit 10,000 CFM+ permit 17.20 Repair units 805 14) Non - portable evaporate cooler < 3 hp; absorb. unit, 955 10.00 to 100k BTU 15) Vent fan connected to a single duct 3 -15 hp; absorb. unit, 1,700 6.80 101k to 500k BTU 16) Ventilation system not included in 15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00 mil. BTU 17) Hood served by mechanical exhaust 30 -50 hp; absorb. unit, 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 handling unit to 10,000 cfm 656 69.95 Air handling unit >10,000 cfm 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 656 5.40 appliance permit 22) More than 4 -per outlet (each) Hood served by mechanical exhaust 656 1.00 Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $ Commercial or industrial incinerator 4,590 Other unit, including wood stoves, 656 8% State Surcharge $ inserts, etc. Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $ Each additional outlet 63 Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum charge -two hours) $72.50 per hour. 2. Inspections for which no fee is specifically indicated (minimum charge -half hour) $72.50 per hour 3. Additional plan review required by changes, additions or revisions to plans (minimum charge-one-half hour) $72.50 per hour * State Contractor Boiler Certification required for units >200k BTU. ** Residential A/C requires site plan showing placement of unit. i:.dsts\forms\mech- fees.doc 10/11/00 CITY 6F TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested — l �AM PM BLD Location 4/0 ? Suite MEC Contact Person � – l . Ph � g/ _ 3 8 g —00 (7 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: L -, , _ f / �� SIT Slab -��—a_ 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 • ' rains - - : RT FAIL MECHANICAL3 Post Main Rough In Gas Line Smoke Dampers S PART FAIL CTRICAL 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 ? f . 7 , Other Date a Inspector a Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.