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Permit i/ CITY TIGARD MECHANICAL PERMIT i DEVELOPMENT SERVICES PERMIT #: MEC2003 -00337 �:IIi 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/19/03 PARCEL: 2S 109AB -09300 SITE ADDRESS: 14226 SW 132ND TERR SUBDIVISION: RAVEN RIDGE ZONING: R -7 BLOCK: LOT: 022 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 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: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Extend ducts and grilles to finish basement. Owner: FEES MARC MOORE Description Date Amount 14226 SW 132ND TERR TIGARD, OR 97224 [MECH] Permit Fee 6/19/03 $72.50 [TAX] 8% StateTax 6/19/03 $5.80 Phone: Total $78.30 Contractor: RITE -WAY HEATING + A/C INC PO BOX 1815 HILLSBORO, OR 97123 REQUIRED INSPECTIONS Phone: 503 Duct Inspection Final Inspection Reg #: LIC 00071242 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 -00 I Issue By: � ,!zaiLL. A _ 1 ' Permittee Signature: • Call (503) •39 -4175 by 7:00 P.M. for inspections needed the next business day • Mechanical Permit Application / OFFICE USE ONLY Received // Mechanical , / Y Date/By: / 9 03 Permit No.: // f e a 0 0 3 - . 0 0 3 5 7 Cit o f Ti and Planning Approval Building Y g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By; • Permit No.: Phone: 503- 639 -4171 Fax: 503-598-1960 Land Use Internet: www.ci.ti ard.or.us g _ �� d'l +la Co Case No.: Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information. �:�, :,� �..�,,��� . acv � -�- �,; :��•,� , a - gralk.�. tai TAI'PE°tOF WORK . LVP- - !:' -,_ ° - ._ ,: fix' $, COMIYIEg7C4 EEE* SCHEOUa5110SE,CHECiOIST ?. ❑ w construction ❑ Demolition Mechanical permit fees* are based on the total value of the work Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all tf : CATEGORYuOF CONSTRUUCTION 4 »«•- mechanical materials, equipment, labor, overhead and profit. 1 & 2- Family dwelling ❑ Commercial /Industrial Value: $ See Page 2 for Fee Schedule ❑ Accessory Building El Multi- Family °" SIDENT1AIsEQUIMFNT /SYSTEMS FEE SCHEDULE El Master Builder ❑ Other: oh 1 Description Qty Fee(ea.) Total JOBANITK conditioning** .. , *! s; _ .. L ® _ INF,ORMA�TION and4I�OC�A�'ION°��_ .`�,' "�,� Furnace - add air 14.00 Job site address: /40.26 54) ( 4 7err- Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 Project Name: HOOr'e RPSiG(e/1ll�i Hydronic hot water system 14.00 Residential Cross street/Directions to job site: (for radiator boiler (for 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 Tax map /parcel #: F::-.4.,, : :: _" -, , t 0ihei-4Euei ":Appli -',.e _;. -,, : . . Water heater 10.00 , i °' iNDES.CRIPTION"OF W.ORIZ4 ;; ° .. ,,,, , I :I Gas fireplace 10.00 P fl ki J / y Flue vent (water heater /gas fireplace) 10.00 Log lighter (gas) 10.00 1 � Wood/Pellet stove 10.00 t X Te.o - c e-TS y P Z S Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 PRQ .Y.VAM n;„ ,,, { TENANT ' - `M Other: 10.00 V` `` W �` iEnvironmental EihiuitiBci =Ve iilati iiiiiV a Name: ' ` ' `.,-� _ Address: Range hood/other kitchen equipment 10.00 City /State /Zip: Clothes dryer exhaust 10.00 Single duct exhaust Ph e Fax (bathrooms, toilet compartments, A PRLtewty- i 'Mtie • tCQN,VACTTPERSON M utility rooms) 6.80 Name: i cie a c, foe_ ( art`s e Attic/crawl space fans 10.00 Address: &Igo SL() ett S 1n _ dl . Other: 10.00 City /State /Zip: 7?- and 0� 9 7ZZ3 * *($5.40 for 4, $1.00 each additional) Phone: ‘--E/3) 3o 7 —7 /t 1 Fax: 3) .s'7 x'777 Furnace, etc. ** Gas heat pump ** E -mail: Wall/suspended/unit heater ** Asa ; VS;Mn 'ECONTRACT®RZ. w. ..., ,,, _ .- ' ,,: 1 Water heater ** Business Name: R; - gefet'1" ` Fireplace ** Address: e®, o , !$ ** - Range BBQ ** City /State /Zip: yt/( hero / og 97123 Clothes dryer (gas) ** Phone: 503)13 _ 3 / 6 / Fax: ,t-o3) 693 - 6238 Other: ** CCB Lic. #: 7/. Z d-I 9.'6 (p ti Total: uthor. ' ;' • _ ". .Meehan elif Fees* -. -- ''' . ignature: I. �� , Date (7 ( Subtotal: $ �� w Minimum Permit Fee $72.50 $ 79, . 5 U r S .LC• Plan Review Fee (25% of Permit Fee) $ (Please print name) State Surcharge (8% of Permit Fee) $ -. qU TOTAL PERMIT FEE $ - g . 50 Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. is \Dsts\Permit Forms\MecPermitApp.doc 01/03 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: - $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 $100.00 or fraction thereof. , As:§pinpcf:Valugtmn$TOAPPli40e;M;: Value Total Description: Qty (Ea) Amount Fumace to 100,000 BTU, including 955 ducts & vents Fumace > 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 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 DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested t i?'" 01 AM PM BUP Location I 22, 3;--)14S — 77 - Ai Suite `3 66 337 Contact Person Ph ( ) 3 6- 7/(7 A ar 3 - 00 d--7 Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 00 370 Footing ELC Foundation Access: �- / Ftg Drain Crawl Drain / e' 3 — Q C / ` l `"� �l > �-'t 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 RT FAIL UMBIN Post & Beam _ Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan O ther:: 'ART FAIL NI L -- -m Rough-In Gas Line Smoke Dampers Ina (0 PART FAIL RI Q Service Rough -In UG /Slab `Cow Volte f' Fire iL. PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. S ❑ Please call for reinspection RE: Unable to inspect - no access Fire Supply Line. ADA 9/2 7/0 3 Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL