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Permit ~ /. CITY TIGARD MECHANICAL PERMIT lit It DEVELOPMENT SERVICES PERMIT #: MEC2003 -00260 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/20/03 PARCEL: 2S 101 AB -01608 SITE ADDRESS: 07455 SW BEVELAND RD SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT: 019 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: ELE 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: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: Remarks: Install exterior AC. Cannot be placed in the required set backs. . Owner: FEES KOBERLEIN, PATRICIA LYNN Description Date Amount 7455 SW BEVELAND RD TIGARD, OR 97223 [MECH] Permit Fee 5/20/03 $72.50 [TAX] 8% StateTax 5/20/03 $5.80 Phone: Total $78.30 Contractor: B + S HEATING 67396 CRANE/BUCHANAN RD BURNS, OR 97720 REQUIRED INSPECTIONS Phone: 503 Cooling Unt Insp Final Inspection Reg #: . LIC 45838 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 elm Issued By: �� Permittee Signature: r Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Received FOR OFFICE USE Date/By: 3 - 19 - 511 ) Permit No.:ll ee -000 -OOr) („O Planning Approval Building City of Tigard 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 Post - Review Land Use n?h�� I Date /By: Case No.: Internet: www.ci.tigard.or.us �", A I Contact Juris.: El See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 tie . W Name /Method: Supplemental Information. ., < :_ WS:. EW5-t WOIt ZIAM,` =7y ° =; ,; ,. ' COMMERCIAL FEE ISCHEIK /MAISEICHECKLIST �, $ , ❑ New construction �� ❑ Demolition Mechanical permit fees* are based on the total value of the work K Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all *. ."1: W ATEGORY$ : OE_CONSTRUCTIONS1 � ' mechanical materials, equipmentbor, overhead and profit. , �x �_.� �_,",_ C �` : � /� Cam% ❑ 1 & 2- Family dwelling Commercial /Industrial Value: $_ (O ©0 — See Page 2 for Fee Schedule ❑ Accessory Building ❑ Multi- Family t ,RESIDENTIAT EOUIRMENT/$YSTEMSFEE* SCHEDLItE': ; Description I Qty Fee(ea.) Total ❑ Master Builder ❑ Other: Jxeatiug/Co`ofing ' - - " _ ' fix,, ; -. ,i4 JOB; SI°TEIINFORMATION an_dLOCATION 74' ` x Furnace - add -on air conditioning ** / 14.00 Job site address: 7L1.S'S -3,w • IS Q lie lcoA,d, Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 Project Name: Hydronic hot water system 14.00 Residential boiler Cross s freet/Directions to job site: (for radiator or hydronic system) 14.00 -7.41--. - Stpl..� l �� Unit heaters (fuel, not electric) V C� (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) 10.00 Repair units 12.15 Subdivision: Lot #: L • Qtfier,Fael�QipPliance's__ � " .: x ,.:' ,, Tax map /parcel #: Water heater 10.00 n N DESCRIP ION: irkWORK , , , Q . u , ;; Gas fireplace 10.00 �;} 'v v ,/ !J V r f (•' i.�� c o r / v d e c4tt $ /I Flue vent (water heater /gas fireplace) 10.00 i `E Log lighter (gas) 10.00 Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 iim iPRQPERTYOWNE ,; F ® .'TENANT _.,_ Other : . !,; . ri Cr _, Enyirogineiiii & v6itilaiiiiii "`,_ .': y�` Name: t2 � �'� t+�Q �` Cet Range hood/other kitchen equipment 10.00 Address: 7 Li S .S �• Q P , lm L Clothes dryer exhaust 10.00 City /State /Zip: Td'1,-cv L 7 223 Single duct exhaust Phone: Fax: (bathrooms, toilet compartments, SAP:.P � -- ... ON:TrACrT PERS®N , utility rooms) Name: _EN, /'0 „‘",11--,)Vie_c Attic /crawl space fans 10.00 Other: 10.00 Address: (. 0 , ac„„, /6 23 —7 , -. - :, , �- ,:; � . : ; ~ ° 'i . ..,,. `;4.t-� .. City /State /Zip: off? � 0(/\ C f t 421( `' 7© ( f . * *($5.40 for first 4, $1.00 each additional) Phone: g'© -05s5- Fax: 72 - y Y t/-3 Furnace, etc. ** ' Gas heat pump ** E -mail: Wall /suspended/unit heater ** 03Prii-igg4_,:PACW.VOONTra Water heater ** Business Name: p . - c �`t - Fireplace ** Address: Pt 7 0 o /6-2,3 Range ** Cit City/State/Zip: Ok & _-C " � BBQ ** y l� �S tom!/` �`� T r'' Clothes dryer (gas) . Phone: 2 SO - Sf - Fax: Other: ** CCB Lie. #: r� s&-s.3 j Total: Authorized r LJ Subtotal: $ MeehaiiicibPer iit Fees' / Signature: ���� ��;�� date: . 2 '2 t1 C /� / / Minimum Permit Fee $72.50 $ 7a . � U K- Plan Review Fee (25% of Permit Fee) $ (Please print name) State Surcharge (8% of Permit Fee) $ 6,& TOTAL PERMIT FEE $ i g . 3D 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. i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 ..-• • Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: , . . Total ValiiAtliiii:" -.:_ --,..' .: :Irl'ergiit:E0e.: $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. • -ii6 , ..... „ -. , . . . . . 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 . ' , .i 3-15 hp; absorb. unit, 1,700 . - : ' ,. " . . i , • , 1 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 , • . i 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 l r..=;: $ ... , . . VALUATION: '-:,: ::*,'...,,'' ,-'„..,„L;;-,e, •N x . . . . . . . . . . . . . - , : -• . • . .1 . . . . .- • • , . . I 'I i: \Dsts \Permit Fonns\MecPermitAppPg2.doc 01/03 PP " IIIIIIIII"P- Ir. _ _ _ _ _IS_ 0 A,__ _ _ ___ _ _ _ _ __ _ _ _ __ - - -- - - -- _ _-_ 1-5_ __ i_ v _ o _ - 1 - - -- A - &- - JI - -- r - — - g - -- ' - - — G / _ _ _ _ _ ________,- _ ? 0 . _ _ _ _ f_ _ - 1 14 & t