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Permit
.... ..4 CITY OF TIGARD MECHANICAL PERMIT I DEVELOPMENT SERVICES PERMIT #: MEC2001 -00323 --` " � - • 13125 SW Hall Blvd., Tigard, O R 97223 ( 6 -4171 DATE ISSUED: 9/13/01 PARCEL: 1 S126DC -04800 SITE ADDRESS: 09495 SW LOCUST ST A SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P BLOCK: LOT: 004 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: 1 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: Installation of A/C system (2 components) Owner: FEES MBM MEDICAL Type By Date Amount Receipt 9495 SW LOCUST PRMT CTR 9/13/01 $72.50 2720010000 TIGARD, OR 97223 5PCT CTR 9/13/01 $5.80 2720010000 Phone: 503-245-2415 Total $78.30 Contractor: THERMOTECH 26716 S. BOLLAND RD. CANBY, OR 97013 REQUIRED INSPECTIONS Cooling Unt Insp Phone: 503 - 263 -8900 Final Inspection Reg #: LIC 118695 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 obtain copies of these rules or direct questions to OUNC by calling rSM»aF_a • f Permittee Signature : Issue By: • / � _ 1... � Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day A Mechanical Permit A 1.1 licati ` r. Date received: / / Permit no.: / _ 3 )... i 1g i City of Tigar Project/appl. no.: Expire date: CitygfTigard Address: 13125 SW Hall Blvd, Tiga s, + • 97223 Date issued: By: j Receiptno.: Phone: (503) 639 -4171 / Fax: (503) 598 -1960 t- I� � ao 0 / -oo 24 5 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF. PERMIT' . s ❑ l & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ' JOB SITE INFORMATION '' •' ' ":LL•,'' '• COMMERCIAL VALUATION SCHEDULE ' ,,.,; Job address: 75 lseu ST Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: Al value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ • Lot: IBlock: I Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: I ZIP: 1 &;2 FAMILY DWELLING' PERMIT FEE SCHEDULE •`'. Descriptiop and location of w k on premises: //477 . J � AND COMMERICAL/INDUSCRIAL EQUIPMENTSCHEDULE oil 797 � f/STii f at cd/-/P0Aig,� h ) Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air handling unit CFM Is existing space heated or conditioned? ❑ Yes ❑ No Air conditioning (site plan required) Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system _ ° MECHANICAL CONTRACTOR State boomprerm t I Stat boiler permit no.: ' Business name: )^ rn d y G (9reA o� HP Tons BTU /H Address: '! G S 2 cl /co H Fire /smoke dampers /duct smoke detectors City: _, , I State:0 V' I ZIP: e/ 11 ),O / j Heat pump (site plan required) =I Phone: - 6 3 9'D0 [Fax: I E-mail: Instalt/replacefurnace / burner BTU /H II - i i CCB no.: g-- . ,. l! - / 5 3- Including ductwork/vent liner ❑ Yes O No Ureplace /relocateheaters suspended, ■ - City /metro lic. no.: wall, or floor mounted Name (please print): ' Vent for appliance other than furnace — CONTACT PERSON Refrigeration: Absorption units BTU /H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER Hoods, Type Ti IUres. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) Mailing address: Exhaust system apart from heating or AC City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets ENGINEER 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: (1 ■ 4 , . , .L I _ Date: Se. 13 0 Other: M — Name (print): Al_. I ?' c i I e i�/ �-y) Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ /A . 5 " CI Visa CI MasterCard Notice: This permit application Minimum fee $ Credit card number: / / ex if a p ermit is not obtained Plan review (at _ %) $ / --- si Expires within 180 days after it has been State surcharge 8% Name of cardholder as shown on credit card accepted as complete. g ( ) $/ J $ TOTAL 4 '7 • 30 Cardholder' signature Amount 440 -4617 (6/00 /COM MECHANICAL PERMIT FEES y • • • • COM FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: BTU B 0, 10 e t na Furc o 100,000 =TOTAL V.ALUATION Minimum fee $72.50 :, , PERM x, ' . : Descrlptlon . ' J Pnc Total $1.00 to $5,000.00 I¢Tabl °Mechanical Code , >" ` Qty , ?(E ) ' =Amt Furnace to $10,000.00 $72.50 for the first $5,000.00 and 1) including to 10 000 Bs 14.00 $1.52 for each additional $100.00 or 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 Checkall that appl i: Boiler '>,Heat - " :SAir $1.20 for each additional $100.00 or • For;items_7.11 see , ' or _ 'Pump, ' Cond fraction thereof. footnotes;Fbelow. ! 'Comp`. '' '~ 7) <3HP;absorb unit Minimum Permit Fee $72.50 SUBTOTAL: $ to 100K BTU 14.00 8) 3 -15 HP; absorb 8% State Surcharge $ unit 100k to 500k BTU 25.60 9) 15 -30 HP; absorb 25% Plan Review Fee (of subtotal) $ unit .5 -1 mil BTU 35.00 Required for ALL commercial permits only 10) 30 -50 HP; absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1 -1.75 mil BTU 52.20 11) >50HP: absorb unit >1.75 mil BTU 87.20 12) Air handling unit to 10,000 CFM ASSUMED VALUATIONS. PER APPLIANCE _.? . -,. 10.00 Value Total 13) Air handling unit 10,000 CFM+ Description: Qty (Ea) Amount 17.20 Furnace to 100,000 BTU, including 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 applicance 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: '`;'r $ >1.75 mil. BTU °; , 79i;' , 44 ` Air handling unitto 10,000 cfm 656 8% State Surcharge " " g ; " $ Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: w' 1`' ;', . :: $ Vent fan connected to a single duct 446 ' , ,, ` '' , Vent system not included in 656 appliance permit Other Inspections and Fees: Hood served by mechanical exhaust 656 1. Inspections outside of normal business hours (minimum charge - two hours) Domestic incinerator 1,170 $72.50 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 $72.50 per hour 3. Additional plan review required by changes, additions or revisions to plans (minimun inserts, etc. charge -one -half hour) $72.50 per hour Gas piping 1 outlets 360 Each additional outlet 63 * State Contractor Boiler Certification required for units >200k BTU. ` *Residential A/C requires site plan showing placement of unit. TOTAL COMMERCIAL ,.- A'`'rt $ is \dsts \forms \mech - fees.doc 08/06/01 ,. Wall-Mounted Air Conditioners _, _.,_......... ...,..._______., ._.., .u, 4) .. :_,......,.._, ____ . �� „ Outdoor Unit � w .aa. t seullw 957/CL1251 Wireless - Remote Controller i ®m qA c 4 09KS51/09KLS51 Indoor Unit KS0951 KS1251 4 Outdoor Unit I" ; 1 C 1852/CL1852 ' °fi : _� •g: [ t�. =r • r Wireless ^ - � , Remote Controller �a 7` g "` s ` '" � " r , 18KS52 �,, Indoor Unit � ` ; KS1852 !� 4 DRY °fi ® ® © 3 ' r ON/OFF Timer WASHABLE FRONT GRILLE Wall Mounted Air Conditioners . . . • . , . ,I) Model No. 09KS51/09KLS51 12KS51/12KLS51 18KS52/18KLS52 Indoor Unit Outdoor Unit Indoor Unit Outdoor Unit Indoor Unit Outdoor Unit Unit Model No. KS0951 C0951/CL0951 KS1251 C1251/CL1251 KS1852 C1852/CL1852 Performance & Electrical Ratings Capacity BTU /H Cooling 9,000 11,800 17,000/16,500 Heating Moisture Removal (High) Pints /H 2,0 3.0 4.5/4.3 Dry Air Flow (Hi /Med /Low) ' 270/240/220 270/240/220 330/290 /260 SEER 10.0 10.2 10,6 HSPF Voltage Rating 115 115 230/208 Cooling 8.8 10.9 7.8/8.4 Running Amps Heating Power Input Cooling 900 1200 1,720/1,670 Heating Back -up Heater KW Maximum Fuse Size Amps 15 20 15 Features Controls Microcomputer Microcomputer Microcomputer Low Ambient Control 09KLS51 Equip 12KLS51 Equip. • 18KLS52 Equip. Fan Speeds 3 + Automatic 3 + Automatic 3 + Automatic Timer On /Off /12 -Hour + 1 hr Off On/Off/12-Hour + 1 hr Off On /Off/12 -Hour + 1 hr Off Air Deflection (Horizontal) Manual Manual Manual (Vertical) Automatic Automatic Automatic Air Filter Washable Washable Washable Operation Sound Indoor 38/34/32 41/38/34 41/38/36 Hi /Med /Lo dB -A Outdoor 48 48 52 Flare Type Flare Type Flare Type Refrigerant Piping • 1/4' Discharge 1/4" Discharge 1/4" Discharge • 3/8" Suction 1/2" Suction 5/8' Suction Refrigerant Piping Length* Max. 50 Ft. Max. 50 Ft. Max. 65 Ft. Elevation Difference Max. 23 Ft Max. 23 Ft. Max. 23 Ft. Dimensions & Weight Indoor Outdoor Indoor Outdoor Indoor Outdoor Height 10 -5/6" 21 -1/4" 10 -5/8" 21 -1/4" 11 -7/32" 24- 19/32" Width 31- 11/16" 31-1/2" 31- 11/16" 31 -1/2" 39 -3/16" 34- 21/32" Depth 6- 31/32" 11- 13/32" 6- 31/32" 11 -13/32 7- 23/32" 12- 19/32" .p" Net Weight Lbs. 17.6 66.1 17.6 75.0 26.5 103.6 --' Approvals CUL, ARI, MEA . CUL, ARI, MEA CUL, ARI, MEA • This is maximum elevation difference when the indoor unit is located above the outdoor unit (Refer to the table on the back of the catalogue for more detail.) �l M i croprocessor 3 F n soeeda Art Swe Fla Autmriav -1,'4!. Nigh[ SerDaek M L1I � Pat, �L7 � 1 11�� 6�a^o "` DRY DCont Conol Ring s pooling f Cpohngak Ei li g gta i . 4th Nt, RI MA 1 r 1 b0[FTTme : ... Filteimeld �wrt�omaticaestan perauon p�gy c .. � rim hn Jystem • program TTTTTTme ON /OFF imer ,m ©Failureon far rower . III CITY OF TIGARD BUILDING INSPECTION DIVISION MST ; 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested j U — q AM PM BLD Location Lig $ Suite MEC 000/ 63 23 Contact Person Ph FErF c 2.,3 PLM Contractor Ph SWR BU =: F Tenant/Owner , iZ/ / jam, C�vv J ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: c���1J zti, Slab �. SIT Post & Beam r J Ext Sheath /Shear d,�.e/1J C.. 'L) I'm Sheath/Shear Framing Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling � � r (te') r2( /t)t Roof • Misc: Final PASS PART FAIL q pPLU,MBING �, ll Post & Beam Under Slab �-�-- Top Out Water Service Sanitary Sewer Rain Drains Final / PASS PAID, FAIL L Post & Beam Rough In Gas Line Smoke Dampers • 44 ina) PART FAIL Service Rough In - UG /Slab Low Voltage . Fire Alarm Final PASS PART FAIL • SITE' e. 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 ('//C Date / Inspector O t4A Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.