Permit CI TY OF TIGARD MECHANICAL PERMIT
, elA DEVELOPMENT SERVICES PERMIT #: MEC2002 -00183
Ail DATE 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/15/02
, 1SI3
PARCEL: 1 S136DB -02400
SITE ADDRESS: 11640 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 2
OCCUPANCY GRP: A3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS: 1
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 200,000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm: 0 GAS OUTLETS: 4
Remarks: type 1 grease hood, gas line,make -up air and bath fans.FIRE SUPPRESSION SYSTEM REQUIRED FOR
HOOD
Owner: FEES
CHAMPION, RONALD V AND Type By Date Amount Receipt
ROBERTA E PRMT CTR 5/15/02 $72.50 2720020000
11642 SW PACIFIC HIGHWAY PLCK CTR 5/15/02 $18.12 2720020000
TIGARD, OR 97223 5PCT CTR 5/15/02 $5.80 2720020000
Phone: Total $96.42
Contractor:
AASIA COOLING + HEATING
LIEM TRAN
415 NE 58TH AVE REQUIRED INSPECTIONS
PORTLAND, OR 97213 Final Inspection
Phone: 790 -6324 Gas Line Insp
Reg #: LIC 80640 Mechanical lnsp
Hood Inspection
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
Utilitay otificatio C enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR
9 2- 001 -0080. You\may G •t - '- opies of these rules or direct questions to OUNC by calling
nf1194.F_•1
Issue By: r . . _ # , ` Permittee Signature:
- - all (50 639 -4175 by 7:00 P.M. for inspections needed the next business day
5
Mechanical'Permit Application
Date received: ,� 4, . Permit no. t /� at_a' CA
' City of Tigard - � � eev Project/appl. no.: 're date:
Address: 13125 SW Hall BlviL, _,t-t,
City
ry o f Tigard Phone: (503) 639 4171 � .� Date issued: B I Receipt no.:
Fax: (503) 598 -1960 -- � P o ' N V
. O / D "Y ' t� Case file no.: Payment type:
Land use approval: v " � v i 'MO 9Building permit no.:
� .I T
r
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE ^
Job address: // 6K- 0 S VV f C,( ft' r_ /f K/i(J Indicate equipment quantities in boxes below. Indicate the dollar `k
Bldg. no.: S uite no.: value of all mechanical materi, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $. / 0/00 O ..—
Lot: (Block: ISubdivision: *See checklist for important application information and
Project name: . jurisdiction's fee schedule for residential permit fee. \
City /county: I ZIP: I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
_ N
Descri do and location of work n ises: (A.12416 .vt J AND COMMERICALIINDUSTRIAL EQUIPMENTSCHEDULE
61 , .ANCIA) ∎ hi? XI rJ,a -wt " Fee(ea.) Total Z
_Est. date o ompletion/inspection: ' • Description Qty. Res. only Res. only
Tenant improvement or change of use: SAC:'
Is existing space heated or conditioned? 0 Yes 0 No Arc handling unit CFM
Air botiditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
'MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: 4,- / IA- Cot') (4 if g - _ y7 HP Tons BTU /H
Address: t,t / C (j£ c - c Fire/smoke dampers/duct smoke detectors
-
rns City: 'Per i j p I State: pL I ZIP: Q .7 i )3 Heat pump (site plan required)
Phont r6/ 2 7„ ' 06 1ax: (045s) I E -mail: Install/replace furnace/burner BTU /H
Including ductwork /vent liner 0 Yes 0 No •
i CCB no.: 0 (, ti 0 Install/replace/relocate heaters - suspended,
City /metro lic. no.: I _ wall, or floor mounted
Name (please print): / j rr Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: Chillers HP
Comyressors HP
Address: Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type 1/II/res. 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 dlstrib ion (up to 4 outlets)
- Type: LPG )L /
.NG Oil -
Phone: Fax: E -mail: Fuel piping each additional river 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 F E mail: Woodstove/pelletstove
Other: •
`f Applicant's signature:
/ I Date: Name (print): Not all jurisdictions accept credit cards, please call jurisdiction for more information. PCcInit fee $
❑ Visa ❑MasterCard N ot i ce: T h i s permit application Minimum fee $
expires if a permit is not obtained Plan review (at %) card number: / ( ) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete: .
$ TOTAL $
Cardholder signature Amount 440 -4617 (6/00 /COM)
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 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 or Pump Cond
fraction thereof. footnotes below. Comp
Minimum Permit Fee $72.50 SUBTOTAL: 1 $ 7) <3HP; absorb unit
_724 SD to 100K BTU 14.00 :
8% Statf^ Surcharge $ 8) 3-15 HP; absorb 25.60
S Xt) unit 100k to 500k BTU
25% Plan Review F'et... .3f ;,,ibtotal) 9) 15-30 HP; absorb
Required for ALL commercial permits only $/ /2 unit .5 -1 mil BTU 35.00
8
TOTAL COMMERCIAL PERMIT FEE: $ Q � 10) 30 -50 HP; absorb 52.20
fP, /1Z unit 1 -1.75 mil BTU
�P 11) >50HP; absorb
unit >1.75 mil BTU 87.20
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 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
101 k 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
>1.75 mil. BTU Minimum Permit Fee $72.50 SUBTOTAL: $
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:
Y exaus 1 170 1. Inspections outside of normal business hours (minimum charge - two hours)
Domestic incinerator $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, inclu irlg�wood stoves, / 656 $62.50 per hour
inserts, etc. �f 3. Additional plan review required by changes, additions or revisions to plans (minimum
) Gas piping 1 - 4 outlets j 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: 0? 3z p
All New Commercial Buildings require 2 sets of plans.
is \dsts \forms\mech- fees.doc 02/11/02
5/16/02 Activities for Cas - #: MEC2002 -00183 ,
8:11:47 AM tt
s'
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
y
MECC007 Application received 5/6/02 DEB DONE No Hold BLD 5/6/02 •
MECC008 Permit created 5/6/02 DEB DONE No Hold BLD 5/6/02
MECC011 Routed to Plans Examiner 5/6/02 DEB DONE No Hold BLD 5/6/02 •
MECC014 Plan checked /Approved by P.E. 5/8/02 5/8/02 5/8/02 DWJ DONE No Hold DWJ 5/8/02
MECC015 Reviewed Plans Routed to PT 5/8/02 DWJ No Hold DWJ 5/8/02
MECC705 Gas Line lnsp No Hold DWJ 5/8/02
MECC706 Mechanical Insp No Hold DWJ 5/8/02 ti
MECC732 Hood Inspection No Hold DWJ 5/8/02
MECA799 Final Inspection No Hold DWJ 5/8/02
MECC016 Post - review completed 5/14/02 DEB DONE No Hold DEB 5/14/02
MECCO50 (F) Ready to issue 5/14/02 DEB DONE No Hold DEB 5/14/02
MECC090 (F) Issue permit 5/15/02 DEB DONE No Hold BLD 5/15/02
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Page 1 of 1
CITY OF TIGARD 24 -Hour 7 l'.. oc
ITUIL[ tNG Inspection Line: (503) 639 -4175 r
INSPECTION DIVISION Business Line: (503) 639 -4171 , _ •
BUP
Received Date Requested , -.5 1 1 J AM PM 'k BUP
Location / / „ q U sw / < < ( 44-7 7 Suite •EC)2 GU Z - G U 43
Contact Person Ph ( ) PLM
Contractor Ph ( SWR
&e.ir BUIL DING Tenant/Owner - ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: < - SIT
Post & Beam
Shear Anchors `7
/ 5�' A T y S I
Ext Sheath/Shear
IntSheath/Shear e , 2 , k 1 ._
Framing
Insulation
Drywall Nailing 'as/
Firewall �j�, StiL- 0
Fire Sprinkler
Fire Alarm d - cL-/ (� `
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART AI
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line -- � / CA ADA L )/ a T/ �J� ' 31
Approach/Sidewalk Date ! - Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
{
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 — -
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
•
BUP
Received Date Requested .. '( AM BUP
Location 1 ( ( P � /0C U - r Suite MEC — / ?3
Contact Person Ph ( ) l 34 - Z 2. �� PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam •
Shear Anchors
Ext Sheath/Shear r.
Int Sheath/Shear /" 12 Al
Framing /�; y !�
Insulation (�
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
71s, 1-1iIsICA
e am
mo e Dampers
Fin-
PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
'Fire Alarm
Final El Reinspection fee of $ required bete pection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA � L o
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this ins : cti . record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
-BUILDING Inspection Line: (503) 639 - 4175 "'' --
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received Date Reiluested 6- // AM / -S PM BUP
Location I I 6 L/D P0-ec - r-c, Suite MEC o ? — D z) / g
Contact Person Ph ( ) 6 3 9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR •
Crawl Drain
Slab Inspection Notes: / S IT
Post & Beam �L ' o
Shear Anchors 1 /p
Ext Sheath/Shear ■-.)/d'i
Int Sheath/Shear
Framing ( ' `
Insulation d v
Drywall Nailing ,
Firewall C 1.--- , ),./
Fire Sprinkler
Fire Alarm CCl (-C-".4 S w ( ) -- a. (1.------ Susp'd Ceiling J
Roof
Other:
Final - C� f — a k----
PASS PART FAIL
PLUMBING
Post & Beam 3 . _ CD L I—
Under Slab
Rough -In
Water Service
Sanitary Sewer ti\ S c/fLr ArN,Z....
Rain Drains S S ��1 �/�
Catch Basin / Manhole 3 11 . _-4 • - 2-- 0 • 1
Storm Drain -
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm •
Final 1=1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA �// `� /Zj \� Z
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
— <I