Permit C ity OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2006 - 00554
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2006
PARCEL: 1S135DD-03301
SITE ADDRESS: 11945 SW PACIFIC HWY 206 ZONING: C -G
SUBDIVISION: TIGARD PLAZA LOT: 002 JURISDICTION: TIG
Project Description: Gas furnace change out. Valuation $2850.
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: DOMES. INCIN:
NAT 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
TIGARD PROPERTIES INC Description Date Amount
2106 SE OCHOCO ST
MILWAUKIE, OR 97222 [MECH] Permit Fee 11191200E $93.20
[TAX] 8% State Surcha 11/9/200E $7.46
Total $100.66
Phone:
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Permittee Signature` j7 ;
Issued By: I �i�_. ` _ _
Call 503.639.4175 by 7:00 a.m. for inspections that bus ss day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
RECE!V/ED
Mechanical Permit Application NOV 9 21 FOR OFFICE USE ONLY
City of Tigard cy� Q : . L `` I Permit No. � � ..
13125 SW Hall Blvd., Tigard, OR 97223 r 7 o 1 e 4 : `DJN i r4 V1. ow Review ' -
tr,
Phone: 503.639.4171 Fax: 503.598.1960 I (rte U ,,�, :a;F ,..� I r D ate /B y: Other Permit:
Inspection Line: 503.639.4175 t ' _ _
p /n "II Date Ready/Ely: 1 ® : See Page 2 for
Internet: www.ci.tigard.or.us .
mil Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
' " ' CATEGORY OF CONSTRUCTION. - • Value: $ S 50 • —
. RESIDENTIAL EQUIPMENT /.SYSTEMS FEES *.
❑ 1- and 2- family dwelling 0:Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
. . JOB SITE INFORMATION AND LOCATION Heating/cooling
,, \\ i r Air conditioning or heat pump
Job site address: / I 94' 5W p, 1A / C �V' (requires site plan showing placement) 14.00
City/State /ZIP: 7 i )j ( VJ "// "^^ Furnace 100,000 BTU ( ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 27 -4 Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
jot& /}� 1 �(� / t fi lace 10.00
�� ' `- " / ��° `"' 'v g lighter (gas) 10.00
0 Wood/ ellet stove 0.
p 1 0
Wood fireplace/insert 10.00
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Chimney/liner /flue/vent 10.00
PROPERTY OWNER I ❑TENANT Other. 10.00
Name: M// f7 Environmental exhaust and ventilation
Address: R320 20 I26- t [ � t C Range hood/other kitchen
� (� equipment 10.00
Va
City/State /ZIP: mri - u V�Pi 9T/01105 Clothes dryer exhaust 10.00
00 � hi - ( 2 F ax: ( ) comp
Single-duct exhaust (bathrooms,
Phone: � toilet compartments, utility moms) 6.80
• `'APPLICANT CI CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
".; t :.
CONTRACTOR Barbecue
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1 J/ j7 /-6. Clothes dryer (gas)
Business name: U [/i 0, t
Other:
}ham
Address: pp / 2 _�� I: I ' :, MECH_ANiCAL PE FEES *
City/State /ZIP: e / 9 70/3 Subtotal 9 Lt
Phone: (5}3) 2-6710 - 2.L(' Fax: (5 5) 26h' - 3447/ Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: / L f 1)Der State surcharge (8% of permit fee) 7. �6
TOTAL PERMIT FEE /A .. 6 C1
Authorized signature: ( This permit application expires If a permit Is not obtained within 180
/ days after It has been accepted as complete.
Print name: / i ' C � /TOL I Date: / / WO t • Fee methodology set by Tri -County Building Industry Service Board
` J
m ac2oo6 - 6o3
Form 2a Project Name: //k, aza • � [ /2 &3 Z - Page: /
SUMMARY
Project 1. Project Name • 7 1 (L!W //a. Z 2 - /
2. Project Address / f 1- 1 St'� DG Z G L 40 y
3. City/Town T 5. County �,(
4. Building, Gross Area (ft2) - ^ L —/ U 6. No. of Floors
7. Construction Site Elevation Above 2,000 ft? ❑ YES ❑ NO
Attached Chapter Type ID Description Attach
Forms and Building Envelope Form 3a Building Envelope - General ❑
Worksheets 3b Prescriptive Path - All Climate Zones ❑
* CodeComp Report for Simplified Trade -off ❑
* In lieu of 3b a Floppy disc with .occ CodeComp file ❑
Check boxes to Worksheet 3a Wall U- factor ❑
indicate attached 3b Roof U- factor ❑
forms and 3c Floor U- factor ❑
worksheets 3d Window /Skylight Schedule ❑
Systems Form 4a Systems - General
4b Complex Systems ❑
. Worksheet 4a Unitary Air Conditioners - Air Cooled ❑
4b Unitary Air Cond. - Water & Evap Cooled ❑
4c Unitary Heat Pump - Air Cooled ❑
4d Unitary Heat Pump - Water Cooled ❑
4e Packaged Terminal A.C. - Air Cooled ❑
4f Packaged Terminal Heat Pump - Air Cooled ❑
4g Water Chilling Pkgs - Water & Air Cooled ❑
4h Heat Rejection Equipment ❑
4i Boiler - Gas -Fired and Oil -Fired ❑
4j Furnace & Unit Heaters - Gas and Oil -Fired
4k Simultaneous Heating and Cooling ❑
41 Air Transport Energy ❑
4m Natural Ventilation ❑
Lighting Form 5a Lighting - General ❑
• 5b Interior Lighting Power - Tenant Method ❑
5c Int. Ltng. Power - Space -by -Space Method ❑
Worksheet 5a Lighting Schedule ❑
• 5b Interior Lighting Power ❑
Applicant 7. Name /PY — vl 10. Telephone 2(. )Z ` I
8. Company P I 11. Date (('PIO&
9. Signature 9 . 174 (1. 4vGVIe.yc_.
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Attached No. of Pages Description of Documentation
Document- Sh PS
ation 4' S
te _"?.)
GP ,
i wG • f ° ()
uompiiance wnn va errecnve uiiu iruo
Form 4a Project Name: Page: 2
SYSTEMS - GENERAL • Part 1 of 6
Applicability Plans /Specs •
Discussion of qualifying Show compliance by including a drawing sheet, detail number,
exceptions on page 4 -25 specification section and subparagraph.
1. Applicablity (Section 1317)
• Is this form required?
Form Required. Complete form if a new HVAC system is being installed, or components of an
existing HVAC system are being replaced (I.e., equipment, controls, ductwork, and insulation.)
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❑ Exception. The building or part of the building qualifies for an exception from HVAC code
requirements. Applicable code exception is Section 1317.1. Portions of the building that
qualify:
Area: Exception Li -1 El -2 Li -3
Area: Exception ❑ -1 ❑ -2 ❑ -3
Area: Exception Li -1 ID -2 ❑ -3
❑ Form Not Required. This project does not contain work required to comply with code.
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2. Simple or Complex Systems (Section 1317.9 or 1317.10)
la:Simple System. Building contains only Simple HVAC System(s). Complete this form (4a) and
equipment efficiency worksheets as required. Form 4b is not required.
❑ Complex System. Project includes a Complex System. Complete this form (4a), form 4b and
equipment efficiency worksheets as required.
3. Equipment Performance (Section 1317.5)
❑ No New HVAC Equipment. The building plans do not call for new electrical HVAC equipment,
combustion heating equipment, or heat - operated cooling equipment.
• Complies. All new HVAC equipment have efficiencies not less than those required by code.
The following equipment efficiency worksheets are attached:
❑ -4a ❑ -4b ❑ -4c ❑ -4d ❑ -4e ❑ -4f ❑ -4g ❑ -4h ❑ -4i A -4j
4. Duct Insulation and Sealing (Sections 1317.7 & 1317.8)
Ca No Ducts. The building plans and specifications do not call for new HVAC ducts or plenums.
co Complies. The plans and specifications call for all air-handling ducts and plenums to be insulated
and sealed as required by Sections 1317.7 &1317.8.
5. Distribution Transformers (Section 1316.1)
B No Distribution Transformers. The plans /specs do not call for new distribution transformers.
❑ Complies. All new distribution transformers comply with efficiency, testing, and labeling
requirements of Section 1316.1.1.
❑ Exception. The project qualifies for an exception per Section 1316.1.1, Exceptiion:
❑ -1 ❑ -2 ❑ -3 0-4 ❑ -5 ❑-6 ❑ -7 ❑ -8 ❑ -9 ❑ -10 ❑ -11 ❑ -12 ❑ -13 ❑ -14
Attach relevant documentation for appropriate exception. The plans /specs show compliance in the
following locations:
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4 -1 April 2005
Compliance with OSSC, effective 01/01/05
Form 4a Project Name: Page: 3
SYSTEMS - GENERAL Part 2 of 6
6. HVAC Controls (Section 1317.4)
6.1 System Thermostat /Zone Controls (Section 1317.4.1)
al Complies. All new HVAC systems include at least one temperature control device responding to
temperatures within the zones.
❑ Exception. HVAC system qualifies for an exception from zone control requirements.
The applicable code exception is Section 1317.4.2, Exception ❑ -1 ❑ -2
Portions of the building that qualify:
The plans /specs show compliance in the following locations:
6.2 Off - hour Controls - Auto Setback or Shutdown (Section 1317.4.3)
a Complies. Systems must have at least one of the following features:
51 Control Setback Complies. Each system is equipped with automatic control capable of
reducing energy through control setback during periods of non -use or alternate use of spaces
Equipment Shutdown Complies. Each system is equipped with controls capable of reducing
energy use through automatic shutdown during periods of non -use or alternate use of spaces.
❑ HVAC systems with equipment shutdown are equipped with at least one of the following:
Programmable controls (1317.4.3.1 (1))
❑ Occupant sensor (1317.4.3.1 (2))
❑ Interlocked to a security system (1317.4.3.1 (3))
❑ Manually activated timers with 2 -hour operation max (1317.4.3.1 (4))
❑ Exception. The building qualifies for an exception to the requirement for automatic setback or
shutdown controls. The applicable code exception is Section 1317.4.3 Exception ❑ -1 ❑ -2
The plans /specs show compliance in the following locations:
6.3 Control Capabilities (Sec. 1317.4.2.1)
Complies. Zone thermostats are capable of being set to the temperatures described in Sec.
1317.4.2.1. Where used to control both heating and cooling, zone controls shall be capable of
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providing a temperature range or deadband of at least 5 degrees F within which the supply of
heating and cooling energy to the zone is shut off or reduced to a minimum.
❑ Exception. The building qualifies for an exception to the deadband requirements.
The applicable code exception is Section 1317.4.2.1 Exception ❑ -1 ❑ -2
Portions of the building that qualify:
The plans /specs show compliance in the following locations:
6.4 Optimum Start Controls (Section 1317.4.3.2)
at Complies. Separate HVAC systems have controls capable of varying start-up time of system to
just meet temperature set point at time of occupancy.
❑ Exception. HVAC systems have a design supply air capacity not exceeding 10,000 cfm.
The plans /specs show compliance in the following locations:
6.5 Heat Pump Controls (Section 1317.4.4)
IN No Heat Pump. The plans /specs do not call for a new heat pump
❑ Complies. All new heat pumps equipped with supplementary heaters are controlled to minimize
the use of supplemental heat as defined in Section 1317.4.4.
The plans /specs show compliance in the following locations:
. 5
4 -2 April 2005
Compliance with OSSC, effective 01 /01 /05
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Form 4a Project Name: Page: 1 7 1
SYSTEMS - GENERAL Part 3 of 6
7. Economizer Cooling (Section 1317.3)
f No Cooling. The building plans do not call for a new fan system with mechanical cooling.
❑ Complies. Each new fan system has an air economizer capable of modulating outside -air and
return -air dampers to provide up to 100 percent of the design supply air as outside air.
❑ Exception At least one new fan system qualifies for an exception. The applicable code exception
is Section 1317.3, Exception ❑ -1 ❑ -2 ❑ -3 ❑ -4 ❑ -5 ❑ -6
If Exception 3 is selected complete the following:
(a) Total cooling capacity of exempt units (Btu /hr)
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(b) Total installed building cooling capacity (Btu /hr)
❑ Complies. Sum of exempt units rated at less than 54,000 Btu /hr is <240,000 or a/b
< 0.10 (10% of total building cooling capacity).
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Unit Identifier of exempt units:
The plans /specs show compliance in the following locations:
8. Economizer Pressure Relief & Integration (Section 1317.3.1 and 1317.3.2)
® No Economizers Required. Project does not contain a new fan system requiring economizers.
❑ Overpressurization Complies. The drawings specifically identify a pressure relief mechanism for
each fan system that will relieve the extra air introduced by the economizer.
❑ Integration Complies. Economizer is capable of providing partial cooling even when additional
mechanical cooling is required to meet the remainder of the cooling load.
❑ Exception. The applicable exception is Section 1317.3.2, Exception ❑ -1 ❑ -2
The plans /specs show compliance in the following locations:
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9. Hot Gas Bypass (Section 1317.5)
IA No Hot Gas Bypass
❑ Complies. See allowable amount of hot gas bypass as a percentage of total cooling capacity in
table below.
Unit ID Rated Cooling Capacity Hot Gas Bypass Capacity
Allowable Hot Gas Bypass
rd Rated Cooling Capacity Max Hot Gas Bypass
<240,000 Btu /hr 50%
>240,000 Btu /hr 25%
❑ Exception. Unitary packaged system with cooling capacity no greater than 90,000 Btu /h
4 -3 April 2005
Compliance with OSSC. effective 01/01/05
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Form 4a Project Name: Page: 5
SYSTEMS - GENERAL Part 4 of 6
10. Shutoff Dampers (1317.4.3.3)
al Not Required. Shutoff dampers are not required on this project.
❑ Complies. Each outdoor air supply & exhaust system shall be equipped with motorized dampers
❑ Exception. The building qualifies for an exception to the motorized damper requirement. The
applic -able code exception is Section 1317.4.3.3 Exception ❑ -1 ❑ -2 ❑ -3 ❑ -4 ❑ -5
The plans /specs show compliance in the following locations:
10.1. Shutoff Damper Controls (Section 1317.4.3.3.1)
ad Complies. Outdoor air supply and exhaust systems shall be provided dampers that automatically
shut when systems or spaces served are not in use or during building warm -up, cooldown, or
setback.
❑ Complies. Stair and shaft vents are capable of being automatically closed during normal building
operation and interlocked to open as required by fire and smoke detection systems.
The plans /specs show compliance in the following locations:
10.2. Motorized Damper Leakage (1317.4.3.3.2)
DA Complies. Motorized outdoor air supply and exhaust air dampers have a maximum leakage rate
of 4 cfm /ft2 at 1.0 in w.g. when tested in accordance with AMCA Standard 500 -1998.
❑ Exception. Packaged HVAC equipment may have maximum leakage rate of 20 cfm /ft at 1.0 in
w.g. when tested in accordance with AMCA Standard 500 -1998.
The plans /specs show compliance in the following locations:
11. Piping Insulation (Section 1314)
13 No New Piping. The building plans and specifications do not call for new piping serving a
heating or cooling system or part of a circulating service water heating system.
i..:7.4-,,,,.. Complies. All new piping serving a heating or cooling system or part of a circulating service
n: system complies requirements of the Code, Section 1314.1.
�' water heating Y stem P lies with the re q
ii,,, Exception. New piping qualifies for exception: Section 1314.1, Exception ❑ -1 Li -2
12. Occupancy Ventilation
® Complies. Mechanical ventilation systems provide the required amount of ventilation specified
in Chapter 4 of the Oregon Mechanical Specialty Code.
❑ Complies. Natural ventilation systems provide required amount of ventilation as certified by a
reg- istered architect or engineer as specified by Section 1203.4.1, Exception. Attach worksheet
The plans /specs show compliance in
the following locations:
The plans /specs show compliance
on the following pages:
4-4 April 2005
Compliance with OSSC, effective 01/01/05
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Form 4a Project Name: Page:
SYSTEMS - GENERAL Part 5 of 6
13. High Occupancy Ventilation (Section 1317.2.2)
❑ Complies. HVAC systems with ventilation air capacities of 1,500 CFM or greater that serve
areas having an average occupant load of 20 square feet per person or less from Table
1004.1.2 have a means to automatically reduce outside air intake.
Identify applicable systems:
Plans /specs indicate where equipment (i.e. carbon dioxide sensor) and sequence is specified:
0 Exception. HVAC systems are equipped with an energy recovery device with at least 50%
recovery effectiveness.
Iffi No High Occupancy Systems. Project does not contain an HVAC system as described above.
14. Exhaust Air Heat Recovery (Section 1318.3)
Not Regulated. HVAC system does not have: 1) design supply air cap. of >10,000 cfm, and 2)
min. outside air supply >70 %, and 3) at least 1 exhaust fan rated at 75% of min outside air
❑ Complies. Heat recovery system increases outside air temperature by 20 °F (Climte Zone 1) or
30 °F (Zone 2) and has provision to provide bypass during air economizer mode.
❑ Exception. An HVAC system qualifies for an exception to this requirement. Applicable
exception from Section 1318.3 Exception ❑ -1 ❑ -2 ❑ -3 ❑ - ❑ - ❑ -6 U - 7
The plans /specs show compliance in the following
locations:
15. Large Volume Fan Systems (Section 1318.4.2.4)
El Not Regulated. The building plans or specifications do not call for fan systems over 15,000
CFM that serve a single zone and function for the purpose of temperature control.
❑ Complies. Fan systems are equipped with variable frequency drive or two speed motor to
reduce airflow as required by Section 1318.4.2.3.
The plans /specs show compliance in the following '
locations:
16. Variable Speed Drives (Section 1317.10.3.1)
ea Not Regulated. The building plans or specifications do not call for fan and pump motors 10
horsepower and greater that serve variable -flow air or liquid systems.
❑ Complies. All fan and pump motors 10 hp and greater which serve variable -flow air or liquid
systems are controlled by a variable -speed drive.
❑ Exception. The building qualifies for an exception to the variable -speed drive requirement.
Portions of the building that qualify:
• Applicable code exception is Section 1317.10.3.1, Exception
The plans /specs show compliance in the following
locations:
17. Service Water Heating (Sec. 1315)
thi No New Water Heating. The building plans and specifications do not call for new water
heaters, hot water storage tanks or service hot water distribution systems.
❑ Complies. All new water heaters, hot water storage tanks or service hot water distribution
systems comply with the requirements of the Section 1315.
❑ Exception. The applicable code exception is Section: Exception:
" Portions of the building that qualify:
The plans /specs show compliance in the following locations:
4 -5 April 2005
Compliance with OSSC, effective 01/01/05
Form 4a Project Name: Page: T7
SYSTEMS - GENERAL Part 6 of 6
18. Swimming Pools, Spas and Hot Tubs (Section 1315.5)
Oki No New Pools. The building plans and specifications do not call for new, swimming pools, spas or
hot tubs.
❑ On /Off Controls Complies. Spa and hot tub heaters are equipped with a readily accessible
ON /OFF switch as required by Section 1315.5.1.
❑ Ventilation Controls Complies. Pool ventilation system is controlled based on humidity.
❑ Cover Complies. All heated pools, hot tubs and spas are equipped with a cover.
❑ Heat Recovery Complies. Pools, Spas, and hot tubs, over 200 ft utilize recovered heat as
required by Section 1315.5.3.
❑ Exception. Heat recovery is not necessary as pool is heated by renewable energy or waste
heat recovery sources capable of providing at least 70 percent of the heating energy
required over an operating season.
19. Fume Hoods (Section 1317.2.1.)
❑ No Fume Hoods. The building plans do not call for fume hood systems that have a total exhaust
rate greater than 15,000 cfm.
❑ Complies. Fume hood systems have at least one of the following features:
❑ Variable air volume hood exhaust and room supply systems capable of reducing exhaust
and makeup air volume to 50% or less of design values.
❑ Direct makeup (auxiliary) air supply equal to at least 75% of the exhaust rate, heated no
warmer than 2° F below room set point, cooled no cooler than 3° F above room set point,
no humidification added, and no simultaneous heating and cooling used for
dehumidification control.
❑ Heat recovery systems to precondition makeup air from fume hood exhaust in accordance
with 1318.3 - Exhaust Air Energy Recovery, without using any exception.
The plans /specs show compliance in the following locations:
20. Parking Garage Ventilation (Section 1317.2.3)
rd No Enclosed Garages. The building plans and specifications do not call for enclosed Group S -2
parking garages with a ventilation exhaust rate greater than 30,000 CFM.
❑ Complies. The plans and specifications call for carbon monoxide sensing devices as required by
Section 1317.2.3.
❑ Exception. Open parking garages.
21. Kitchen Hoods (Section 1317.11)
Et Not Regulated. The plans /specs do not call for any new kitchen hoods with exhaust capacity
greater than 5,000 cfm each.
❑ Complies. All new kitchen hoods with a total exhaust capacity greater than 5,000 cfm have at
least 50 percent of the required makeup air; (a) unheated or heated to no more than 60 °F; and (b)
uncooled or evaporatively cooled.
The plans /specs show compliance in the following locations:
22. Outside Heating Systems (Section 1317.12)
No Outside Heating Systems. The plans /specs do not call for new permanently installed heating
systems outside the building.
❑ Complies. All new permanently installed outside heating systems are radiant gas fired systems
controlled by an occupancy sensor or timer switch as required by Section 1317.12.
4 -6 April 2005
Compliance with °SSC. effective 01/01/05
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Worksheet 4j Project Name: Page:
FURNACE & UNIT HEATERS - GAS & OIL -FIRED
Equipment (a) (b) (C) (d) (e)
Proposed
Discussion of equip- Heating Minimum Minimum Minimum
ment ratings and Capacity Ec ET AFUE Compliance
equipment definitions
on page 4 -19. Equip. ID Model Designation (Btu /hr) ( %) ( %) ( %) Schedule (A -E)
- � -1 G-' S oI� 7n 80
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Required Indicate source of information
Document- ❑ GAMA Consumer Directory, page(s):
ation Jia' Product data (Attach data furnished by the equipment supplier, I.e., "cut sheets" ).
Code
Capacity (Btu/hr)
Required
Compliance But not
Efficiencies Schedule Equipment Type Over over Minimum Efficiency
This schedule of equip. Gas Fired Warm -Air 0 225,000 78% AFUE or 80% E,
ment efficiencies was A Fumaces & Combustion
reformatted from code, Furnace /AC 225,000 - 80% E,
Table 13 -P. 0 225,000 78% AFUE or 80% E
B Oil -Fired Warm -Air Furnaces
0 0 & Combustion Furnace /AC 225,000 - 81% E
' " Gas Fired Duct Furnaces ALL 80% E,
D Gas Fired Unit Heaters ALL 80% E
E Oil -Fired Unit Heaters ALL • 80% E,
4 -20
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• Compliance with OSSC, effective 01/01/05
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC20f1(i UOf�t;J
13125 SW hall Blvd., Tigard, OR 97223 D ATE ISSUED: /119/2006
Phone: (503) 639 -4171 471 Ai 4. �
Inspection Requests (24 Hrs.): (503) 639 -4175 `'l l—
INSPECTION WORKSHEET FOR DATE: 11/28/2006 TIME: 7 :03AM PAGE: , 43
SITE ADDRESS: 11945 SW PACIFIC HWY 206 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Gas furnace change out. Valuation $2850.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 -266 -1249
Inspection Request Scheduled For: Date: 11/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message A op
699 Mechanical final 040300 -01 503 - 519 -8523 Y G (3)
Corrections/Comments/Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDI /Zei ONAL FEES ASSESSED
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Inspector: I C1z Date: (( O Phone #: (503) 718 -Zi
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