Permit , ;I
4k. j k CITY OF TIGARD MECHANICAL PERMIT
I i DEVELOPMENT SERVICES PERMIT #: MEC2002 -00260
+ E � f Ij 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/19/02
PARCEL: 1S136AD-04600
SITE ADDRESS: 06707 SW PINE ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: 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:
LPG 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: 1
Remarks: Installation of gas piping to water heater, stove & furnace.
Owner: FEES
HETICK Type By Date Amount Receipt
6707 SW PINE ST PRMT CTR 6/19/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 6/19/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
PARAMOUNT PLUMBING CO
60019 SE 23RD AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 239 -7516 Final Inspection
Reg #: LIC 125438
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 -0 -0080. may obtai copies of these rules or direct question to U Zprig
Iss By: A ii1A �� Permittee Signature: 1
Call (503 9-4175 by 7:00 P.M. for inspections needed the next business day
rU . •R
Mechanical Application ,,
Date received: , /9 o y Permitno.:liie,,, 4
..h1. City of Tigard Project/appl. no.: ire date: •
Address: 13125 SW Hall Blvd, Tigard OR 97223
City of Tigard Phone: (503) 639 -4171 Date issued: � 1 �7
Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
❑ New construction 0 Addition/alteration/replacement 0 Other:
' JOB SITE INFORMATION COMMERCIAL VALUATION SCIIEDULE
Job address: 0 9- S' AI iLe_ ..Viiee i Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: Block: I Subdivision: *See checklist for important application information and
Project name: oil r 'a I jurisdiction's fee schedule for residential permit fee.
City/county: I ZIP: 9•i2 2 1 I & 2 FAMILY DWELLING PERMIT FIT; SCHEDULE
Descri ion and location of work on premises: , 4-i' //te i , AND COMMERICALIINDUSTRIAL EQUIPMENTSCHEDULE
U,�/ S ?o ✓G 15.4 /..../4.c
a- v Fee(ea.) Total
Est. datd of completion/inspection: D escription Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
space insulated? 0 Yes ❑ No Air conditioning (site plan required)
Is existing P Alteration of existing HVAC system
NI ECI IAN I CAL CONTRACTOR Boiler/compressors
name: .r ia,s, 01,9 , ' . HP Tons BTU /H
Address: 60 S f ► ,2,7' /f� Fire /smoke dampers/duct smoke detectors
City: A r /,., of I State: 0' - I ZIP: f? L o Z Heat pump (site plan required)
Phone: .24f ? I E
E Install/replacefurnace/burner BTU /H
CCB no.: /,2 S-9.1 Including ductwork/vent liner ❑ Yes 0 No
Install/replace /relocate heaters — suspended,
City /metro lic. no.: S/ 6- / wall, or floor mounted
Name (please print): t 2, - 4 z)„.1, , X Vent for appliance other than furnace
Refrigeration:
// Absorption units BTU/H
Name: &,..� 41 410%442- 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 U 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 on (up to 4 outlets) 3
Type: LPG JC NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 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 Fax: I E -mail: Woodstove/pellet stove
Other:
Applicant's signature: I Date: Other
Name (print): •
Not all jurisdictions axept credit cards, please call jurisdiction for more information. Permit fee $
❑ Visa 0 MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $ '
$ (n
Cardholder signature Amount C
,0 5-6 1� 440-4617 (Cy00/C'OM)
•
1
MECHANICAL PERMIT FEES ' i `
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: $ 7) <3HP; absorb unit
to 100K BTU 14.00
8% State Surcharge $ 8) 3-15 HP; absorb 25.60
unit 100k to 500k BTU
25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb 35.00
Required for ALL commercial permits only unit .5 1 mil BTU
TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20
unit 1 -1.75 mil BTU
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 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: $
>1.75 mil. BTU
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:
1,170 1. Inspections outside of normal business hours (minimum charge - two hours)
Domestic incinerator 1
$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, including wood stoves, 656 • $62.50 per hour
inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum
Gas piping 1 - 4 outlets 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: All New Commercial Buildings require 2 sets of plans.
i:\dsts\forms\mech-fees.doc 12/26/01
i _ f
CIT etiTIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 M
ST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested AM v I PM BUP
Location A 0 Suite MEC , 00 Do
Contact Person I � : Ph ( ) i i - 1 0 4 0 PLM vL - w 2-3
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC I�v�
Footing
Foundation Access: ELC
Ftg Drain m �� ELR V�
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 1 �l 4,c n mot i. QA/V\ S wv� q
Framing J �l/D
Insulation 12/1-4-U •
Drywall Nailing �a/ , A L
Firewall '?) C41-1(-� S� l r Z '
Fire Sprinkler
Fire Alarm \j -bL j e •
Susp'd Ceiling
Roof 3 •) 44 V ► (` t- ' (/ i -,� C.� 6:-. -J C t1 /
Other: - Q -- �� t1••
PASS PART FAIL L
PLUMBING • Y ) 1 &._C D W 1 O f %(_,f Z L c
Post & Beam Q66 Under Slab Ci) 6 0 T pri- G`" A•rk_,{
Rough -In
Water Service
Sanitary Sewer
Rain Drains A
li O
Catch Basin / Manhole , V _'L��. lam p
Storm Drain N.
Shower Pan
Other:
- 11# FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
• ke Dampers
Fina
Le FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final I 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 y /�
ADA ' n /�
Approach/Sidewalk Date l `C ( b Inspector Ext /q
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY QETIGARD 24-Hour G e ` % I
• BUILDING • • .\' • � • Inspection Line: (503) 639 -4175 •
M INSPECTION DIVISION Business Line: (503) 639 -4171 i
Received Date Reques 6/a AM PM BUP
Location 6 7 D 7 /4-' -i Suite MEC A - 00 24 b
Contact Person fc Ph ( 5:)-9 -- C ? PLM — o3 V
Contractor C.f4i Ph (. oat - 70 4 f - 1 q3 SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: � D rn OC)
Ftg Drain - ELR
Crawl Drain ( �� SIT
Slab Inspection Notes:
Post & Beam Anch
Ext Sr Sheath/Shear ors . iy „ - �v�
Int Sheath/Shear
Framing I • 1 3 ‘//. # � i 1.3 a t ( 4'{
Insulation
Drywall Nailing
Firewall '„ 4 �/L^ I
Fire Sprinkler "'�
Fire Alarm
Susp'd Ceiling
Roof /
Other: — A. A `� r_ — r kXr64
Final
PASS PART FAIL
PLUMBING
Post & Beam 1)lr, YV 1 (5kk.
Under Slab
Ya er Service
�;/4 — 6-IL/
Sanitary Sewer
Rain Drains '
Catch Basin / Manhole
Storm Drain
Shower Pan .
Other:
Final
o p PA FAIL
M CHANICAL
Post & Beam
Rou• i -In
r
Smoke Dampers
Final
A PART FAIL
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 111 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date / z " �� Inspector \ C� E 29 2-
Other:
Final DO NOT REMOVE this inspection record from the Job site. '
PASS PART FAIL