Permit CITY T I GA R D MECHANICAL PERMIT
r DEVELOPMENT SERVICES PERMIT #: MEC2002 -00147
.. II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE I 2
PAARR E CELL : 2511 S112DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 235
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 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: 0 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of water source heat pump in LAN room.
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI PRMT CTR 4/11/02 $72.50 2720020000
PORTLAND, OR 97224 5PCT CTR 4/11/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 233 -6911 Final Inspection
Reg #: LIC 38868
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 N • ' ation� enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952- 1 -0080. You \ may ob n copies of these rules or direct questi to C calling
ran. 94.R-Q1 c1
Iss a By: ■
f,p.� I ink /r, ., 1 Permittee Signature:
Call (503) 6 '-4175 by 7:00 P.M. for inspections needed he rleict business day
I
,
Mechanical Permit Application
Date received: // 02- Permit no.: r..i110a G0;/// ,
'A i City of Tigard Project/appl. no.: / lrpi a date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By Receipt Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: ayment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: �.✓- .? O SLv RE, O LA, nop L•OA.,c Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: { e g 3i' value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 5 J 0 0 •
Lot: IBlock: ISubdivision: *See checklist for ihlportant application information and
Project name: n7 - eyZ..6 E-tiSp 77. 8 US ct7CPy jurisdiction's fee schedule for residential permit fee.
City /county: -12 ,0 . I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and 1 "cation of work on premises: l A./ Lt — AND COMMERICAL /INDUSTRIAL EQUIPMEN'TSCHEDULE
'sL,el —cam // e Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? CI Yes ❑ No Air handling unit CFM
space insulated? 0 Yes ❑ No Air conditioning rati of existing plan HVAC system
Is existing P Alteration of existi HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
L 0 l p �f State boiler permit no.:
Business name: / /
/VSSpn . _z- HP Tons BTU /H
Address: Ewe, ] .. Fire/smoke dampers/duct smoke detectors
City: , , e-v p State I ZIP: 97 -,?.3. Heat pump (site plan required)
Phone:,,T3„ /j I Fax Nr -9 7e' E-mail: Install /replacefurnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: g - `�lo Install/replace/relocate heaters- suspended,
City /metro lic. no.: ire$ - e... wall, or floor mounted
Name (please print):JeAc e7 Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: . 9 E , 1 iA/ j 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 lures. kitchen/hazmat
hood fire suppression system
Name: 6C.., / ,tali 5 T 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 i ing each additional over 4 outlets ,
p p g (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
E -mail: Woodstove/pelletstove
Phone: _ Other:
Applicant's signature: WW2. 1 Date: Atari Other:
Name (print): .'1=, 1 ,,. A , ,-
Not all jurisdictions accept credit cards. lease can jurisdiction for more information. Permit fee $ �ot
CI Visa 0 MasterCard Notice: This permit application Minimum fee $
P lan review (at %
Credit card number: / / expires if a permit is not obtained ( %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ /j . 80
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 7 5 1 - Y - ) '
Cardholder signature Amount ■ 440 -4617 (6/00/COM)
•
MECHANICAL PERMIT FEES k i. -
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL PERMIT FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1'A 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. Co mp .
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 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
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:
Domestic incinerator 1,170 1. Inspections outside of normal business hours (minimum charge -two hours)
$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:Wsts\formsknech- fees.doc 02/11/02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DI,`VISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested r ' AM PM BUP
Location (e ( � Suite Z3-s MEC 'ZOOZ 06(`
Contact Person Ph ( ) 2 3 3 " � ! / ( PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
/V
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PAS PAT FAIL
ME HANIC •
P am
Rough -In
Gas Line
S e Dampers
'n
SS ART FAIL
RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call f r reinspec on RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date v� Spector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL