Permit � , CITY OF TIGARD MECHANICAL PERMIT
1� DEVELOPMENT SERVICES PERMIT #: MEC2002 -00046
,j" I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/29/02
PARCEL: 1 S134BC -00300
SITE ADDRESS: 12220 SW SCHOLLS FERRY RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: 1 VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Relocate diffusers, return air duct.
Owner: FEES
BPP RETAIL LLC Type By Date Amount Receipt
BY BURNHAM PACIFIC PROPERTIES PRMT CTR 1/29/02 $72.50 2720020000
ATTN: JOHN WATERS 5PCT CTR 1/29/02 $5.80 2720020000
SAN DIEGO, CA 92101
Total $78.30
Phone:
Contractor:
DAMAR HEATING IANC
PO BOX 56327
PORTLAND, OR 97238 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 288 -8980 Duct Inspection
Reg #: LIC 0087256 Final 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
Utilityp.csfititr Center. Those rules are set forth in OAR•952- 001 -0010 through OAR
952-"01-0080. Yo may octa r pies of these rules or direct questio s to O NC by calling
M111 -a1 RQ
Iss a By: j � � ji �� � �j/ :� Permittee Signature: .-Z -
• Call (503) • 175 by 7:00 P.M. for inspections needed the next business day
A • -.
MechanicalPermit Application
Date received: t a ct l ap__ Permit no. :6J &ova .pa 9 p
' .te l i.
'r:� �. City of Tigard Project/appl. no.: Expire date: •
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ► ommercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 20 It/ SCJJQ ((, S Lir 14 4 / Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical al materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Val $ 500 , d .
Lot: I Block: I Subdivision: *See checklist for important application information and
Project name: L,17 gS - rite/ r r IV Ay jurisdiction's fee schedule for residential permit fee.
City /county: , I ZIP: I & 2 FAi1IILI' DWELLING PERMIT FIT SCHEDULE
Description and location of work on premises: gfi(.0( /2 (1( AND COMME11IC.AL /INDUSTRIAL EQUII'M ENT SCI IEDUI.E
19J f S f rli i t PrIn2 a A (A ptor 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
space insulated? ❑ Yes ❑ N o Air rati conditioning ti ngplan C
Is existing system
g P Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
Business name: # A PI 4 2 orc, , i z, State boile permit no.:
HP Tons BTU /H
Address: 6'O. 0 1C $ 6 312 Fire/smoke dampers/duct smoke detectors _
City: (l/}f• I State:&' I ZIP: S72] _Heat pump (site plan required)
Phone: :,j3 -23C- 74 I Fax :236 -65521 E -mail: Install/replacefurnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: '72 5 G 1/ — lO — (3 Install/replace/relocateheaters- suspended,
City /metro lic. no.: Y3 S wall, or floor mounted
Name (please print): t ,1 u l 6, (, / 1 Vent for a liance other than furnace
e e on:
Absorption units BTU/H
Name: n l( (4 1466/1.,3 Chillers HP
Address:
Compressors HP
Environmental exhaust and ventilation:
City: po 4 er I State: O/I. I ZIP: Appliance vent _
Phone:, -S /Q -I b0 ? Fax: . E -mail: Dryer exhaust
Hoods, Type U 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 distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel i ing each additional over 4 outlets
p p (schematic required) _
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: Fax: I E -mail: Woodstove/pellet stove
Other:
Applicant's signature' ��1/ I Date:/ 0 L Other:
Name (print): pia/44 4 / , ''/(G /,e f
Not all jurisdictions accept credit cards, please call jurisdiction for more information Permit fee $ '2g.5 5 )
U Visa ❑ MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at _ %
Credit cats Hamner Expires within 180 days after it has been ( %) $
Name of cardholder as shown on credit card $ accepted as complete. State surcharge (8%) .... $ 5 • R(�
TOTAL $ "/ S' . C)
Cardholder signature Amount 4404617 (600/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: $ 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
-
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 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 Boller 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.
iAdsts\forms\mech- fees.doc 12/26/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 ST w..
BUP
Received Date Requested � AM PM BUP
Location 423, ? 060 4-4
Contact Person RICA) Ph ( ) 57? ?g07 PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner 9- ELC
Footing
Foundation ELC
Fog Drain Access: (gejo c. .e �,' -,, �s ELR
Crawl Drain CZW c-+ •
Slab Inspection Notes: � '1.Srec �u�1 r / SIT
Post & Beam y� �
Shear Anchors _
Ext Sheath/Shear rte'" `� '
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam /
Under Slab
Rough -In • J
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Aff-1
Gas Line
Smoke Dampers
` PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm -
Final J 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 . /.2 -7/0 Y Inspector Ext
Approach/Sidewalk Date p
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL