Permit C ITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2000 -00434
- � ti�il DEVELOPMENT H BMENg So R 9 2 639 -4171 DATE ISSUED: 11/2/00
PARCEL: 1 S133DA -01300
SITE ADDRESS: 11105 SW SUMMER LAKE DR
SUBDIVISION: AMART SUMMERLAKE ZONING: R -7
BLOCK: LOT: 035 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:
FU EL 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: Replace gas furnace.
Owner: FEES
JOHNSON, CHRIS E + Type By Date Amount Receipt
SCROGGINS, MARY A PRMT CTR 11/2/00 $72.50 2720000000
11105 SW SUMMER LAKE DR 5PCT CTR 11/2/00 $5.80 2720000000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
SPECIALTY HEATING + FABRICATIO
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
o Heating Unt Insp
Phone: 620 -5643 Final Inspection
Reg #: SUP 2570RET
LIC 006657
ELE 34 -341CR
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 -0080.
You m C --- obtal opies of these rules or direct questions to OUNC by calling (503)246 -9189. •
Issue , Permittee Signature: a A , L IYI -
.
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Date received: // G Permit no.: J`/fc;,rc - y
4"07 r..1,
*
All- j, " �•� I City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT '
,Ell & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construct ion C lddition/alteration/replacement 0 Other:
JOB SITE I NFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: /1) S ao ,54'tt)Ner 44e AO Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ •
Lot: [Block: jc 7 Subdivision: *See checklist for important application information and
Project name: e r/5 �G/l 'V73'� jurisdiction's fee schedule for residential permit fee.
City /county: 19 ,ref) �l4sH [ ZIP: 9 7 ag- 1 & 2 FAMILY DWELLING PERMIT' FEE SCHEDULE
Description and locatio1 of work on premises: 6, lef J 9a4 AND COMMERICAL/INDUSTRIAL EQUIPMENTSCII:EDULE
jy)QC •Ci 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? ices 0 No Air conditioning unit CFM
space insulate Yes 0 No • Air conditioning (site plan required)
Is existing P Alteration of existing HVAC system
A'IECIIANICAL CONTRACTOR Boiler /compressors
Business nam • /QC /4t.- ' t �� • 4 , � hG State boiler permit no.:
5_ HP Tons BTU/H
Address:
� 0..) / i Q1 ' s' r Fi re / smo k e dampers/duct smoke detectors
City: T 0 [ State: 0 ,e[ ZIP: q 771 of 3 Heat pump (site plan required)
So3 Co8O6 kL/ E - mail: Inst all /replace furnacelburner i4 OWBTU /H
Phone' Fax;59� p 7 /( Including ductwork/vent liner 0 Yes 0 No
CCB no.: l l.5 7' Install/replace/relocate heaters - suspended,
City /metro lic. no.: Ib 96 wall, or floor mounted
Name (please print): • a rpr 4 j 114 eiS Vent for appliance other than furnace
CONTACT PERSON Refrigeration: .-
Absorption units BTU/H
Name: A- Ti4 Lee py .c4z 44 ei (? A. Chillers HP
Address: 9'.5a- 8' S[- . ). / / et S' j- Compressors HP
Environmental exhaust and ventilation:
Ti
City: 4.id [ Sta e:Q . [ ZIP: q 70 Appliance vent
Phone' 3 6 -6,6 ' Fax: 59(01)8' E -mail: Dryer exhaust
OlVrER Hoods, Type I/ IUres. kitchen/hazmat
I I hood fire suppression system
Name: ( 4 L i . 5 6 0 1. . J Exhaust fan with single duct (bath fans)
Mailing address:) /O ...5k) m/l/ fr 4 4.ge U) Exhaust system apart from heating or AC
Fuel piping and distribution to 4 outlets)
City: g'(�r [ State pg_1 ZIP:Q 7-8 Type: LPG 1 Oil ,
Phone S 36 t Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: ( State: I ZIP: Insert - type
Phone: Fax: (E -mail: Woodstove/pellet
�� Other:
Applicant's signature: qdity r [ Date: /0/3//46 Other.
Name (print): 1t t -11/Z(ei1 ,e1iiiMWW
Not all jurisdictions accept credit cards. please call jurisdiction for more information. Permit fee $
0 Visa 0 MasterCard Notice: This permit application Minimum fee $ 7 -' O
Credit card number. / / expires if a permit is not obtained Plan review (at %) $ r
Expires within 180 days after it has been
State surcharge (8 %) $ 'S•
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $ • 3
Cardholder signature Amount 4404617 (6/00 /COM)
•
•
Commercial Schedule
1 &2 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE
Description
Furnace to 100,000 BTU Table IA Mechanical Code . Oty Price Total
I) Furnace to 100.000 BTU
including ducts & vents 955
including ducts & vents 14.00
Furnace > 100,000 BTU 2) Furnace 100,000 BTU«
including ducts & vents 17.40
including ducts & vents 1,170 3) Floor Furnace
including vent 14.00
floor furnace 4) Suspended heater, wall heater
•
including vent 955 or floor mounted heater 14.00
suspended heater, wall heater 5) Vent not included in appliance permit 6.80
• or floor mounted heater 955 6) Repair units 12.15
Check all that apply: 'Boiler Heat Air.
Vent not included in appliance permit 445 For Items 7 -10, see or Pump Cond Oty Price Total
Repair units 805 footnotes 1,2 Comp •
7) <3HP; absorb unit to
< 3 hp; absorb.unit 100K BTU 14.00
8) 3 -15 HP; absorb unit
to 100k BTU 955 look to 500k BTU 25.60
9) 3 -15 hp; absorb.unit unit -11 milBTU - 35.00
101k to 500k BTU 1700 10) 30 -50 HP: absorb • . .
unit 1 -1.75 mil BTU 52.20
• 15-30 hp; absorb.unit 11) >50HP; absorb unit '1.75 mil BTU
87.20
501k to 1 mil. BTU 2310 12) Air handling unit to 10,000 CFM
30 -50 hp; absorb.unit 10.00
13) Air handling unit 10,000 CFM.-
1 -1.75 mil. BTU 3400 17.20
> 50 hp; absorb.unit 14) Non portable evaporate cooler 10.00
5725 15) V f connected to a sin duct
> 1.75 mil. BTU 6.80
Air handling unit to 10,000 cfm. 656 16) Ventilation system not included in
appliance permit 10.00
Air handling unit > 10,000 cfm 1170 17) Hood served by mechanical exhaust
10.00
Non - portable evaporate culler 656 18) Domestic incinerators
•
•
vent fan connected to a single duct 446 17.40
19) Commercial or industrial type incinerator
Vent syst not included in appliance permit 656 69.95
Hood served by mechanical exhaust 656 20) Other units, including wood stoves 10.00
Domestic incinerator 1 170 21) Gas piping one to four outlets
5.40
Commercial or industral incinerator 4590 22) More than 4-per outlet (each)
1.00
Other unit, including wood stoves, inserts, etc. 656 - Minimum Permit Fee $72.50 SUBTOTAL
Gas piping 1-4 outlets 360 8% SURCHARGE i l
Each additional outlet 63 r PLAN REVIEW 25 % OF SUBTOTAL �`- ' rr ;ix
- ;;;r .
Required for ALL commercial permits only . i -!
TOTAL '`
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum Charge -two hours)
$72.50 per hour
2. Inspections for whiUh no fee is specifically indicated ( minimum Charge -ha(1 hour)
372.50 per hour
Total Valuation Fee 3. Additional pan review required by Changes. additions or revisions to plans (minimum
chargeone -had hour) 072.50 per hour
'Slate Contractor Boiler Certification required
$1.00 to $5,000.00 Minimum $72.50 '-Residential MC requires site pan snowing placement of unit
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
each additional $100.00 or fraction thereof,
to and including $10,000.00
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54
• for each additional $100.00 or fraction
thereof, to and including $25,000.00
$25,001.00 to $50,000.00 • $379.50 for the first $25,000.00 and $1.45
for each additional $100.00 or fraction
thereof, to and including $50,000.00
$50,000.00 and up $742.00 for the first $50,000.00 and $1.20 •
for each additional $100.00 or fraction
thereof
.-CreY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested !/— AM PM BLD
Location /1/ 0 S 5 �uyi'►n'► / � /4 ,PY Suite MEC 2- -Oa (f 3 �/
Contact Person Ph 6z4 -5 ' y3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final •
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
ja4SS PART FAIL
CMECHAI�J�Al�
- Pa sts & Beam
Rough In
Gas Line
Smoke Dampers
• S PART FAIL
CTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date .. 1 Inspector Ext
Final
PASS PART FAIL D • N' T REMOVE this inspection record from the job site.