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Permit CI TY OF TIGARD MECHANICAL PERMIT 1i ; 2/5/01 1 -00045 "I- DEVELOPMENT SERVICES PERMIT #: -' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/5/01 PARCEL: 1S134CD-10000 SITE ADDRESS: 11530 SW TIGARD DR SUBDIVISION: BURLWOOD NO.4 ZONING: R -4.5 BLOCK: LOT: 001 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: 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: 1 AIR HANDLING UNITS FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Furnace replacement, add on a /c. Placement of a/c unit must comply with standard setback requirements. Owner: FEES BAKER, ERIC A + JOELLE L - Type By Date Amount Receipt 11530 SW TIGARD DR PRMT CTR • 2/5/01 $72.50 2720010000 TIGARD, OR 97223 5PCT CTR 2/5/01 $5.80 2720010000 Total $78.30 Phone: Contractor: CLIMATE CONTROL INC 16500 SW 72ND AVE PORTLAND, OR 97224 • REQUIRED INSPECTIONS Gas Line Insp Phone: 453 -4822 Heating Unt Insp Reg #: LIC 62196 Cooling Unt Insp 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 Utility Notification Center. Those rules are set forth in OAR 952 -00 010 throtOAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calli (503)246 -9189. Is a By: �� 1 %��L t Permittee Signature: __ Call (503) 639 , 175 by 7:00 P.M. for inspections neede • the next business day ,. _:. r . . Mechanical Permit Application Date received: ,2 -5-o/ Permit no.:MEC der/ - •� .2 City of Tigard ProjecUappl. no.: Expire date: City ofTigard 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 • X I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: //5 3U ,5t j 716 RD 1 . 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: IBlock: I Subdivision: • *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: Tj4/�p / //As4'. p I ZIP: 922,3 1 S 2 FAMILY DWELLING PERMIT FEE SCIEDULE d AND COMMERICAL /INDUSTRIAL E UIPMEN'TSCHEDULE Description and locati n of work on premises: /V�9tL� Q . {�l'1ed t/ /HD - ow A/G Fee (ea.) Total Est. date of completion/inspection: 2..1, 7 / Description Qty. Res.only Res. only Tenant improvement or change of use: HVAC: Air handling Is existing space heated or conditioned? 0 Yes 0 No unit CFM Air conditioning (site plan required) / _ /%f, oo Mee Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: CL /"n 477,...---- Conl7)PoL State boiler permit no.: HP Tons BTU /H Address: /6504 5(. 7.Z.Ad Fire /smokedampers/duct smoke detectors _ City: PpR-7 I State: eik I ZIP: 97ZZ� - Install/replacefurnac (o BTU /H Phone: 5 3- y53-�8 F 5 3'968 71Z -mail Including ductwork/vent liner�'Yes 0 No � /�.OD / Z' CCB no.: EZ196 Install/replace/relocate heaters- suspended, City /metro lic. no.: /'/!f wall, or floor mounted Name (please print): /VA-A' aGv�.e._ Vent for a. p fiance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: / /we POtygz_ Chillers HP OI / Compressors HP Address: Environmental exhaust and ventilation: City: ���� /5 State: I ZIP: Appliance vent Phone: 5)3 -e/53 -1/872 Fax: E - mail: Dryer exhaust OWNER Hoods, Type 1/ IUres. kitcheil/hazmat hood fire suppression system Name: Lz7 <'/C /3,4 Exhaust fan with single duct (bath fans) Mailing address: / /C30 sjAJ 7 ,) i Exhaust system apart from heating or AC �R Fuel piping and distribution (up to 4 outlets) • City: 64W) I State: ZIP: 9 722 Type: LPG NG Oil / 5: l ief S qU Phone: 503 5791127 Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) / Number of outlets Name: ' y /ly Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert - type Phone: 1 Fax: Ami I E - : 'I: Woodstove/pellet stove Other: Applicant's signature: �� - /„ _ , � iAralaU 'O/ Other: Name (print): • - A ,- Not all jurisdictions accept credit cards, please call jurisdiction for more information. t Permit fee $ 3 3.4 ❑ Visa 0 MasterCard Notice: This permit application Minimum fee $ 72 • SD expires if a permit is not obtained Pl review (at % Credit card number: / / %) $ Expires within 180 days after it has been State surcharge (8%) "" $ S. a ( 8% O Name of cardholder as shown on credit card accepted as complete. o $ TOTAL $ 78.3a Cardholder signature Amount 440-4617 (6/00/COM) MECHANICAL PERMIT FEES ° • COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total (Ea) Amt $1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code • Qty $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. r" Comp* ' ; *" . 7) <3HP;absorb unit to 100K BTU 14.00 ASSUMED VALUATIONS PER APPLIANCE: 8) 3 -15 HP; absorb • Value Total unit 100k to 500k BTU 25 60 Description: Qty (Ea) Amount 9) 15-30 HP; absorb Furnace to 100,000 BTU, including 955 unit .5 -1 mil BTU 35.00 ducts & vents 10) 30 -50 HP; absorb Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20 ducts & vents 11) >50HP: absorb Floor furnace including vent 955 unit >1.75 mil BTU 87.20 Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 13) Air handling unit 10,000 CFM+ permit 17 20 Repair units 805 14) Non - portable evaporate cooler < 3 hp; absorb. unit, 955 10.00 to 100k BTU 15) Vent fan connected to a single duct 3 -15 hp; absorb. unit, 1,700 6 80 101k to 500k BTU 16) Ventilation system not included in 15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00 mil. BTU 17) Hood served by mechanical exhaust 30 -50 hp; absorb. unit, 3,400 10.00 1 -1.75 mil. BTU Domestic incinerators >50 hp; absorb. unit, 5,725 17.40 >1.75 mil. BTU 19) Commercial or industrial type incinerator Air handling unit to 10,000 cfm 656 69.95 - Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves Non - portable evaporate cooler 656 10.00 Vent fan connected to a single duct 446 21) Gas piping one to four outlets Vent system not included in 656 5.40 appliance permit 22) More than 4 -per outlet (each) Hood served by mechanical exhaust 656 1.00 Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: • , , <' $ Commercial or industrial incinerator 4,590 , Other unit, including wood stoves, 656 8% State Surcharge .- - $ inserts, etc. . Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $ Each additional outlet 63 Required for ALL commercial permits only " TOTAL COMMERCIAL $ . TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: Other Inspections and Fees: 1 Inspections outside of normal business hours (minimum charge -two hours) $72.50 per hour 2. Inspections for which no fee is specifically indicated (minimum charge -half hour) $72.50 per hour 3. Additional plan review required by changes, additions or revisions to plans (minimum charge-one-half hour) $72.50 per hour * State Contractor Boller Certification required for units >200k BTU. ** Residential A/C requires site plan showing placement of unit. i:\dsts \forms\mech- fees.doc 10/11/00 . .i, LIMATE CONTROL 16500 SW 72nd Avenue Portland, OR 97224 503-453-4822 FAX: 968-7224 HEATING & AIR CONDITIONING 503-453-HVAC . , , . j <,7_ - 6?0/067 A • , 1 , • / , •! ._... . . . - ___-_-_ -+- ----- g 1 \ ■ ______---------- . .. . , \ . \ , 1 . 1 i • SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE i PORTLAND • 453-4822 VANCOUVER • 360-254-3063 .,. . 1, -c! CITY of TIGARDBUILDING INSPECTION DIVISION 'lib sT 2 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested - AM �,PM B Location //,3' 5 a' 12 Suite A / Contact Person Ph 453 - es& Z' PLM Contractor Ph SWR BUILDING Tenant/Owner • ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain • Crawl Drain Inspection Notes: r:. j..: ,.. SGN Slab �' a;�l 'T"'" Li�/V 'L SIT Post & Beam Ext Sheath /Shear • - Int She Framing ath /Shear P I /' 2 _ 000 c z' N �( J Dry a 1/�,�/.. _00 . Drywall Nailing V V \li 1 Firewall . Fire Sprinkler Fire Alarm 5L / ' r l/1 n s 5 _ b Susp'd Ceiling v (/ wT �-C ��� J Roof Misc: 4?--t + I v 9-7\ i V o Final PASS- PART FAI a , s AM_ !�- - LA:;\ • PLUMBING • Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL V AIslirAt) - Beam Rough In Gas Line Smoke Dampers C.Final3 • - PASS PART FAIL _ ELECTRICAL 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 Inspector 4i1 Ext3 1. Final - PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY"OF TIcARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 602::: Date Requestedd 61 AM PM BLD Location 4 (5 k.1 \ Suite , IQ — d‘b4T Contact Person Ph PLM Contractor C vv\ o _ C_ .a 1 Ph SWR BUILDING Tenant/Owner • ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear. V&A) b _ c ` ^ 5 Framing 4-✓�a� �,LJ�® Insulation S ° AI 1/V\ � Drywall Nailing � w` Firewall Fire Sprinkler ` V • Fire Alarm I A Essoloi Susp'd Ceiling Roof Misc: Final • PASS PART FAIL • PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Post & Beam. - Rough In Gas Line Smoke Dampers PART FAIL RICAL 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 3 t Other Date Inspector Ex Final PASS PART FAIL • DO NOT REMOVE this inspection record from th'e job -site. .