Permit CITY OF TIGARD
MECHANICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: MEC2001 -00247
��!�?;:,'� i� 13125 SW Hall Blvd., Tigard, OR 97223 (5 639 -4171 DATE ISSUED: 7/3/01
PARCEL: 2 S 102 B C -01807
SITE ADDRESS: 10360 SW WALNUT ST
SUBDIVISION: NO. TIGARDVILLE ADDITION ZONING: R-4.5
BLOCK: LOT: 026 JURISDICTION: TIG
CLASS OF WORK: ALT 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FU,RN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS: 4
.Remarks: Replace gas furnace, gas piping to 2 fireplaces, range and water heater.
Owner: FEES
THOMAS, MARC C + CAROL A Type By Date Amount Receipt
10360 SW WALNUT ST PRMT CTR 7/3/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 7/3/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
SPECIALTY HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 620 -5643 Mechanical Insp
Reg #: LIC 66578 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 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246 -9189. 1n
Issue By: Permittee Signature: Yl.�t�.;� ` IY 4,1Z1.Q,[. )
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Date received: 7/3/0 / Permit no.://E Z y7
Al-' .III City of Tigard Project/appl. no.: Expiry date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: B 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 1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi - family 0 Tenant improvement
0 New construction _ddition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: I0.3 $ 0 5(.l) (4) • n 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: +A i ytf}S jurisdiction's fee schedule for residential permit fee.
City/county: 0- 4 f) - (,JAr / I I ZIP: 9' - ?-3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Descri 'on d location of work / o o n premises: �e7o ' c AND COMMERICAL/INDUSTRIAL EQUIPM ENTSCIIEDULE
QLQ / p �Pt ^5 ft) 2 i v.e_(� (aC�e�
ic i ly Fee(ea.) Total
Est. date f completion/inspectio /144 4 ccJa fo b, Description Qty. Res. only Res. only
Tenant improvement or change of use: H
Air handling unit CFM •
Al
Is existing space heated or conditioned? 0 Yes 0 No conditioning n
Is existing insulated? 0 Yes 0 No Alteration of exixi stti n i ngplan required)
g s P ace Altt errati existing HVAC system
m
MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name G y�.L - '' - 9 4 ♦ 4.7 hL HP Tons BTU/1 _
Address: q 6 cscti 0- r) S' r / / Fire/smoke dampers/duct smoke detectors
City: T�CLI d I State: 0,�l ZIP: q 7,9 v.3 Heat pump (site plan required)
Phone 92 /( E -mail: Install/replacefurnaceIburner(d0OQ '.)BTU /H
Including ductwork/vent liner 0 Yes k'No I
CCB no.: c,4.5 7 Er' Install /replace/relocate suspended,
City /metro lic. no.: I b yco wall, or floor mounted
Name (please print): • a rm4-4 • 11-f i(S Vent for appliance other than furnace
CONTACT PERSON Refrigeration: . _
• Absorption units BTU/H
Name: A-114 L. re N h 17 e le. Chillers HP
Address: '75%9- $' •L - r/fral et ST- Compressors HP
Environmental exhaust and ventilation:
City: Tira,,,e., ( Sts e:0e I ZIP: q 70 1.4--3 Appliance vent
Phone ;3 (,.0-p -SC, ' Fax: 59gp-J!g' E -mail: Dryer exhaust
OWNER Hoods, Type I/11/res. kitchen/hazmat
hood fire suppression system
Name: nian g 0 MA-- -C Exhaust fan with single duct (bath fans)
Mailing address: JO 36 0 Slc) W AL. nut - Exhaust system apart from heating or AC
Fuel piping and distribution (up to 4 out ets)
City: 70(fre.,0 I State:ce. I ZIP: cy 7 3 X '
Type: LPG NG Oil
Phone: 0- — / 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: I State: I ZIP: Insert-type
Phone: fax: I E -mail: Woodstove/pelletstove
yy _�-� -�-� `� Other:
Applicant's signature: .rd�'��' �I�' Date: 7�.3/D / - Other.
Name (print): t'/¢-14 Z - Gti4 /4/4/.U
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
cr
0 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 $
Cardholder signature Amount 440-4617 (6/00 /COM)
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Commercial Schedule •
1 &2 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE
Description
Furnace to 100,000 BTU Table IA Mechanical Code Oty Price Total
including ducts & 955 1) Furnace to 100,000 BTU
g 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 d) 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
Vent not included in appliance permit 445
Check all 7
that apply: Boiler Heat Air
pp p For Items 7 -10, see or Pump Cond Qty 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 100k to 500k BTU 25.60
3 -15 hp; absorb.unit 9) 15-30 HP; absorb
unit .5-1 mil BTU 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
> 1.75 mil. BTU 5725 15) Vent fan connected to a single duct
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 colter 656 18) Domestic incinerators
vent fan connected to a single duct 4-46 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 1170 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 rim sefi
Gas piping 1-4 outlets 360 8% SURCHARGE lam DEEM
Each additional outlet 63 PLAN REVIEW 25% OF SUBTOTAL _ =?
_ Required for ALL commercial permits only ._ _ _ :,, --
,
TOTAL
Other Inspections and Fees:
I. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour
2. Inspections for which no lee is speorically indicated (minimum charge -half tour)
$72.50 per hour
Total Valuation Fee 3. Additional pan review required by changes. additions or revisions to plans (minimum
charge-one-had hoar, $72.50 per hour
'Sate Contractor Boiler Certification required
$ 1.00 to $5,000.00 Minimum $72.50 "Residential NC requires site plan showing 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
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• $25,001.00 to S50,000.00 $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
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