Permit CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC2003 -00387
,�.�I DEVELOPMENT H BMEN9 Tigard, ) 639 -4171 DATE ISSUED: 7/8/03
PARCEL: 2S 104AD -03501
SITE ADDRESS: 12820 SW WALNUT ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: 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: 2 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:
FURN < 100K BTU: 2 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace (2) furnaces and adding (2) a/c units.
Owner: FEES
CHRIS JAM Description Date Amount
12820 SW WALNUT ST [MECH] Permit Fee 7/8/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 7/8/03 $5.80
Phone: 503 - 314 - 0886 Total $78.30
Contractor:
COST PLUS HEATING + AIR
7132 N FESSENDEN ST
PORTLAND, OR 97203 REQUIRED INSPECTIONS
Phone: Heating Unt Insp
hone: 286 2009
Cooling Unt Insp
Reg #: LIC 47978 Final Inspection
1
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 -00
Issu By: ` _ ! -, _ , JAL ! i - Permittee Signature:/ ,,,,./f,,e,__
' Call (503) 7 9 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanic Application A lication FOR OFFICE USE ONLY
N� Received ,I Mechanical
r
Date/By: ! Y O. Permit No.: r oq 0J3-!'Jj93
Cl of TI and Planning Approval Building
`J g Date/By: No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By. Permit No.:
Phone: 503- 639 -4171 Fax: 503- 598 -1960 Post - Review Land Use
G "fu-I . t' Date/By. Case No.:
Internet: www.ci.tigard.or.us'
Contact Jyns.• El See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: / Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
Ii 1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
El Accessory Building ❑ Multi - Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooli g
JOB SITE INFORM and LOCATIOI�i Furnace - add -on air conditioning ** ► 14.00
Job site address: /.. g� ��� j't�"� - Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Cross street/Directions to job site: (for orid radiator boiler
� ( radiator or hydronic system) 14.00
11 .5) Wq t AA i ,3 Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: Lot #: Repair units 12.15
#: Other Fuel Appliances
Tax map/parcel
Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
R e. Z �, C I 'J' ? S , Flue vent (water heater /gas fireplace) 10.00
- A.1 et.......) Ric Log lighter (gas) 10.00
Wood/Pellet stove 10.00
b" 44.t4-" "' C./4`Q ` ,:f ~ v. ' Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER 1 ❑ TENANT Other: 10.00
Name: c t,, (; 5 J .ftvl Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 10.00
Address: 1 z - zo S(-4._) L„)0, (pLet-
Clothes dryer exhaust 10.00
City /State /Zip: - t 5 V1- 02 "i - i zz 3
Single duct exhaust
Phone: 7, ) c/ - e5'� (1 Fax: (bathrooms, toilet compartments,
❑ APPLICANT 21 CONTACT PERSON utility rooms) 6.80
Name: V-ct,.c SAti t e-/SLY. Attic /crawl space fans 10.00
Address: Other: 10.00
Fuel Piping
City /State /Zip: * *($5.40 for first 4, $1.00 each additional)
Phone: St.)3 - 781 -169v Fax: Furnace, etc. **
Gas heat pump **
E -mail: Wall/suspended/unit heater **
CONTRACTOR Water heater **
Business Name: C, sr Plu 144 Fireplace **
Address: - 7 13Z 0,1 - etch Range **
City/State/Zip: Para. O& c 2e 3 BBQ **
y P Clothes dryer (gas) **
Phone: »3 - eet. - zoo'? Fax: 284 -4s Other: ** Total:
CCB Lic. #: 14797Y eVI 11'
Authorized Mechanical Permit Fees*
�1 f Subtotal: $
Signature: SCI f � " Date: Minimum Permit Fee $72.50 $ /O''. - 0
Plan Review Fee (25% of Permit Fee) $ _
(Please print name) State Surcharge (8% of Permit Fee) $ J . TO
TOTAL PERMIT FEE $ 7 g, 36
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri - County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01 /03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information -
Commercial Fee Schedule:
•
Total Valuation: Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
$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
$50,001 00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
Assumed Valuations Per Appliance:
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor fumace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industnal incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc
Gas piping I-4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
i:\Dsts\Permit Forms\.MecPermitAppPg2.doc 01/03
. , ............e
,
.-------
-------1
, /----
i • .----- ,
, 4
--„,
I • ,,,,
. ,
,
1 ,
1 C N#J ' 0 - . 00°N7gC9 '
3
, .
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPEOTIOKDIVISION Business Line: (503) 639 -4171 - 00 l a-/
Received Date Requested AM PM 6 A 2 BUR
1
Location - � v Gu Gl':/� Suite -- MEC ' " a
Contact Person rl eto MEL _e I Ph ( 9 ) � 1 �i 9� ( �L�M , ��
. Contractor SC y �✓! Ph ( ) ' 7 / q �SWR �?7r POO--a5
BUILD�I Tenant/Owner ELC 3 -a() VI 2_
Footing
Foundation
Ft g Drain 6 J , ELC
Access: ��O /e7 ELR
Crawl Drain
Slab Inspection Notes: ,�,' u SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear 1 ' y/i It Sheath/Shear 4 I „ / i „ / ! ci /�T S�- k,
Framing vV /� /V� -Gt ///
Insulation kf,;44/, / 9k (�� 3 - ae)30& ��i 4a�)
Drywall Nailing /'”
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
• ali
AS PART FAIL
!'Ii'iI ]I*
Post & Beam
- Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
" N L
. Beeam
Rough -In
Gas Line
Smoke Dampers
_ ART FAIL
y11:1r
Service / '" e c /i G f /
Rough -In IL " /c 'e
UG/Slab
Low Voltage
Fir- larm
,� PASS PART ` ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd:
SITE ❑ Please call f• r reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date - Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL