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12390 SW Alberta Avenue
CITYO F TIGARD — MECHANICAL PERMIT
lY DEVELOPMENT SERVICES PERMIT#: MEC2000-00433
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/2/00
PARCEL: 2S103BC-03600
SITE ADDRESS: 12390 SW ALBERTA AVE
SUBDIVISION: CANOGA PARK ZONING: R-4.5
BLOCK: LOT: 010 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP:
FIRE DAMPERS?: 30 -50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CIA DRYERS:
FURN >=100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Insi3Cjtion of gas furnace and associated gas piping.
Y Owner: _ _ FEES --- ---
TURNER, JEFFREY VERN Type By Date Amount Receipt
12390 SW ALBERTA AVE PRMT C1 R � 11/2/00 $72.50 27200C3000
TIGARD, CR 97223 5PCT CTR 11/2/00 $5.80 272000000C
Phone:
Total $78.30
Contractor:
SPECIALTY HEATING + FABRICATIO
9528 SW TIGARD ST
TIGARD, OR 972.23 REQUIRED INSPECTIONS
Gas Line Insp
Phone:620-5643 Heating Unt Insp
Reg#r:SUP 2570RET Final Inspection
LIC 006657
EI_E 34-341 CR
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire! if work is not started within 180 dgys of issuance, or if work is suspended
for mere than 180 dais. ATTENTION Oregon law requires you to fellow rules adopted in the 0. 3gon
Utili',y Ngtification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You . ay obtain c9pies of these rules or direct questions to OUNC by calling (FL13)246-9189.
k". r;ue y: , � — Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Date received://-/- 610 Permit no.:Zf e, �
Ci of Tigard =
. � � Projecdappl.no.: Expire date:
City nfT igard Address: 13125 SPIV Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Vase rile no.: Payment type:
Land use approval: _V Building permit no
t
7tl2 family dwelling or accessory ❑Commercial/industrial U Multi-farnily U Tenant improvement
construction iWdition/alteration/replacement U Other:AL
JOB ! ' !N- COMMERCIA1, VALUATION SCHEDUCE
job address: .? 7-) 77 _ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: I Suite no.: _ value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/account no.: T profit. Value$
Lot:_ Block: Subdivision: "See checklist for important application Itillormation and
Project name: :P F - 7" e .jurisdiction's (*, . schedule for residential permit fix.
City/county: Z ZIP: -- t WOt
Description and ocation of wort(on premises: t
9L 9Fee(ea.) Total
Est.date of completion/inspection: / Description Qty. Res,only Res.only
Tenant improvement or change of use: A
Is existing space heated or conditioned?J,l'es U No Air handling unit CPM
Air conditioning(sitepanrequired)
Is existing space insulated? 'es :]No teration of existing HVAC system — --
MECHANICAL'(,'9NTRA(-I%0R ot er compressors - --
Business nam C', 4 t, 4 State boiler permit no.:
Address: 601 S(v / f a-1 S/- HP Tons
ire/smog emper uct smoke etector
City: State:0,e-01 ZIP:q 7,-A a 3 Heat pump(site plan require )
Phone' (o_go6k./ Fax 698' 1! Email Insta I rep acefurnac urne fl/H
7 CIO
I.rcluding ductwork/vent liner Yev11i No I
CCR no.: nsta rep locate
lie.n_o.: J _ wall,or floor mounted _
Name(please pript'v r ' I t-1{tf 1 S ant fora ranee other an furnace
! e' geration:
ERSON
Absorption units BTUi H
Name: T-P Lef& 0 �� r) Chillers HP - --_--
Address: C7S,�9- 13"' - Com resso:s HP
Cit Sta e:G ZIP:_Cj ronmeata a ust an vent at on:
Y' T f 'f _ — Appliance vent
Phone 3 Ce.2p-5r,; Fax:59gp1/8' E-mat Dryerexhaust — _Hoods,Type res. itc eNhazmat
hood fire suppression system
Name: e r Exhaust fan with single duct(bath tans)
r e xhaust s slem a art from eating or AC
Mailing address:�, 3 D.� W_ e r,r=_! Y B
City: Q State: ZIP: y j'�,�-3 ]Fuelpiping an st ut on(up to outlets) y
Type: LPG NG Oil L
Phone: r -al5 Fax: E-mail: uel ii in eacft ami duona over 4 outlets -—
esspiping(schematic required) _
Name: Number of outlets
---- -- 1 app ace or equ prnent: 1
Address: Decorative fireplace
City: State: ZIP: insert-type - -
Phone: Fax: I E-mail: stov0pelletstove
cam— ——
Applicant's signature: Q �, ate ; CS 0 Ot( ter:
Na all jutisdicurra oaccept crnrit card:,please call jurisdiction far more information. Permit fee.....................$ 7.a
U visa 2 MasterCard expires
This permit application Minimum fee................S
expires if a permit is not obtained '—�—�
Credit card number---- _ —/ L-- flan review(at lo) $
Expiry within 180 days after it has been State surcharge(8%) ....$
Name of cardholder m shown on credit card S accepted as complete. TOTAL $ �_
--- Cardholder ugiamre Amount J 440.461116/9)/CONiI
Commercial Schedule
182 Family Dwelling Schedule
ASSLIMEU VALUATIONS PER APPLIANCE --.-.----.
- Oes�plwn
Furnace to 100,000 BTU Table 1A Mecharical Code Oty Price Total
.including ducts Fs vents 955 1)) rumax+o 100.000 BTU ---
_•� Indudi�ducta d vents 14.00
rumace> 100,000 BTU 2) Fum3ce 100,000 BTU-
inrludln duct!d venls - 17.40
including ducts&vents 1,170 3) Fors Fumacc
floor furnace - -- -- Includin vent 14.00
4) Suspended heater,watt heater
lncludinq vent955 _or floor mounted healer _v 14.00
suspended heater,wall heater 5, vent not Included in av le,anC&perm l 6.80
or floor mounted heater _ 955 0) Repair units 1215
Vent not included in a lian.;a permit- i 4..i Chec*all that apply 'Boiler Heal Air
Pp p _ For hems 7.10,tee 0, Pvmp Cono Oly Pnoe Total
Repair units 1105 footnotes 1,2 Comp
7)K3HP;absorb unit to
<3 h(`,absorb.unit +ooK emu 14.00
6)d-15 HP,absorb and
to 100k BTU 955 t00k l0 500k B'7 25.60
3-15 till;absorb.unit 9)15-30 HP;absorb
un4 5.1 mil BTU 35.00
101k to 500k BTU 1 700 10)30-50 HP,absorb
-- -- un4 1-1 75 and BTIJ 52.20
15-30 hp;absorb.unit 11)>50HP,absorb and>1.75 mil BTU -
501k to 1 mil.BTU 2310 - _ 87.20
_ 12)Au hanW6ng 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 Y 141 Non-portable evaporate cooler _ 1000
> 1.75 mil,BTI' 5725 I Sj Vent fan connected to a single dud
6.80
Air handling unit t 10.OG)efm 656 16)Ven;Aalwn system not included in -
appliance permit 10.00
Air handling unit> 10,000 fm _ 1170 17)Hood served by nMdtanial exhaust
Non-portable evaporate wile.- � 656 - 10.00 -
. 161 Domestic 4+cu+eralors
vent fan amnerted to a single Juct 446 _ 17.40
---- 19)commercial or industrial type incinerator
Vent sysl,not included in appliance permit 656 09.95
Hood served by mechanical exhaust 656 20)other units,including wood stoves to 00
Domestic incinerator - 1170 21)Gas piping one to four outlets- -
5.40
Commercial or industral Inclnera!or 4590 22)More than".r outlet(each)
Other unit,including wood stoves,inserts,etc. 656 Minimum Permit Fee$72.50 SUBTOTAL 1.00
Gas piping 1-4 outlets -360 6%SURCHARGE
Each additional cutlet 63 PLAN REVIEW 25%OF SUBTOTAL
�_- Required for ALL commercial permits only
TOTAL
rtrI
+naeedldns and falls:
inarx,-d ns outside of norma t•seirss roan mange t-i Ivwrsl
172 50 p•r hour
2 inspect vis 1y wt rh ro ke n s/a f-ft,-Mcaled im,nimum mage had rvan i
�� $12 50 nem i--w
TSIaI-V Alua� cn _-___.F - 3 Addaiwui Man rev..+rm-ed by rPaN..t addNms In dans lnxnim,n^
durge one.7ue tare)972 50 per Ivan
_
*State r inbsda.sodic cerw"tnn 0i.i"M
S1.00to$5,000.00 -- Minimum;;" en l aeadentsai�n:r«,n.,,deda,enc+igdacemenl and
$5,001.00 to S10,000.00 $72.50 for the first 55,000.00 and S 1.52 Cor
e:ch additional$100.00 or fraction thereof,
to and including 510,000.00
SI0,001.00 to 525,000.00 �i S148.50 for the fir--t 510,000.00 and S1.54
for each additional S 100.00 or fraction
thereof,to and including$25,000.00
$25,001.00 to$50,000.00 $379.50 for(lie first$25,000.00 and S1.45
for each additional S 100.00 or fraction
thereof,to and including 550,000.00
$50,000.00 and up $742.00 for the first 550,000.00 and$1.20 1
Cor each additional$100 00 or fra;.tian -I
thereof J
CITY OF TIGARD BUILDING INSPECTION DIVISION � MST
24-Hour Inspection Line: 639-4175 Business Line: 639.4171 ----
BUP
Requested. 00 — ANi PM BLIP
Location 12 'S� /!,1-� �� _ Suite MEC ZOX7
Contact Person Ph G 2D- 5_6 `f 3 PLM
Contractor Ph _—� SWR
(BUILDING Tenant/Owner ._—,—_.— -- ELC _ —
Retaining Wall ELFT ---- -
Footing !-Access: FPS
Foundation ---
Ftg Diain --- SGN
Crawl Drain Inspection Notes:
Slab --- --------- ---- --- SIT _ --
Post&Beam
Ext Sheath/Shear - ---
Int Sheath/Shear
sr �� Y' -
Framin,
Insulation
Drywall Nailing 33 - -
Firewall
Fire Sprinkler --- __M__---._ --_.__--- - ------- --
Fire Alarm _
Susp'd Ceiling - - - - ---
Roof
Misc:
Final -_--
PASS PART FAIL_ ---- -- - - -----
PLUMBING ------- ----- --- --
Post&Beam
Under Slab - ---.----
Top Out 'a
Water Service __- - - --
Sanitary Sewer
Rain Drai- _ -- - -- - - _ - -- - --
Final
PASS PART FAIL _ - - -----
MECHANICAL
L
Post& Beam -- -- __- ---- ---- ----- --
ou , --..._ -. -- ----- -
as �
Smoke Dampers
in
)PART FAIL --_ _.------ ----
ELECTRICAL - - - - -
Service -� - ----- --
Rough In
UG/Slab —._. - --- -- --- --
Low Voltage
Fire Alain, ----
Final
PASS PART FAIL -.-_--- - - - -SITE -----
Backfili/Grading -
Sanitary Sewer
Storm Drain ( Reinspection fee of$ required before next inspection. Pay at City Hall, 1311.5 SW Hall Blvd
Catch Basin Unable to inspect-no access
Fire Supply Line ( I Please call for reinspectior.RE: __-_ ._ _-_._ i 1
ADA
Apprr.bch/Sidewalk mate d4 Inspector - _ Ext
Other -��-- --
FInal
FASB PART FAIL DO NOT REMOVE this inspection record from the job site.