10240 SW CENTURY OAK DRIVE-1 _II
10240 SW Century Oak Drive
I
�� �1 ������ __ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: M 21102 -ooa77
13125 SW Hall Blvd., Tigard, OR 9722: '503) 639-4171 DATE ISSUED: 101/25102
PARCEL: 2S 1 11 CC-035W
SITE ADDRESS: 10240 SW CENTURY OAK DR
c'_16DIVISION: SUMMERFIELD ZONING: R t
BLOCK: LOT: 058 JURISDICTION: TIG
CLASS OF WGt2K: 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 HOOFS:
FUEL TYr'ES 0 3 HP: DOMES. INCIN:
3 15 HP: COMML. INCIN.
MAX INPUT BTU 15 -30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
OG :
GAS PRESSURE: 50 + HPC
:
FURN s 100K BTU: 1 _ AIR HANDLING UNITS OTHER CLO DRYERS:
FURN >=100K BTU: <- 10000 cfrn: GAS— ASOIJT'LETS:
UNITS:
> 10060 cf►n:
Remarks: Replace furnace with like kind.
Owner: —s FEES ---�
WHITE,JEAN H Descrir tion Date Amount
10240 SW CENTURY
RY OAK DR
TIGARD, OR 97223 MECIII Permit Fcc 10/25/02 $72.50
IMECI11 Permit Fee 10/25/02 $0.00
IT'AXJ8%StatcTax 10/25/02 $5.80
Phone: 111X]8%StatcTax 10/25/02 $0.00
Contractor: I Total $78.30
SHAMBURG HEATING LLC
239-15 SW BOONES FERRY RD
TUALATIN, OR 97062 REQUIRED INSPFCTIONS
Phone: 501-692-5561 Heating Unt Insp
Final Inspection
Reg #: 126881
This permit is 15 sued subject to the regulations contained in the Tigard Municipal Cade, State of C.e. Specialty Code,
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon Isw
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-00
I
t ' �
f ( � Permittee Signature:
Issued try
Call (503) 639.4175 by 7:00 P.M.for inspections needed the next business da,r
tttttta�i
Mechanical Perinit Application
Date r777,1
City of Tigard Projecedete:
CityofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223Date issued: Receipt no.:
Phone: (503) 639-4171 _ _
Fax: (503) 598-1960 Case file no.: Payment type-
Land use approval: Building permit no.:
' OF PERM IT
i J I &2 family dwelling or accessory U ComInCiLial/industrial U Multi-family U Tenant improvement
U New construction U Acldition/altcration/replacement U Other:
1
)N COMMFRCIIAL
Job address: ; -z 1/o .5 w c ) Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mect,anical materials,equipment,labor,overhead.
Tax map/tax lot/account no.: profit.Value$
Lot: Block: I Subdivision: 'See checklist for important applictltion information and
Project mime: jurisdi iiun's fee schedule for resiriential permit fee,
City/county: 7.IP: ----_- YPE IT.FEE SCIIEDtU
Description and location of work un premises:— ! r
_ hcx(ca.) 'total
Est.date ofcomplction/inspection: Desai on Q11., Res.only I Res.only
Tenant improvement or change of use:
existing space heated or conditioned?U Yes U No Air handling unit --CFM—
Is —
Aircnndning(site p anrequ re )
Is existing space insulated?U Yes U No __kAlteration of existing HVAC system
u er/compressors
Business n ic: ` State boiler permit no.:
/ HP Tons BTU/H
Address: it smo c, dampers/duct smoke detectors
CityI State:- ZIP: 7r eat pump(site plan required)
Phone:4p9A. 7. Fax: E-mail: nsta rep ace urnac �TU7I /
CCB no.: ^$ � Including ductwork/vent liner U Yes U No
-_ nsta rep ace re ocate heaters-suspended,
City/ntelm lic.no,: _ wall,or floor mounted _
Name(please print): Vent for appliance other than Iuinace
4 1 eir gent on:
Absorption units BTU/11
Name: Chillers HP
--Address:- _ - ---- Compressors HP
_ _ .__— Environmental exhaust an ventilation:
City _ State. ZIP:_—_ Appliance vent
Phone: Fax: E.mail Drycrexhaust _
Floods,Type res, itc en a71 zmat—
houd fire suppression system
Name: ) < < ,,, / _ Exha'ast fan with single duct(bath fans)
Mailing address:J a s o a1 r t 1 Ezl a rst s stem a an from eattn or C
piping andistribution(up to outlets)
City: T �1 •vn - State: �7:IP: 7 /.2 � T LPG NO Oil
Phone:s'o j c !• I'ae: I mail: h i r;i,1; Lo (1 a Fuel pipingeach additional aver 4 outlets
' Processp p ng(sc ematicrequire ) _
Number of outlets
Name:
ter Ilited app once or equipment.
Address: L t corauvefireplace
City: -- State: ZIP: &Ri-type --
Phone: -"y Fax: Email: stov pe et stove
-Wer:
Applicant's signature: _ �y ru Date: ay /,.L ter:
Name (print): ` e a /� �tI, % 7
lNot all jutiuliclions xaept credit cants,pleau call Jurisdiction for more inGxrttatim Permit fee.....................
U Visa U MasterCard Notice:This permit application Minimum fee................$
Crecil(ciad number:— expires if a permit is not obtained plan review(at _ %) $
%pire- s within 180 days after it has been State surcharge(8% $
J.
NNa ne of ca diol i a+t awn on crc it cc�u -- accepted as complete. g ) — —
s TOTAL .......................$
6itihoWWaii,tnaiurr Amount 4404617(6KOCOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCl-'._:DULE:
TO�VALUATION PERMIT FEE: Description: - Price Total
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Oty (Ea) Amt
$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 8 vents 14.00
fraction thereof,to and Inciudinb 2) Furnace 100,000 BTU+
$100000. 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
425 000.00. 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 of Pump Cond
fr2-tion thereof. footnotes below. Comp ••
Minimum Permit Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit
$ to 100K BTU 14.00
8%State Surcharge $ 8)it 15 absorb 25.60
unit 100kk t to 500k BTU
25%Plan Review Fee of subtotal 9)15-30 HP;absorb
( )
Requlred for ALL commercial ermits onlunit.5-1 _ 35.00
TOTAL COMMERCIAL PERMIT FEE: $ 30-50'1 i;al BTU absorb
unit 1-'./5 mil 52.20
Lunit
__`_ 11)>50h7,absorb
unit>1.75 mil BTU _ 87.20
ASSUMED VALUATIONS PER APPLIANCE: 1))Air handling unit to 10,000 CFM
10.00
Value ,Total 13)Air handling unit 10,000 CFM+
Description: O (Ea) Amount 17.20
Furnace to 100,000 BTU,including 955 14)Non-portable evaporate cooler
ducts&vents 10.00
Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct
ducts&vents _ L6.8Floor furnace including vent 955 16)Ventilation system not Included in
Suspended heater,wall heater or 955 a liance ermit floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included In appliance 445
ermit 18)Domestic Incinerators
Rts 805 17.40
e air uni
<3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator
to 100k BTU __ 69.95
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101k to 500k BTU _ 10.00
15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
mil.BTU _ _ 5.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1.75 mil.BTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1,75 mil.BTU
Air handling unit to 10,000 cfm 656 8%State Surcharge $
Air handling unit i,10,000 cfm 1,170
Non-portable eva orate cooler _R56 _ TOTAL RESIDFNTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not Included in 656 _
appliance Permit
Hood served b mechanical exhaust 656 Other Inspections and Fees:
estic Incinerator 1 170 1 1 Inspections outside of normal business hours(minimum charge-two hours)
E62 50 per hour.
Cor tmercial or Industrial incinerator 4,590I 2 In apectlons for which no fee Is specifically indicated (minimum charge-half hour)
Otter unit,Including wood stoves, 656 i $62 50 pet hour
Inserts etc. 3 Additional plan review required by changes,additions or revisions to p,ins(minimum
Gas P11 In 1-4 outlets 360 1 charge-one-half hour)$62.50 per hour
Each additional outlet 63 _ "State Contractor Boller Certification required for units 3-200k BTU.
TOTAL COMMERCIAL S * Residential A/C requires site plan showing placement of unit.
VALUATION: All New Commercial Buildings require 2 sets of plans.
I:Wsts\forms4nech-fees.doc 02/11/02
�I
CITY OF TIGARD 24-Hour
BUILD114G Inspection Line: (503) 639-4175
r",ST _
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Received Date Regjested 7 AM _ PM ___ 13UP
Location .— QV7 Suite MEC OD -
Contact Parson Mr� _ ...— Ph( —) PL.M '
Contractor Ph SWR
BUILDING Tenant/0�% _ __ --__ ELC —_
Footing ELC -
Access:
Ftg Drain, ELR - _—
Crawl Drain
Slab Inspection Notes: -- SIT
Post& Beam
Shear Anchors
Ext Sheath/Sh,,ar
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -- -- -- ---- -- - - -
Firewall
Fire Sprinkler -- - ---
Fire Alarm
S,jsp d Ceiling -
Roof
Other: - — - - -
Pinel -----i----
PASS PART FAIL
Ci \- ------- --- -
PLUMBIN —_ — ---_-- -- --- —
Post&Beam
Under Slab -- ------ ----
Rough-In
Water Service - -- - ------ -- -- ----
Sanitary Sewer
Rain Draine, ---—
Catch Basir,/Manh:Ae
Storm Drain —
Shower Pen
Other. _—
Final _
PASS PART FAIL
AECHANICA-L�_i_ — ---
Post& Beam
--
�
Smoke Dampers - -
F' al
PAS PART f Alk'
TRICAI. _
Service
Rough-In
UG/Slab
Low Voltage ----
Fire Alarm
Final [-1 Reinspection fee of$—__ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_PA_SS_PART FAL_ _L
517E 0 Please call for reinspection RF: ❑ Unable to inspect-no access
Fire Supply Line
ADA
A coach/Sidewalk Date __ �16, �
PP Inspector � __ Ext
—�
Other
Final ADO NOT REMOVE this inspection record from the jc b site.
PASS PART FAIL