10415 SW CENTURY OAK DRIVE 10415 SW Century Oak Drive
CITYO F T I GA R D ___ MECHANICAL PERMIT
�,..
PERMIT MEC20U1 00095
DEVELOPMENT SERVICES
DATE ISSUED: 3/23/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110DD-01600
SITE ADDRESS: 10415 SW CENTURY OAK DR
SUBDIVLJON: SUMMERFIELD .ZONING: R-7
BLOCK: LOT: 023 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
i YPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS WIO APPL: VENT SYSTEMS.
STORIES- BOILERS/CO'#!PP ESSORS HOODS:
FUEL TYP-ES 9 - 3 HF: 1 DOMES. INCIN:
LPG 3 - 15 HP: COMFAL. INCIN:
MAX INPUT: BTU 15 30 HP: REPAIR UNITS:
F IRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE. 50 + HP: CLO DRYERS.
FURN < 100K BTU: 1 AIR HANDLING_ UNITS OTHER UNITS:
FURN —100K BTU: c= 10('00 k;fm: GAS OUTLETS: I
> 10000 cfm:
Remdrks: Replace existing gas furnace with new gas furnace, gas piping, and a/c unit. Placement of a/,unit must
comply with standard setback requirements.
Owner: _ FEES
DICK ALEXANDER Type By Date Amount Receipt
10415 SW CENTURY OAK FRMT CTR 3/'k3/01 $72.50 27200'iu00C
IGARD, OR 97224 5F';T CTR ,/23/01 $5.80 272001000C
Tot:,i $78.30
Phone:503-655-8919 I --- —
Contractor: —
Al"CTIL SHEET METAL CO.
4320 N WILLIAMS AVE
POf2Tl_AND, OR 97217 REQUIRED INSPECTIONS _
Gas Line Insp
Fhone:503-281-0752 Heating Unt Insp
Reg#:LIC 8897 Cooling Unt Insp
Final Inspection
This permit is issued subject to the regulations contained iii the Tigard ML,.icipal Code, State of Ore.
Specialty Codes and all other applicable I- ws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 001-0010 through OAR 952-001-0080.
You may obtain copies of these pules or direct questions to OUNC by Calling (503)246-9189.
Isiue By: �1„�,,1G� Permittee Signature: X_
Call (503) 639-4175 by 7:00 P.M. for inspections needs the nex slness day
Mechanical Permit Application
-- Date received: a p Permit no.:
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Hkd.'1 i)nut1.()It 11722). Date issued: By:
Phone:Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Paymenttype:
Land use approval: _ Building permit no.:
61 W t
1 &2 family dwelling or accessory U Commercial/industrial U Mulu family U Tenant improvememt
13 New constniction U Actdifion/alteration/replacement U Other:
JOB SITE INFORMATION
Job address: `& 1 Indicate equipment quantities in boxes below.Indicate tine dollar
Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: Subdt ,sion: 'See checklist for important application information and
Project name: # jurisdiction's fee schedule for residential permit fee.
City/county: IP: 1
I kscription and I atlon f ork on premises: 1 t 1 t 'm 1
1� Iee(trr.) lolal
Fst•date ofcompleti n/inspection: Desert ran Qty. Res.onl Rec.onl
'Tenant improvement or change of use: / hap
Is existing space heab_d or con onedY wYes U No Air handling unit _�_,CFM
Ai con itioning(site plan require )
Is existing space insulated?Ld Yes U No terauon o ex st ng system
of er compressors
[fusine.,s name: > State boiler permit no.:
HP Tons—BTU/14
Address: 1 / ? tr smoke dampers/duct smoke etectors
City: Slate ZIP: 9� /'7 cat pump(s to p an requmre )
Phone: Fax . mail; nsta replace urnac urncr;r.��C
CCB no.: , Including ductwork vent liner t3Yes U No
nstn rep a.-I re ocatc -suspended
City/metro lie.no.: 1462 _ wall,or floor mounted
Name( lease print) t�/ r/L. f f j' /P;tet �+ ent ora lance u1 etMan furnace
e eral on:
Absorption units BTU/H
Name: ' r Chillers. HP
Address: Com ressors _ HP
—• .nv rontrlenta ex act an vent at on:
City: Slate: ZIP: Appliancevent
Phone: Fax E-mail: Dryer exhaust
c o s, yppee I/7l/res. itc a azmat
hood fire suppression system
Name: 9. ) �!, C _ Lx. ,,just fan with single duct(bath fans)
Mailing address: le)f - Txhnust system a art from heating or AC
late: 7. ,�` ue piping ands str nt on(up to outlets)
City: oS
o S ct�_ •C% _._ Tyle; LP(, I_ NU Oil r
Phones 'C r {;mx -- I: mail: Fuelpiping eac additional over outlets
11, rocecspiping(rccinaocrequire )
Number of outlets
Name: ter IrsiQ appi e or equipment:
Address: Ihcorativefireplace _
City: state: ZIP: nsert-tyPC _
Phone: AFa E-mail: Woodslove/pelleatove _
Uth
et:
Applicant's signature: Datc: � 7+ Other:
Name(print)' e"/!/2l
Nd all jurisdictions accelu credit cants.please call lurtadictim for amre InrotmatMnPermit fee.....................$ _
Uvisa UMasterCard Notice:'Thispermit e.pplication Minimum fee................$ _
r expires if a permit if not obtained plan review(at — %) $ _�-
Ctedit card number- -- --�--� — v ithin Igo days ally r it has been _
e"pin" Y State surcharge(R96) ....$ . �• �
N me of c tkr as-'_fii iiw`n one i—rctTi�er3—� accepted as complete. TOTAL. ll �r��o
S
Cardholder signature V Amount 44BA171trOutCOM1
MECI IANICAL PERMIT FEES
COMMLr.CIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION:` FEE: Description: Price Total
- - - Table 1A Mechanical Code qty (Ea) I Amt
51.00 to$5 000.00 Minimum lee$72.50 1) Furnace to 100,000 BTU
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and Including ducts&vents 14.00
$1,52 for each additional$100.00 or Furnace 100,000 BTU+
fraction thereof,to and including 2) Furnace
ducts 0 vents 17.40
$10,000.00. Includin3) Floor Furnace
25
$10,001.00 to 5 ,000.00 $148.50 for the first$10,000.00 and Including vent 14.00
$1.54 for oach additional$100.00 or 4) Suspended heater,wall heater
fraction thereof,to and including 14.00
$25,090.00. or floor mounted heater
325,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 51 Vent not Included In appliance permit
$1.45 for each additional$100.00 or 6'80 --
fraction thereof,to and including 6) Repair units
_ 12.15
$50,000.00.---
$50,001.00 and up 742.00 for the first$5(1,000,00 and Check all that apply: Boller Heat Air
$1.20 for each additio❑al$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. _ footnotes below. Com '
7) c3HP;ab5ort nit
to 100K BTU _ 14.00
r ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb
Value Total unit 100k to 500k B U 25.60
Description: Qty (Eal 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,tin0 BTU including 1,170 unit 1-1.75 mil B'rU 52.20
ducts&vents 11)>50HP:absorb
Floor furnace including vent 955 _ unit>1.75 mil BTU 1 87.20
Suspe,ided heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted healer _ 10.00
Vent not Included In applicance 445 1 3)Air handling unit 10,000 CFM+
permit 17.20
Re air 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
3-1f,hp;absorb.unit, 1,700 6.80
101(to 500k BTU 16)Ventilation system not Included in
15-u0 hp;absorb.unit,501k to 1 2,310 appliance permit __ 10.00
mil.NTU 17)Hood served by mechanical exhaust
30-uL hp;absoe .unit, 3,400 _ 10.00
1-1.75 mll.BTU 18)Domestic incinerators
>50 hp;absorb.unit, 5,725 11.40
>1.75 mil.BTU 19)Commercial or Industrial type incinerator
Air handling unit to 10,000 drn 658 69.95
Air handling unit>10 000 cfm 1,170 20)Other units,Including wood stoves
Non-portable eve orate cooler 656 10.00
Vent fan connected tqjjInj le 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 I'm Minimum Permit Fee$72.50 SUBTOTAL: ate.
Commt sal or Industrial Incinerator ___4,590 _
Other unit,Including wood stoves, 656 8%State Surcharge $
insects,etc. __
Gas I In 1 4 outlets 360 _. 25%Plan Review Fee(of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL 5 TOTAL RESIDENTIAL PERMIT FEE: $ ''
VALUATION: -
Other I spectio s and Fees:
1 Inspections outside of nor al business hours(minimum charge-two hours)
$72 50 per hour.
2 Inspections for which no fee is specifically indicated (minimum charge-half tour)
$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 requlred for units>200k BTU.
"Residential A/C requires site plan showing placement of unit.
I:\dsts\forms\mach-fees.doc 10011100
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CCB#8897 4320 N.Williams Avenue,Portland.OR 97117 oMrp 503.281.0752 503.282.5722
1$20543
Dick & C'arolinc \lcxanacr
' 10415 SW C'entury Oak
Tigard, OR 97224
.lir Conditioning Site Plan
yv
4 iarage
S\V Century Oak