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10515 SW CENTURY OAK DR
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CITY O F I I GA R MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: tOEC2003-00439
13125 SW Hall Blvd., Tigard, OR 97223 1503) 639-4171 DATE 15•;UED: 7/29/03
PARCEL: 2511 ODD-02100
SITE ADDRESS: 1051` SW CENTURY OAK DR
SUBDIVISION: SUMMERFIELD ZONING: R.7
BLOCK: LOT:028 JUKISDIC1ION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: kVENTS W/O APPL: VENT SYSTEMS.
STORIES: B_O_ILERG!COMPRESSORS HOODS:
FUEL TYPES _ v i - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
i-IRE DAMPERS?: 30 - 50 HP: ROODSEPAIR UNITS:
GAS PRESSURE: 50 + HP: COD DRYERS:
FbRN < 100K BTU: AIR HANDLING _UNITS OTHECLO DRYERS:
FURN >=130K BTU: <= icnn0 cfm A,,;O UNITS: 1
> 10000 cfm:
G<`.:i OUTLETS:
Remarks: Replace Etas fireplace with new.
Owner: _ FE_F-S
PERRY, MARIE S +GRANT W TRS Description Datr! Amount
10515 SW CENTURY OAK DR ---
TIGARD, OR 97224 IMI4'111 I'erniit Fee 7129/03 $72.50
I;'i AXI `"° '5tatel"ax 7/29/03 $5.80
Phone: Total _ $78.30 _
Contractor:
KENTEC HEATING CONTRACTOF,
PO BOX 233
WOODBURN, OR 9707' REQUIRED INSPECTIONS
Phone: 503-982-6082 Mechanical Insp
Final Inspection
Reg #: LIC 63621
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. S!�,ecialty Codes
and all other applicable laws. All work will be done in accordance with a- iroved plans. This permit Wil 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 ad.- ted in the Oregon Utility Notification Center. Those uies are set forth in OAR 952-001-00
7
is4ved By: •� �li,pf� Permittee Signatura:
~ Call (503) 639.3175 by 7:00 P.M. for inspections needed the next business day
FOR OPFICC-11SE ONLY
n'�cchanieal Permit Application Received Mechanical
Date/B : /P 1 d 51 Permit No.:HEGr -7,-DD 2
City of Tigard Planning Approval Building
ttste/By: Permit No:
13125 SW Hall Blvd. Man Review Other
Tigard,Oregon 97223 Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Isnd Use
Date/By: Case No.:
Internet: www,ci.tigard.or.us Contact Juris.: See Page 2 for
24-hour Inspection Request: 503-639-4175 Nanw/Method: Supplemental Informs ion.
TYPE OF WOVK COMMERCIAL FEE*SCHEDULE_-USE CHECKLIST
❑ New construction I H 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.
_ 1 &2-Family dwelling-_ ('ommercial/Industrial Value: $ See Page 2 for Fee Schedule
RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE
E] Accessory Building_ Multi-Tamil Description --i I Q Fee ea. Total
Master Builder 90 — Ileatlnp,/c'oolin
JOB SiTE INFORMATION and LOCATION Furnace-add-on air conditionin ** 14.00 _
Job site address: / /,,- c �!r�c i i, ^� ' li Gas heat pump 14.00 -
Suite#: _ Bld ./A t.#: Duct work 14.00
Project Name: ,' r ; ft r Hydronic hot waters stem 14.00
— Residential boiler
Cross street/Directions to job site: for radiator or hydronic s stem _ 14.00
PUnit heats-s(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 A Itancw
Tax ma / aroel #: _ _ Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
�, /ter!% / °�j,•t �/,r,k. U. Flue vent(water heater/Les r'place 10.00
Lo lighter(gas) 10.00
-- Wood/Pellet stove 10.00
Wood fire pace/insert _ 10.00
Chimne /lin.r/flue/vent 10.00
rl PROPE— AW OWNER TENANT _— Other:
Name: Range
Exhaust&Ventilation
— - -- - -- - Range hood/other kitchen equipment 10.00
Address: Clothes dryer exhaust 10.00
City/State/Zip- Single duct exhaust
Phone: _ Fax: (bathrooms,toilet compartments,
JUAPPLICANT I EJ CONTACT PERSON utility rooms) 6.80
_Name: /1./, ki ���%�, - - - - Attic/crawl space fans —_— 10.00
Other: 10.00
Address: _ — _ Fuel Piping
City/State/Zi : _ **($5.40 for first 4 $1.00 each additional _
••
Furnace,etc. _
Fax:
---------- Gas heat pump •'
E-mail: _ _ Wall/suspended/unit heater ** _
CONT CTOR Wavr heater *'
Business Zme: H't' .R,-r, Fire .ace **
�!� 1" Range
Address: _-- •*
'c' > 3 DBQ .�
City/State/Zip: c�0 "�'* ' 01? e Z! Clothes dryer as — •*
Phone: S'r lJax: S'u - .�'i�/ Other: - -- —_ -••
_ Total: _
CCD Lic. #: G Mechanical Permit Fees*_
Authorized i' �/ __ Subtotal: S ` S
Signature: r L /lC�t Date '',
_ Minimum Permit Fee�7?50 S
Plan Review Fee(15%of Permit Fee) 1 $ _
(Please print name) State Surcharge(8%of Pmmit Fee) s 5, er
TOTAL PFRMIT FEE S g, v
Notice: This permit application expires ifis r. -nd1 Is not(),),allied rsilhln *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.
is\DstsTermit Formq\MecPcrmitApp.do 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Inl';,)rmation
Commercial Fee Schedule:
Total Valuation: Permit Pee:
$1,00 to$5,000.00 Minimum fee$72.50
S5,00i.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 tha first 510,000.00 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 one including
S50,000,00. _
$50,001.00 and up $742.00 for the first$50,000.00 and
S 1.20 for each addii ional$100 Ott or
fraction thereof.
Assumed Valuations Per A (lance:
-- — Value To!-.l
Description: Qty (r1a) Amount
Furnace to 100,m)5'rU,including 955
ducts&vents
Furnace>100,000 BTU including ducts 1,170
&vents
Floor furnace 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 I mil 2,310
BTI I
30.50 hp;absorb.unit, 3,400
1- .75 mil.BTU
>5U hp;absorb.unit, 5725
>1.75 mil.BTU
Air handling unit to 10,000 cfm 656
Air handling wilt>10,000 cfm 1,170
Non- ottabi:evaporate cooler 656
Vent fan connected to a single duct 446 _
Vent system not included in appliance 656
ttnit _
Hood served b n hattical exhaust 656
Domestic incinerat._ 1,170
Commercial or Industria'incinerator 4,590
Other unit,including w,antstoves. 656
inserts etc.
Gas piping 1.4 outlets _ — 360
Each additional outlet 63
TOTAL COMMERCIAL.
VALUATION:
ODs's\Perrnit Fomis\MecPerrni1AppPg2.doc 01/03
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
yc BLIP --
Received __-_ _Date:requested __L AM _ -__ BU_P _
Location —...___. SUlte -- MEC 3c1
s r —Td _ _M
Contact Person Ph qC -71 PLM
Contractor __- __ _ SWR —
BUILDING Tenait/Owner _- --_ _ - ELC
Footing _ ELC _
Ft uDrain n AccesS:� ';
9 ELR
Crawl Drain
Slab Inspectio Vote /` 6� - SIT
Post&Beam — `9 L --
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - ---
Insulation
Drywall Nailing - - - - -- -- - -----
Firewall
Fire Sprinkler --_ --- -- ----- -- ------
Fire Alarm
5uzp'd Ceiling --
Roof % `d
Other:_ - -�
Final
_PASS PART FAIL
PLUMBING
Post& Beam
Under Slab — —
Rough-In
Water Service ——-- ---- ---
Sanitary Sewer
Rain Drains ----- -- -- --
Catch Basin/Manhole
Storm Drain -- ---�_--------- -- - —
Shower Pan
Other: —
Final
PASS PART FAIL
Post& Beam
Rough-In - -- --.--
Gas Line —
SmQkuoDampers ---- --- --- - — -- ----
F'
PART FAIL ----_�r-- ------ ---- --- ------
CTRICAL
Service -- -----_._— --.. --------------- ------
Rough-In
UG/Slab
Low Voltage --
Fire Alarm
Final [� Reinspection fee c! —_— required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please ca 1 for r nspection FIE:_. — — Unable to inspect-no access
Fire Supply Line ) ,% �
ADA
Ar�t,roach/Sidewalk
Date L_.3 Inspector - Ext --
Other
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL