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13336 SW CHELSEA LP
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00502
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/22/00
PARCEL: 2S102D13-03300
SITE ADDRESS: 13336 SW CHELSEA LP
SUBDIVISION: CHELSEA HILL ZONING: R-12
BLOCK: LOT:010 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF UGE: SF UNIT HEATER': VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL. VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ _ 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 • 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: L LO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
GAS OUTLETS: 2
> 10000 cfm:
Remarks: Gas piping to range& dryer
0%nor: _ � FEES_
WILLIAMS, DOROTHY ANN Type By Date Amount Receipt
13336 SW CHELSEA LOOP PRMT CTR 12/22/00 $72.50 272000000C
TIGARD, OR 97223 5PCT CTR 12/22/00 $5.80 2720000JOC
Total $78.30
Phone:
Contractor:
9RUNER PLUMBING
PO BOX 23965
TIGARD, OR 97281 REQUIRED INSPECTIONS
Gas Line Insp
Phone:503-624-4880
Reg#:LIC 81837
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all othe applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utilitv Notification Center. Those ruses are sat forth in OAR 952-001-0010 through OAR 952-001-0080.
'r"ou may oht9in copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: �O Permittee Signature: _—
Call (5 3) 639-4175 by 7:00 P.M.for Insprictions needed the next business day
Mechanical Permit Application
Datereceived P. �Z
City of 'Tigard Project/appl.no.: Expire date:
CitynfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.
Phone: (503) 639-4171 ---- '
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.:
rAfl & mily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvo now
struction U A(I(lititm/alteration/replacement U Other:
INFORMATION
Job address: /3 3 3(a . I ' LJI-,Q-Ll, Indicate eq1.111MICnl quantities in boxes below. Inaicale lite dollar
Bldg.no.: rSuite n,: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: 113lock: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP:
Descripti n and locatidn of-work on remise It 1 i k RICAN 01111K1 t
i zq I ovy Fee(en.) Total
Est.dale of completion/inspection: zr I)ewcri(Nirnt _ (py. Res.only Res.onh
Tenant improvement or change of use: Air handling unit CINIs existing space heated or conditioned?U Yes U No Air conditioning(site plan require )
Is existing space insulated?U Yes U No Alteration of existing HVAC system
Boiler/compressors
�(�„� State boiler permit r,o.:
Business name:
NP Tons BTU/H _
Address: ,p , Q� Z3 pl S _4�_ ire/smoke dampers/duct smoke detectors
City: T Slat . ZIP -+2? cat pump(sue p an required)
Phone:
_ Fitt dyo Fax:e.z y 2( E-mail: nsta rep ace timac wrner
CCB no.: Ir, luding ductwork/vent liner U Yea U No
1 3�7_ Install/replace/relocateen eaters-suspe
City/metro lie.no.: -1-t c„-� ;r- (a(�,p wall,or floor mounted
Nome(pleaseprint): Vent fora lance other than furnace
Kefrie
nt on:
Absorplionunits _ BTU/H
Nanr. Chillers---- HP
-- Com ressors_• HP
Address:
-- --- -- t - my ronmenta ez ust an ventilation:
CH. Stale: ill' 1 Appliance vent
Phone: Fax F-mail: )ryerex aunt
o s, yoef-TTpe / Tres. itc�eni7c h tzmat --
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
Mailing address: Exhaust systema art from heating or AC
- - - -- Fuelpiping andistribution up to outlets)
City: - ---- -- Slate: LII' - TYlx- --
LPG Z NO Oil
I
I'It �nr I ,n nwil
Fuel piping enc i a itiona over outlets
Process piping(schematic required)
tne: Number of outlets
Na
t er st apliance or equipment:
Address: Decorative fireplace
City: State: ZIP: nsen-type._
—. ---
Phone: I E-mail: Woodstove/pcllet stove
Applicant's signature: Date: Mier
«;
Name (print):
Not all jurisdictions accept credit cards,please call)udsdicdon for more Information Permit fee.....................$ _
U Visa U MasterCard Notice:This permit application Minimum fee................$
expires if a permit is not obtained Plan review(at — %) S
Credit rand mmmber: _--------- --_ __—L—1-
within 180 days after it has been State surcharge(8%) ....$
-
Name of cardholder v shown on credit card accepted its complete.
s TOTAL .......................$
Cardhold.r signature Amount
440-4617(&MOCQM)
a►�
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
OTAL VALUATION: FEE: Description: - -T- Price Total
TMinimum fee$72.50 Table 1A Mechanical Code City (Ea) A-A
$1.00 to$5,000.00 _
1) Furnace t
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and ccs&
Includingducts 0 BTU
&vents 14.00
$1.52 for each additional$10C)0 or 2) Furnace 100,000 BTU+
fraction thereof,to and Includin; including ducts&vents 1740 _
10 000.00, 3) Floor Furnace
$10,001.00 to$25,000.60 $148.50 for the first$10,000.00 and including vent _ 1400 _
$1.54 for each additional$100.00 or 4) Suspended heater,wall heater
fraction thereof,to and Including or floor mounted heater 14 CD
_
$25.0 0.00. -
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included In appliance port.ilt
Fi DO
$1.45 for each additional$100.00 c r
fraction thereof,to and Including 6) Repair units
12 15
$50.000-00. --
$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 or Punip Cond
fraction thereof. footnotes below. Comp* T_
` 7)<3HP;absorb unit
to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb
Value Total unit 100k to 500k BTU 2560
Description: Qt Ea Amount. 9)15-30 HP;absorb
Furnace to 100,000 BTU,including 955 unit.5-1 frill BTU 35.00
ducts&vents 10)30-50 HP;absorb
Furnace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU 5220
ducts&vents 11)>50HP:absorb
Floor furnace Including vent 955 unit>1.75 mil BTU 87.20 -
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater _ 110 00
Vent not included in applicance 445 13)Air handling unit 10,000 CFM+
ermit 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
3-15 hp;absorb.unit, 1,700 6.80
101k to 500k BTU 16)Ventilation system not included in
15.30 hp;absorb.unit,501k to 1 2,310 appliance p2rmit 10.00
mil.BTU 17)Hood, lrved by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00
1-1.75 mil.BTU 18)Domestic incinerat. .s
>50 hp;absorb.unit, 5,725 17.40
>1.75 mll.BTU 19)Commercial or Industrial type Incinerator
Air handling unit to 10,000 cfm 656 69.95
Air handling unit>10,000 cfrn 1,170- 2.0)Other units,Including wood stoves
Non-portable evaporate cooler 656 10.00
Vent fan connected to a sin Ig a duct 446 21)Gas piping one to four outlets
Vent system not Included in 656 5.40
appliance. ermlt -- 22)More than 4-per outlet(each)
Hood served_by mechanical exhaust 658 1.00
Domestic Incinerator 1.17() Ulinimum Permit Fee$72.50 SUBTOTAL: $
Commercial or industrial Incinerator 4 590
Other unit,Including wood stoves, 658 ---- 8%State Surcharge $
Inserts etc. _
Gas piping 1-4 cutlets 360 25%Plan Review Fee(of subtotal) $
Each additional outlet 63 Required for ALL commercl.r permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION: T__ ---- -- _
Other Insaectlone and Fees:
1 Inspections outside of normal business hours(minimum chargd-l%vc hours)
$72 50 per hour
2 Inspections for which no fee is specifically Indicated (minimum chary.half hour)
572 50 per hour
3 Additional plan review required by changes,additions or revisions to pli ns rminlmum
charge-one-half hour)$72.50 per hour
State Contractor Boller Certification required for units>200k BTU.
"'Residential AIC requires site plan showing placement of unit.
is\dsts\forms\nlech-fees.dor 10/11/00
CITY OF TIGARD BUILDING INSPECTION DIV'.20ION
24-Hour InMSTspection Line: 639-4175 Business Lir--: 639-4171 --
BUP
Date Requested Z' -2 _—AM -PM _ _ BLD �—
Location X 33 5� �-�1.��S�4.— Suite
MEC
Z '_
Ccntact Person !.,ilei r" Ph .5" y PLM ^
Contractor Ph _ SWR
BUILDING Tenant/Owner 0e'5? GA','41a17Pu ELC _
Retaining Wall ELIR
Footing Access:
Foundation FPS
Fig Drain SGN _
Crawl Drain Inspection Notes ----------------
Slab SIT
Post& Beam ----- ------- —
Ext Sheath/Shear
Int Sheath/Shear - -
Framing
Insulation —
Drywall Nailing
Firewall --- —�-- _- -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof -
Misc - -- --- . _
Final
PASS PART FAIT_ - --- --- --- -----
PLUMBING
Post& Beam --- -
Under Slab
Top Out
Water Service
Sanitary Sewer - ---
Rain Drains
Final
SS _PART FAIL.
ANc- S M - --- - --
Post& Beam ---- - -
Rou h In
Smoke Dampers
i - - -
PART FAIL
MItTIR ---
Service
Rough In _-- ------- -- ---
UG/Slab
Low Voltage -
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading -- - ---- -- —
Sanitary Sewer
Storm Drain [ J Reinspection fee of$_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Please call for reins
Fire Supply Line I J F ion RE: [ J Unable to inspect no access
ADA �7
Approach/Sidewalk
IU
other _ ate _Inspector— Ext
Final
PASS PART FAIL DO NOT R MOVE this inspection record from the join site.
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