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CITYO F T i GA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00063
13125 SW Hall Blvj., Tigard, OR 97 223 (503) 639-4171 DATE ISSUED: 02/23/2001
PARCEL: 1 S 134AA-00900
SITE ADDRESS: 11344 SW IRONWOOD LP
SUBDIVISION: ENGLEWOOD TONING: R-4.5
BLOCK: LOT: 016 JURISDICTION: TIG
CLASS OF WOZK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE:: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORSHOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
I-PG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
--- OTHER UNITS:
FURN >=100K BTU: <= 10000 Cf m: GAS OUTLETS: 0
> 10000 cfm:
Remarks: Install gas furnace.
Owner: _ __ — FEES
BREWER,WILLIAM W AND Type By Date Amount Receipt
NANCY I_ PP,MT CTR 02/23/20( $72.50 2720010000
11344 SW IRONWOOD LOOP 5PCT CTR 02/23/20( $5.80 2720010000
TIGARD, OR 97223 — _ — _._
Phone: _-
Total $78.30
--- — - ----
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 972.02 REQUIRED INSPECTIONS
Heating Unt Insp
Phone:503-234-7331 Final Inspection
Reg #:LIC 1441
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is riot started within 180 days of issuance or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: Permittee Signature:
Call (503)639-4175 by 7:00 P.M. for inspec tions needed the next busines day
Mechanical Permit Application
Z\.1 Date received:?- al Permit no.: _ 4
CityCi of Tigard —
gi Projecl/appl.no.: Expire date:
City o f F4y ss: 13125 SW Hall Blvd,Tigard,OR 97223
Phone.: (503) 639-4171 Date issued: 2 2 � B Receipt no.:
FaMr3) 598-1960 I L'� Case file no.: Pa 6 nttype:
VES
r' I U V, --
V LS Land use approval: Building permit no.:
Mail
J-11 2 fam-:y dwelling or accessory U Cc,nmercial/industrial U Multi-family U Tenant improvement
U *%; construction U A(Idition/al(cration/replaeemer,l U Other: ._.
jOB SITE INFORMAI ION, COMMERCIAL VALUATION SU11111111111LE
Joh address: Ll 1- r,W JWC-l UJCA.yl 1)0Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,c,Juipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
L,ot: Block: Subdivision: *See checklist for important application information and
Project nam -11
, J//4-1, � j r-c ep r^ — Jurisdiction's fee schedule for residential permit fee.
VIA, BE
City/county: 1 1 r I ZIP: 7k 1111W 111H
Description and 1 ation of work on premises:. _
,A h/s7f1 t.L 6t'n Fee(ea.) "Total
Est.date of completion/inspection: melon Qty. Res.only Res.only
Tenant improvement or change of use: C.
space heated or conditioned?U Yes U No Air handling unit _CFM__
Is existing P it conditioning(site plan required)
Is existing space insulated?U Yes U No Alteration of existing ]VAC system
oiler compressors
Business nam:: - c F. e y State boiler permit no.:
_1N GUt� , �� t_ _s_ HP Tons BTU/14
Address: ,/ ?,. 3F ,/) /L(-? r ire/smo adamper. smoke detectors
City: ?G,,- Q., Slate:j�;C I ZIP: 9 7 Z cat pump(site plan required)
Phone: Install/replace— furnace wrner
CC B no.. Including ductwork/vent liner O Yes U No
>✓ nsta /replace/relocate eaters-.suspended,
City/metro lie.no.. (a wall,or Moor mounted
Name(please rint): "'H Ile) c u Vent fora iance other than furnace
Refrigeration:
Ahsorptionunits___ BTU/11
Name: ut/�.�/ f'
Address: --T' Com ressorti III'
nv ronmenta ex must an vent at nn:
City: _ State: l.IP: Appliance vent
Phone: ; Fax: [:-mail: )ryerexhoust
too s, ype res. itc en/ azma
hood fire suppression system —
Name: J-, ", Exhaust fan with single duct(bath ft ns) f
Mailing address: 1 r ! T Exhaust system n arl from heating,rr AC J
City: r ^ State:Gy1 ZIP: 9 7 .> Oe p ....g andistribution(up to out ets)
Type; LPG __ NC __ Oil
Phone:,,;' U i Fax: L-mail: ue i in eacTi a it+ons over out cts
rocesspiping(schematicrequ re )
Number of outlets
Name: !! _ - ter listed appliance or equipment.,
Address: Decorative Fireplace _
Cit — ZIP: Insert-type
Phone: Fax: mail: Wooditeve/pellet stove
Other:
Applirant's signature: _ I rrtr: .-TWITOF
Name (print): �—
Not all Jurisdi•:tom accept credit cards,please ca!1 jurisdiction for more Information. Permit fee.....................$ _
Noticc:"Phis permit application Minimum fee................$ _
U Visa J Mm,terCard expires if o permit is not obtained
Credit card number: — Plan review(at ` %) $
na
Name _ within 180 days atter it has been ---- —
as com tete. State surcharge(8%x)....$ J
of car of r ass own on credit c accepted S P T(1TAL .............. ........$ --_- -
- Cardholder signature Amount 440-4617(&% OM)
3Z 7
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total-
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code ary (172) Amt
$5,001.00 to$10,000.UO $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&vents 14.00
fraction thereof,to and including 2) Furnace 100,000 JTU+
$10,'00.00. includinq ducts&vents 17.40
$10,001.00 to$25,000.0G S'48.50 for the first$10,000.0,3 and 3) Floor Furnace i
$1.54 for each additional$100.UO or including vent _ 14.00 -_
fraction thereof,to and including 4) Suspended heater,wall heater
_ _ _ $25,U00.00. 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 _ _ G.80
fraction thereof,to and includ;ng 6) Repair units
__ $50,000.00.
$50,001.00 and up $742.00 for the first$50,000.00 ani Check all that anply: Boiler Heat Air
$1.20 for each additional$100.00 ui For sterns 7-11,see or Pump Cond
fraction thereof, footnotes below. Com ••
v- �- - --- �- 7)<3HP;absor.,.snit - - �- -�-
ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU ___ 14 00 l __
8)3-15 HP;absorb j�
Value Total
Descrl tion: I Qt Ea _ Amount unit 100k l0BTU _
Furnace to 100,000 BTU,including 955 9)15-30 HP;; 5 60
absorb
bs
unit.5-1 mil BTU 35.00
ducts&vents ---�
''urnace>100,000 BTU Including 1 170 - unit
301.7 mil absorb
unit 1-1.75 mil BTU 52.20 _
ducts&vents __-- 11)>50HP:absorb
Floor furnace Including vent 955 ___ unit>1.75 mil BTU I 87 20
Sullpended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
tioor mounted heater 10.00
Vent not Included in applica.nre 445 13)Air handling unit 10,000 CFM+
permit ____ �____. 17.20
Re"pi, 805 _____ 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 10 GO
to 100k BTU --- 15)Vent fan connected to a single duct
3-ib-hp;abr•orb.unit, 1,700 _ _ 6.80
101k to 500k BTU ---- 16)Ventilation system not included In
15.30 hp;absorb.unit,'\f?IkIk to 1 2,310 appliance permit 1000 _
mil.BTU 17)Hood served by mechanics;exhaust
30-50 hp;absorb.unit, 3,400 _ 10.00
1.1.75 mil.BTU 18)Domestic Incinerators
>50 hp;absorb.unit, 5,725 _ 17.40
>1.75 mil.BTU 19)Commercial or industrial type incinerator
Air handlingunit to 10,000 cfm 656 69.95
Air handling unit>10,000 cfm 1,170
Non-portable evaporate cooler 658 20)Other units,including wood stoves _ 10.00_ _
Vent fan connected to a single duct 446 _ 21)Gas piping one to four outlets
Vent system not Included in 656 _ 5.40
2pyllarce permit _ _-_ 22) acre than 4-per outlet(cath) ---- - --�
Hood served by mechanical exhaust 656 1.00
Domestic Incinerator _ 1 170 - Minimum Permit Fee$72.50 SUBTO TAIL: $
Commercial or industrial Incinerator 4,590
Other unit,Including wood stoves, 658 �.-_------ 8%State Surcharge _
Inserts,etc. _
_Gas piping 1-4 outlrt^ 360 - 25°/.Plan Review Fne(of subtotal)
Each additional.utlet63 Rewired for ALL commercial permits only
TOTAL COMMERCIAL Pt-
TOTAL. RESIDENTIAL PERMIT FEE: $
VALUATION:
Other Inspertlono and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72 50 per hour.
2 Inspections for which no fee is specifically indicated (minimum charge-half hour)
$72 50 per hour
3 Additional plan review ruyuired t,,;,isnges,additions or revisions to plans(minimum
charge-one-half hour)$72 5L mer how
'State Contractor Boller Certification required for units>200k flTU.
*"Residential A/C requires site plan showing placement of unit.
IAdsts\formslmech-fees.doc 10/11/00
CITY OF TIGARD BUILDING INSPECTION DIVISION Msr
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 �—
2
BUP __—
_Date Requested 3••- / — AM _PM BLD.
Location } sw� r� - u��� _ Suite
Contact Person ��/l �� Ph � _�� y PLM
Contractor Ph SWR
BUDING — Tenant/Owner
IL — —FELC
FRRetaining Wali ELI2 _
Footing Access: .�
Foundation 7 FPS
Ftg Drain -� SGN
Crawl Drain Inspection Notes --------
Slab _�_--- — --- — ----- SIT
Post&Beam —
Ext Sheath/Shear
Int Sheath/Shear —
Framing i� ;%n 1(!�_� ��c'C i; 7--
Insulation Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
SuspA C1.11ing
Roof
Misc —__----
Final
PASS PART FAIT-
PLUMBING
Post& Bear-11 — -- — — — — — --V
Under Slab
Top Out ------------- ------- -
Water Service
Sanitary Sewer ._.._—
Rain Drains
Final
PASS_ PART FAIL
CHA
ost&Beam ----- - - ----- -- -- - — --------
Rough In
Gas Line � �.,��..<< - — ----- ---
Smoke Dampdrsu — -- -------
Final —
±ASS FART FAIL
ELECTRICAL -- --- --- __--__---- - --------------Service
Rough In —�� --- J--- ---
UG/Slab
c•w Voltage
�Final
Fire Alarm
---------------------__---
PASS_ PART FAIL
SITE
Rackflll!"rading -- ---- - ----- ----- --------- ----- —
San?'ary Sewer
Storm Drain [ ]Reinspection fee of$ — rec;uired before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply line [ ]Please call for reinspection RE:-- __ --_ [ ]Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date L2 _ _—_ Inspectors _ —_ Ext ^�
Final —
PASS—PART FAIL DO KNOT REMOVE this inspection record from the job site.