10110 SW KENT PLACE 7M
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10110 SW Kent Place
CITY OF TIGAR®
A
_ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT# MEC2002 00021
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUER: 1/10/02
PARCEL: 2S114BB-03700
SITE ADDRESS: 10110 S'N KENT PL.
SUBDIVISION: PICKS LANGi`1G N0.1 ZONING: R-4.5
p,._��;;. LOT: 051 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR F` & Ew(AP COOLERS:
TYPE OF USE: SF 'JNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS_ _ HOODS:
FUEL TYPES 0 3 HP: DOMES. INCIN
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 30 HP: REPAIR UNITS:
FIFE DAMPERS?: 30 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTIt: AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:—`v GAS OUTLETS- 1
> 10700 cfm:
Remarks: Installation of gas piping for one outlel
Owner: _ �--' _FEES
BURKS, JENS F AND REBECCA L Type By Date Amount Receipt
10110 SW KEN PLACE PRMT CTR 1/10/02 $72.50 272002000C
TIGARD, OR 97223 5PCT CTP 1/10/02 $5.80 '_(2002000C
— Total $78.30
Phone: _ - ----
Contractor:
HOLMES 'NSTALL.ATION SERVICE
RAYMON D FLANDERS
33535 NW JADIS ROAD REQUIRED INSPECTIONS
CORNELIUS, OR 97113 Gas Line Insp
Phone:647-9320 Final Inspection
Reg #:LIC 102473
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approver]
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oreton law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. 'r ou may obtain copies of these rules or direct questions to OUNC by calling
(tin AV2Ar;-al ga
Issue By: /, (ice/ Permittee Signature:
C811 (503)'6394175 by 7:00 P.M. for Inspections needed the next business day
l' a Aawnieal Perruit.Application
Date received: Permit no.:
City of Tigard Project/appl.no.: Expire date: �-
(tr, Address: 1312.5 SW Ifall Hlvd.Tigard,OR 97223 --
Phone: (503) 639-4171 Date issued: By: Receipt no_:
Fax: (503) 598-1960 Case file no.: Payment type:
LanJ use approval: huddiny pernnt no
& 2 f,unily dwelling or accessory U Commercial/indw mal U Multi-family LI Tenant improvement
U New construction ]Addition/alteration/replacement U i)cher.
011I.S1 11, a •
Joh address: (� / C Fni P r•:��_ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no...____— value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ ___
Lot: Block: I Su di, isinn _ 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: � ZIP: IMMM lAdIMIMMILMN 101
Description and location of work on prv!wises: I A,r,
1(ryea.) total
Est.date of completion/inspection: IAwc•ription (Ay. Res.only Res.only
Tenant improvement or change of use:
Is existing space heated or conditioned'?U Yen U No Air handling unit ___ CFM
Is existing space insulated'?U Yes U No A rcon icon ng(sue plan uquirecTj
g p Alteration of existing IIVAC system
of er compressors
;Z.asiness name: 0"{ (' T(^ f►�r` Stetc holler permit no.:
Address: G./-"— �A 01 c„ HP Tons__B'1 rs
rir•smo a amper uct smo eaetectors
City: yy I State: r' I ZIP: tleat pump(site plan required)
Ph. Fax: E-mail: osis rep flee urnac canner__ /
CCB no,; b ll Including ductwork/vent liner U Yes U No
nsta rep ac re ocale healers--suspcn e(,
City/metro lic.no.: l ? _ wall,or floor mounted
Name(please p)int): 1�- 'C! -(' 5 vent for a,i'I�tannce other than furnace N^
e gest o9 n:
Absorption units_---_ BTU/H
Name: Chillers _ III'
Address: /p d �,� Compressors
--- m ronmenta ri, ausr and vent at un:
City: (Oct,1J Slt'le LIP: J Appliance vent _
Phone: - 0 Fax: Email: )ryerex hausi --
uo s, ypc / I res, itc a azma(�—
hood fire suppression system _
Name: i;xtih-ist fan with single duct(hath fans) ` —
Maflin� dress O I 10 Ex gust system apart from Itcalm or AC.
City: „S Stat ZIP: 7 Z Z, ue piping and, t on(up to outlets)
— — -. fyI)e: LI t, NC Oil
Phone: -b S lax: E-ma l: ue t n enc a al ilio over out
rocem p p a(v hematic required) _
Name: Numhcr of outs(:.,
--- A er slM app once or equipment:
AJdress: _ Decorativc fireplace
City: _ — State: �IP: Insert-type —
Phone: Fax: ' E-mail: t ocrstov et stove
Applicant's signature: _ Date:
Name (print):
Nall juddkanru seer ,It redli came, au+call iuri aliens,Im mnre i rfannailon Permit !Ce...... .............
d or
Notice:This permit application Minimum fee................$
U Visa U MaeterCard expires it's permit is not obtained plan review(at — %) $
PTC rs within ISO days after it has been
-iaune of c oti-der as shown oa CAP i evWd-'"-" accepted as complete. TOTAL ....$State surcharge(89F}.... —_
_ S
Carer sleatrre _««�` —Amount 4104617 16K)WOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: PnTotal
Oty (Ea)
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Arnt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 0 BTU
Includingductscts&vents 1400
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
$10'0L00,00' ------_-
fraction thereof,to and Including including ducts&vents 1740
- --- -"
$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 14.00
$25 000.00. or floor mounted healer _
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit 6.80
$1.45 for each additional$100.00 or
fraction thereof,to and incluc Ing 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: Boller Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp
Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<31-111;absorb unit
14.00
to 100K BTU
8%State Surcharge $ 8)it 15 k to
absorb
unit 100k to 500k BTU 25.60
25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb
unit.5-1 mil BTU 3501
Re ulred for ALL comma,^ial permits only10►30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1,75-mil BTU 5 .20
11)>50HP;absorb
-"- _-- ----- -
unit>1.75mil BTU 87.20
12)Air handling unit to 10,000 CFM
ASSUMED VALUATIONS PER APPLIANCE: 10.00
Value Total 13)Air handling unit 10,000 CFM+ -
Description: _ Qt 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 - 6.80
Floor furnaco Including vent 955 19)Ventilation system not included in
Suspended heater,wall heater or 955 appliance permit 10.00
floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included In applicance 445 10.00
permit 805 18)Domestic incJnerators 17.40
Re air units
<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 1,310 21)Gas piping one to four outlets
mil.BTU 5.4.0 -
30-50 hp;absorb.unit, 3,40( 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 _
Alr handlinu� nit to 10,000 cfm _ 656 -- 8%State Surcharge $
Air handling unit>10,000 cfm _ 1,170 _
Non-portable evaporate_cooler 658 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not Included in 656 -
a fiance erm - Other Inspections and Fees:
Hood aPrved by mechanical exhaust _858 1. Inspections outside of normal business hours(minimum charge-Iwo hours)
Domesdc Incinerator 1,170 S62 50 per hour
4,590 2 Inspections for which no fee is specifically indicated (minimum charge-hall hour)
Commercial or Industrial Incinerator
Other unit,including wood stoves, 858 $62 50 per hour
inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum
charge-one-half hour)$02 50 per hoar
Gagi e 1-4 ODUetB
Each additional outlet _ _83 - 'State contractor Bader Cerlification required for units>200k BTU.
"Residential AJC requhes site plan showing placement of unit.
T_OTAL COMMERCIAL S
VALUATION: _ All Now Commercial Buildings require 2 sets of plena.
i:\dsts\forms\merh-fees doc 12/26/01
CITY OF TIGARD BUILDING INSPECTION DIVISION h"ST
^^-Hour Inspection Line: 639-4175 Business Li ae: 639-4171
BLIP
Date Requested �/� —__AM_ --PM _ _ _ IBLID
Location 10110 AZ eVOl` PC, Suite MEC
Contact Person QFC u ;S Ph 'n5 ` PLM
Contractor Ph SWR -__��------
BUILDING Tenant/Owner ELC
Retaining Wall ELIR
Footing Access: FPF
Foundation -—----- - --
Fog Drain SGN
Crawl Drain Inspection Notes: ,�Lr �LL ��
Slab SIT
Post&Beam �.� le l D Q-- .� N --- --
Ext Sheath/Shear 0
Int Sheath/Shear
Framing
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler - - —�- -- -- -
Fire Alarm
S��ap'd Ceiling �� -- ---- — —
-- - -
Roof — ✓l I � �,
Misc: - - -
Fina! -----
PAS_S PART FAIL
,PLUMBING
Post&Beam -
Under Slab
Top Out -
Water Service
Sanitary Sewer
Rain Drains
Final
P 3PART FAIL
CHAN�'AlJ
Gas Lin -_
pg� eYbampers
Final -71 ---_
ZFtl PART" FAIL
ICAL
Service
Rough Ir
UG/Slab -_.-
Low Voltt ge
Fire Alarn - - �-----
Final
PASS 'ART FAIL
SITE _ _
Backfill/Grading - -- --- -- -- - _
Sanitary Sewer
Storm Drain ( J Remspec tion tee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ( F'leasr call for minspectinn RE: _ ( J Unable to Inspect-no access
Fire Supply Line
ADA r;
ApproachiSidewalk Date '�_Z_Inspector Ext
Other -�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the jolt site.