15405 SW KENTON DRIVE 15405 SW Kenton Drive
A
CITif OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#. MEC2003-00240
13125 SW Hall Blvd., Tigard, OR 0223 (503) 639-4171 DATE ISSUED: 5/9/03
PARCEL: 2S1 12CB-1 0800
SITE ADDRESS: 11 105 SW KENTON OR
5 UBL
')IVISION: ',,,)HFORD CAKS NO. 2 ZONING: R-7
BLOCK: LOT: 122, JURISDICTION: TIC'
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE 0= USE: SF UNIT HEATERS. VENT FANS:
OC-:UPA,gCY GRP: R3 VEN TS W/O ADPL: VENT SYSTEMS:
STORIES: _ BOILERS/CG_MPRESSORSHOODS:
FUEL TYPES 9 - 3JHP: DOMES. INCIN:
LPG 3 ;{P: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?- 30 - 50 HP: WC)ODSTOVES:
GAS PRESSURE: 50 + HP: CLO [DRYERS:
FURN OOK BTU: _ AIR HANDLING UNITS _ OTHFR UNITS:
FURN >=100K BTU: <_ 10000 cfm: GAS CUTLETS:
> 10000 cfm:
Remarks In.t.Ul;r.i.ui „I 12; gas Outlets fair gas store anal gas cooktoh.
Owner; _ FEES
GERALO J. MOORE Description Date Amount
15405 SVVJ KEN]"ON DR NII Cl I l Pcrmit I cr 5/9/03 $7250
TIGARD -)R 97224 i 1 .\NI x"„State"fa.r 5/9/03 $5.80
Phone: 503-X66-4 142 L Total $78.3U
Contract_r: _
HEAVENLY HEAT DBA P. SHAMBERG
PO BOX 647
DONALD, OR 97020 REQUIRED INSPECTIONS __
Gas Line Insp
Phone: 503-o78-31)rcO Final Inspection
Reg#: LIC 147952
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
not started within 180 days of ist,uance, or if work is suspended for (nore 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 952-001-00
Issue By: �a Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the rext Lisiness ds
Mechinical Permit Application '
Rcccwal Mechanical
Date/By. 'q i l i'crmit No.:
Planning Approval Building
city of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. 11 Plan Re%iew Other
Tigard,Oregon 97223 Date/By: Permit No,:
Phone: 503-639-4171 Fax' 503-598-1960 Post-Revicw [-and Use
Date/By: Case No.: _
Internet: www.ci.tigard.or.0-. ContactSee Page 2 for
24-hour Inspection Request. 503-639-4175 Narnc/Method: r G Supplemental Inrarmation._
_ TYPE OF WORK COMMERCIAL FTs;''SCHEDULE-USE CHECKLIST
New construction Demolition Mechanical permit fees•are based on the total value of the work
Addition/alteration/re placement Other: performed. Indicate the value(rounded to the nearest dollar)of all
--
CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit.
1 & 2-Famil dwellin Co�mmerr lal/Industrial Value: S_ See Page 2 for Fee Schedule
y g - RESIDENTIAL EgUIPMENT/SYSTEMS FEE''SCHEDULE;
Accessory Building90tilcir:
Multi-Family _ Desr•iplion ( Fee ea. Total
Master Builder � - Hestin r Coollu —1
JOB SITE INFORMATION and LOCATION Furnace-add-on air conditionin " - 14.00 _
Job site address: -V4 o KE.a;TI^r-1 L7>K. - Gas heat pump14.00 _
_Suite #: I Bldg/Apt.#: Duct work 14.00 _
Proj�est Name: - H dronic hot waters stem 14.00
—� Residential boiler
Cross street/Directions to job site: for radiator or h dronic s stem 14.00
Unit heaters(fuel,not electric)
in wall,in-duct suspended,etc. 14.00
Flue/vent for any of above 10.00
Subdivision: - -- Lot#: Re air units 12.15t
__ Other Fuel A [lances
Tax map/pa cel #: _Water heater 1 10.00 -
—DESCRUTION OF WORK Gus fireplace 10.00
Flue vent(water heater/ as fir lace) 10.00
-__--- -- _-- -----
log lighter(gas)_... 10.00 -
--- --- - — Wood/Pelletstove 10.00 _
Wood fire lace/insert 10.00
-�--e Chiinne /liner/flue/vent _10.00
PROPERTY O`NN_ E_R i TENAN T Other: 10 1)0
Name: F <] r OOG�E Environmental Exhaust&Ventilation _
t-( = 1--1�1- Range hood/other kitchen equipment 10.00
Address: lb q f.,5- 5 .,�� (<-C-1 _ Clothes dryer exhaust 10.00
_Cit /y State/Zip: z'!c /'-?Q--r-L-qLT? L4--- Single duct exhaust
L Phone:rc.,- - t L Fax: (bathrooms,toilet compartments,
APPLICANT CONTACT PERSON utilityrooms) 6 80
! - Attic/crawls ace fans 10.00
Name': �--- --
--- ----------- -- — Other: 10.00
Address: _— Fuel PIPInit
City/State/Zip: ``CS5.40 for oral 4,$1.00 each addltlond
Phone: _ r1 aX: Furnace,etc. _
Gash eat pump "
Wall/sus ended/unit heater "
F C69TRACT0It Water heater
_Business Name: :4 H ff c R T- Fireplace
�`."
Address: F '. '� as
_City/State/ > iJL, aJ/�'�'C> Clothes dryer as
Phone. ( '7 , 4; 1�1 ax: _ _ Other: _yam I " �-
CCB Lic. #: W2 7`�4�ems►" _ Total:
Mechanical Permit Fees _
Authorized Subtotal: S _
Signature: _-__ _�- bate: J ,3 --_ Minimum Permit Fee$72.50 S .�—
Plan Review Fee 25%of Permit Fee S
- _. t Please hent name) --�� State Surcharge(8%of Permit Fee S
TOTAL PERMIT FEE $�
Notice: Th1c permit application expires If a per mil is not ohtained whhfn •F'ee methodology set by Trf4'ounty Building Industry Service Board.
180 days after 11 has been accepted as complete •'Site plan required for exterior AA units.
is\Dsts\Permit Foenns\MecPernu1App.duc 01103
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation:$1.11Permit Fee:
0 to$5,000.00 —_ — Minimum fcc$72.50
$5,001.00 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 the first$10,000.00 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 and including
$50,000-00.
_t5. 01.00 and up $742.00 for the first$50,000.00 and
I $1.20 for each additional$100.00 or
I�____ fraction thereof. _
Assumed Valuations Per A liance:
Value Total
Descri tion: _ t Fa Amount
Furnace to 100,000 BTU,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
fair units SOS
<3 hp;absorb.unit, 955
to IOU BTU 1,700
3-15 hp;absorb.unit,
101k to 500k BTI1 —
15.30 hp;absorb.unit,501k to 1 mil. 2,310
BTU
30-50 hp;absorb.unit, 3,400
1.1.75 mil.BTU
>50 hp;absorb.unit, 5,725
>1.75 mil.BTU _
Air handling unit to 10,(1(10 ci'm 656
Air handling unit>10,000 cfm 1,170
Non-portable evaporate cooler 656 Y_
Vent fan connected to a single duct 446
Vent system not included in appliance 656
_Lennit
Flood served by mechanical exhaust 656 _
Domestic incinerator a 1,170 —
Commercial or industrial incinerator 4,590
Other unit,including wood stoves, 656
inserts,etc. '
Gas piping 1-4 outlets 360
Cach additional outlet 63
i o'rAl,COMMERCIAL $
VALUATION:
ODst0ernut Forms\Mecl'crn*AppP92.doc 01/03
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
IIJSPECI ION DIVISION Business Line: (503) 639-4171
�-7� BUP -- -- -
Received of Date Requested __AM_ PM BLIP
Locaticn _ z c' Ov, Suite _ MEC :3 __6Q yL'
Contact Person ^rlan � ���' Ph(_ ) �_/19 3U�' y PLM _
Contractor ___ _ _ Ph(--) SWR
BUILDING Tenant/Owner ---.__ EI_C -__
Footing ELC
Foundation ACCL'Ss:
Ftg Drain ELF! _
Crawl Drain —
Slab Inspection Nates: SIT -
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing _-- ___- -- - - ___.. -----------
Insulation
Drywall Nailing
Firewall
Fire Sprinkler --
Fire Alarm /
Susp'd Ceiling -�
Roof —
Other -
Final
PASS KEIT FAIL
--
PIUMBI'4G _
Post.4 Beam r.L_
Under Slab ----- _-- _ —_
Rough-In
Water Service --
Sanitary Sewer r
Rain Drains -
Catch Basin/Manhole mo =w'fes'
Storm Drain -
Shower Pan
Other: -------.------
Final
PASS PART FAIL .—�_____�_--------_--
IM&WA_L _.__ _._ --- -- -
Por;:& Beam — - -
Rough-In --
o e
n-e-)Dampers — -- -
Final
PASS PART FAIL - "--
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm --�--_----- !--_—
Final Reinspection fee o1$ � required before nex!inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART F] Please call for reinsp ction RE:_ _ Unable to inspect-no access
Dire Supply Line
ADA
Oahe Inspncltor � Ext
Approach/Sidewalk .%1
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL.