11420 SW DAWN'S COURT C
U
C
11420 SW Dawn's Court
1\ CITY O F T I G ® R _ MECHAR!Ir:AL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00511
DATE ISSUED: 11/15/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134DC-06900
SITE. ADDRESS: 11420 SW DAWN'S CT
SUBDIVISION. DAWNS INLET ZONING: R-4.5
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: UTR _ FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL. VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS.
FUEL TYPES 0 3 HP: DOMES.
WOD 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 • 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP: CLU DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITS OTHER UNITS:
FURN >-=100K BTU: <- '10060 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation ut woodstove insert
_Owner: e _FEES
KENNETH DAVIDSCN Description Date Amount
11420 SW DAWNS CT I MF:C'III Permit Fee 11/15/02 $72.50
TIGARD, OR 97223 1 ME CII J Permit Fee 11115/02 $0.00
[TAX]81/o StateTax 11/15/02 $5.80
Phone: 503-624-1072 [TAX] 80%StateTax 11/15102 $0.00 .I
Contractor: _ Total $78.30
OWNFR
REQUIRED INSPECTIONS
Woodstove Insp
Phone: Fi,gal Inspection
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laver;. All work will be done in accordance with approved plans. This permit will expire if worts is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION- Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are spat forth in OAR 952-001-00
Issued By: Permittee Signature: 1 - `__ �_�_ r
— ---— —
Call (503)639-4175 by 7:00 P11. for inspections needed th,, next businass day
\� Mechanical Permit Application
Date received:/ /rDr Permit no.:
(.ity of Tigard Prgject/appl.no.: _ Expir date:
C'i.v(P.,I'if nn/ Address: 13125 SW Hall Blvd,Tigard,OR 97223 bate issued: B Receipt no.:
Phone: (503) 639-4171 type:
Fax: (503) 598-1960 Case file no.: Payment
Building permit no.:
Land use approval: _ ----"
t '
U Multi-family U Tenant improvement
:�Uew
&2 family dwelling or accessory U CommerciaUindustrial y
construction U Addition/alteration/re-placemen( Ll Other:
t t
Indicate equipment quantities in boxes below. Indicate the dollar
Job address:/�y� t7 t� J/r- 6�j1 �f` value of all mechanical materials,equipment,labor,overhead,
Bldg. I Suite no.:
profi►, Value$
Tax map/tax lot/account no.:
Lot: Block: Subdivision: *See checklist for important upplication information and
jurisdiction's fee schedule for residential permit fee.
Project name'
City/counZIP: 1
r t
Description and location of work on premises:, — I ftYlca.) Total
12 4C 1,
//V< _ Res.only R-smols
Ihu•riplion �
Est.date of completion/inspection: C:
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned?U Yes U Nu ir c
Aon itioning(site P an required)
Is existing space insulated'?U Yes U No Alteration of existing system
1 --Boiler/compressors
State boiler permit no.:
Business name: r_ (' _ HP Tons BTU/H _
Address: Fire/smoke amr, duct smo a electors
pe
J State: Z.IP: eat pump(site p an rcqu re )
City: - nsta rep ace urnace/burner 3
I ncluding ductwork vent liner U Yes U No
E-mail:
Pltf me: ax:_ I _
CCB no,: _ nstall/t aceTre Dente eaters suspen e
City/metro lie.no.: wall,or floor mounted _--
cnt l'or a lance of er t Ian urnace
Name(please print): Refrigeration:
cONTACt PFR'4014 Absorption units _ BTU/11
Chillers__ -- HP
Name: _ - Com ressors — HP
Address: _ nv ronmenta exhaust and vent at on:
City:_ State: ZIP: Appliance vent ---
E-mail: fryer exhaust
Phone: 1 ;t� oo s, ypc , /ra.kitc ten azmat
hood fire suppression system --
C Exhaust fan with single duct(bath fans) _
Name: C "� !9 sI — x roust syst_e�mapiu from Icatin or L
Mailing address: j/ rf V S W A 4/S_ rte_ Fuel p�Tg� str tut on lop to If outle
_City: /1 State:Q%L ZIP: 1rf ? t Type; _LW NG oil
s)
_
Phone: e,ry-/�%,t Fax I mail: uc i ingcacta ditiona over ouTets
r rocesspiping(sc ematicrequire 1
Number of outlets
Name; ___ t eripsi app ante or tequ pment:
Address: Decorative fireplace
--- .!. — _ Slate:__
ZIP:
nsert-l e
City: _ Woo stov_ et
Phone: Fttx; �E stove
mail: fit c>F t r
Applicant's signature:" �/ _r Date: —)'�tT�ei:—
(p r. ,('E-N�1yFTi� ,••'t rte^' - - _,
Name not Permit f_.. $
............
Not oil Jurisdictions accept credit cards,pleas cell jwisdiction f m mtxe Information Notice:This permit appl'cation Minimum fee................$
U Visa U MasterCard expires if a permit is not obtained plan review(at ___ %) $ —
Credit card number within 180 days ar'.^r it has been State surcharge(8%) ....$ �1
Name of cardholder as shown im cre:dit cd is
TOTAL ......
accepted as complete. ........... .....$
-- Canlholder signature
"I-M17(ISWCOMI
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDUI-E: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
-- _ -1 -- - --- - -
TOTAL VALI IATION. P_ERMIT_FEE. Description Price Total
$1.00 to$5,000.00 _ Minimum fee$72.50 1) F na Mechanical Coda __-_ Qh (Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to ducts
& 0 BTU
$1.52 for each additional 5100.00 or including ducts&vents 14.00
fraction thereof,to and Ir cluding 2) Furnace 100,000 BTU+
_
$10,000.00. Includingducts&vents 17.40
$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
$25.000.00. 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 6.80
fraction thereof,to and including 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 Puma Cond
_ fraction thereLf. footnotes below.
Comp
Minlmum Permit Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit
$ to 100K BTU 14.00
- - 8)3-15 HP;absorb
8%State Surcharge $ unit 100k to 500k BTU 25.60 _
259/.Plan Review Fee(of subtotal) � 9)15-30 HP;absorb I J 35.00
Required for ALL commercial permits onlyunit.5-1 mil ;a
TOTAL COMMERCIAL PERMIT FEE: $ unit
301.7 mi absorb 52.20
unit 1-1.75 mil BTU
11)>50HP;absorb
unit>1.75 mil BTU 87.20 -
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00
Value Total Ea Amount 13)A!r h:iidling unit 10,000 CFM+
17.20
Description: D
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 furnace includin i vent 955 16)Venlilarion system not Included in
Suspended heater,wall heater or 955 appliance permit 10.00
floor mounted heater 17)Hood served by inachanical exhaust
Vent not Included in appliance 445 1 10.00 -
permit 18)Domestic incinerators
Repair units 805 17.40
<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;ahsorb.unit,501k to 1 2,310 21)vas piping one to four outlets
mil.BTU 5.40
30-50 tip;absorb.unit, 3,400 22)Mire than 4-per outlet(each)
1-1 75 mil.BTU _ _ 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: 5
>1,75 mil.BTU I _
Air handling unit to 10,000 cfm 656 J - 8%State Surcharge a
Air handling unit>10,000 cfm__ 1,170
Non-portable evaporate cooler 656 TOTAI RESIDENTIAL PERMIT FEE:
Vent fan connected to a single duct 446
Vent system not Included in 656 -- - - -- -
81PPITEeepermlt Other Inspections and Fees:
H9T served_by mechanical exhaust 656 1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic Incinerator 1,170 $62 50 per hour
Commercial or industrial Incinerator 4,590 _ 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour)
Other unit,Including wood stoves, 656 $62 50 per hour
Inserts,etc. _ a Additional olan review required by changes,additions or revisions to plans(minimum
Gas iping 1 4 outlets_ 360 charge-one-half hour)$62 50 per hour
Each additional outlet _�. 83 'State Contractor Boller Certification required for units>200k BTU.
..Residentlai AIC requires site plan showing placement of unit.
TOTAL COMMERCIAL s
VALIJj%TION: All Nov.Commarciai Buildings require 2 sets of plans.
I:%dstslfonnslrnech-fees.doc OV11102
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP
--- --- ._
Received _ Date R ested , �'Z'' AM_—_ PM— BLIP
Location � rSuite _ MEC 0 ' c�dam_
Contact Person �-n--� ! Ph (_ ) y ZD 7 2, pLM
Contractor_ Ph(_ ) SWR
BUILDING Tenant/Owner -_. ELC
Footing
Foundation
access: ..� _ ��^, ELC
Ft9 Drain ELR
Crawl Drain --�-1-�
Slab Inspection Noteg" / -_ SIT -
Post&Beam
Shear Anchors --77 - -
Ext Sheath/Sheai z d`
Int Sheath/Shear -
Framing _ -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler � �ov
Fire Alarm
Susp'd Ceiling _
Roof
Other:
Final
PASS PART FAIL - - --
PLUMBING _
Post R Beam
Under Slab _
Rough-In
Water Service
Le
Sanitary Sewer
Rain Dr-tins --
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: --
Final -
_ RT FAIL -�- -- ^^ --
ECHANICA
Rough-In --- ---- _ -------
Gas Line
Sm ke Dampers -
ilia
PART FAIL - - - — —_-
EL TRICAL
---
Service -- -- ---- ---- -
Rough-In
UG/Slab --- -- - - - -
Low Voltage
Fire Alarm - — -
Final ':1peinspection fee of$
PASS PART FAIL --required before next inspection, Pay at City Hall, 13125 SW Hall Blvd.
SITE ` _`_— F] Please call for reinspection HE:_ r-_ F-1Unableto inspect-no access
Lin
Fire Supply o Ext.y
ADA Date / i -�.
Approach/Sidewalk II�� • a Inspector
!_ � _
Other:
Final DO NOT REMOVE this Inspection record from the poh site.
PASS PART FAIL