11315 SW 91ST COURT 11315 SW 915` Court
CITYO` T I G A R MECHANICAL PERMIT
IJEVEiG""RL IT SERVICES PERMIT#: MEC2003-00085
13125 SW Hall Blvd.. Tigard, OR 97223 (503, 639-4171 DATE ISSUED: 3/5/03
SITE ADDRESS: 11315 SW 91ST CT PARCEL: 1S135DB-11500
SUBDIVISION: DAKOTA GROVES
BLOCK: ZONING: R-4.5
-' LOT: 008 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN:
TYPE OF USE: SF EVAP COOLERS:
UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL.:
VENT SYSTEMS:
STORIES:
BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LP(_ 3 - '15 HP:
MAX INPUT: BTU COMM
L INCIN:
15 - 30 HP:
FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP WOODSTOVES:
FURN < 100K BTU: _ AIR HANDLING UNITS =LO DRYERS:
FURN >=100K BTU: <= 10000 cfm: OTHER UNITS. 1
> 10000 cfm: GAS OUTLET'S• 1
Rcmarks: "as piping and I outlet for bas logs.
Owner:
DONNA BECK Description Date
11315 SW 91ST CT Amount
TIGARD, OR 97223 [MECIII Permit F'ee 3/5/03 $72.50
(TAXI 8%,StateTax 3/5/03 $5.80
Phone: 503-598-8975 T.)ta1 $78.30 —
Contractor:
SUBURBAN@HOME
6014 NE 112TH AVE.
PORTLAND, OR 97220
REQUIRED INSPECTIONS
Phone: 503-257-5438 Gas Line Insp
Reg #: LIC 143335 Mechanical Insp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with apl roved
plans. This permit w 11 expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 clays. ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Votification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699.
Issued By: Permittee Signature: _
C Ill (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Date received? .C 2 Pcrmitno.()1EC _
City of TigardOM
Address: 13125 SW I lall Blvd,Tigard,OR 97223 Projcct/appl.no.: Expire date:
City nj Ti,r;and g
Phone: (503) 639-4171 Date issued: ByJ Receipt no.:
Fax: (503)598-1960 Case file no.: - Payment type:
Land use approval: Building permit no.:
t
XXI &2 family dwelling or accessory U Commercial/industrial U Multi-family
U New construction J Tenant improvement
U?1Jifili�rli/,rlteration/rrplacement U 00wi
Job address: Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ _
Lot: Block: Subdivision: *See checklist for important application information and
Project Hume: jurisdiction's fcc schedule for residential permit file.
City/county: CL ZIP: t
Description and Ioc ion of work on premises:_ ,p_1 , �,r t s t
+V.zxL � r� r�
Est. tc of completion/inspection: -_ I'�Y•(�•) 'Ibral
_ C• Description Qt - Res.only Res•onl
Tenant improvement or change of use: --
Is existing space heated or condilione l U No Air handling unit CFM
Is existing space insulated?U Yes [ oAu con It oning(sac plan require ) --
�,. teratton o cxisUng system Boiler/compressors
_Business name: VxA-, State boiler permit no..
Address: l�1I�-�Th 11- {�_ o Ht' __Tons BTU/l I
HIP
c orit!mr•.,% uct smo a electors
City: . - f State: ZIP:4catpumps f,an requ rc ) ---
Phone: lWit--) Fax i �r E-mail: nsta re lurnac urncr /
CCB no.: `y 3 _ Including ductwork/vent liner U Yes U No
City/metro lic,no.: nsta rep ac re ocatc caters-susp-e c , -
wall,or floor mounted
Name(please print): i (' (_`� enl Ior:i iance other than furnace —
e l;cration:
Absorption units_____ _ BTU/N
Name: Chillers _ HP
Address: Com ressors _ HP
City: State: 71P; IR ronmenta ex do an vent at on:
-- Appliance vent
Phone: rax: -mail: Drycrexhaust
0o s,Type res. tc en iaxmai - —
hood fire suppression system
Name: +� t (� Exhaust fan with single duct(bulli fans)
Mailing address: 1- �'
.,� 15V IQ �10
Mau srem apart from coria or C
0,V cA ': Fur"p p ng an dr m on(11 to out cts)
Phone. -71 1'ux: Type: 1.1'(; ,& NG __ oil tiO 5,40
I? moil: ucpipingeac a u Ina over outlets
r p ng(sc ematicrequire )
Name: Number of outlets
_ ste apance or empint:u
p( ity: 7ecorativefireacc
n - tatscr —
lot`tJ
ell-
Phone:
-'a x: :-mtul; oo stov l e ct-ii stove
" Other:Applicant's signature:' 1bate: -�t e --
Name (print):
Not all)ur Adicllone accepr crrdir carte,pleme call lurimliction for morr Information Permit fee...•.................$ -
LI Visa U MasterCard 'J arse:This permit applic,tion Minimum fee................$
r•rrdir card nun,her _L-f c+pires if a permit is not obtained ,
Expires within 180 days after it hes been Plan review(al _._ ) $
__ State surcharge 8%
Nmne of...0 al rTrr ar aliown nn cm U c accepted as complete. R ( ) $
_. _ s TOTAL .......................$
--Car-tr hal er alEnnlurr Ain
4404617(6"W*0M)
Commercial Schedule 1&2 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE Des ripti^^ oly Price Toul
-- Table to Mechanical Code
FurnP to 100,000 BTU t) Furnace t ooto�000 eru 14.00
955 Indudm duds E vents
including ducts&vents — 2) Furn,ce 100,000 aTu• 17 4s
Fum¢.ce>100,000 BTU taaudi dugs a veins
1,170 31 Fbor Furnace 14
.00
incluci a ducts&vents _ ind°dln Ve"t --
4) suspended heater,wa!I healer 14 00
floor furnace T Iloor mounted healer — —
955 660
including vent 5) Vent not inck in app!lance Peat'"
suspended heater,wall heater12.15
955 6 Repair units
or floor mounted heater — check att mal apply aotlor Heal Air on
Vent not included in
appliance permit 445 Fork 7.10,see
footnotes or Pump cons city Price Tool
tes 1,2 Corn ••
605 7)<3HP,absorb unit to 14.00
Repair units IUOK STU
<3 hp,absorb.unit 8)3.15 HP,absorb un6 2560
955 100k to 500k BTU _
to 100k BTU e)15T+P.absorb 35.00
unn.5.1 mil6TU —_-._ --- - -- -----'— ---
3.15 hp;absorb.unit 1700 IO) ,1 HPe B,a' _ 52.20
101k to 5001r BTU unn t•t 75 m
11)>'S011P,sbsu,..arse 1 75 mil aTU 67.20
15-30 hp;absorb.unit —
501 k to 1 mil.B1'U 231 0 -t 2j Alr helldimg unH to 10,000 CFM 1000
30-50 hp;absorb.unit 13)Air handhnq unit 10,00(j CFM• i--- i7.20 _
1-1.75 mil.BTU 3400 t4`)Ncr•p liable evaporate vrotcr
10.00
>50 hp;absorb.unit15)tient tan conneded to a singb dud 6A0
>1.75 mil.BTU 10.00
5725 --
656 18j VenUlalbn system not Induced!n
Alr handling unit to 10,000 cfm .pplancn Ixnn"--
1 170 17)Hund served by meaunlcal exhaust 10.00
Air handling unit>10,000 cfm _
Non- ortable evaporate roller 656 t8)t�silckldnoralors —lor
_ 17,40 -
vent fan connected to a single duct 446 19)Commercial industrial type lncmers
89,95
Vent syst.not Included In appliance ermit 656 20)cher unn— s;Mauarng w°°d slopes 10 00
Hood served by mechanlcal� 656 ____._----------
1170 21)Gaa P!Drn9 one to teat outfits —
Domestic Incinerator 22)More than i-iWl eutkt(Ha
4590ch)
1•so --
Commerclal or Industral Incinerator _ -.--
65fi Inlmum .60 Permit Fes 12SU13TOTAL
Other unit,Including wood stoves,inserts_,etc. — e%sunciwRoe
Gas i Ing 1-4 outlets 360 •-- F5I;REVICw25%or sualoM. .
Foch additional outlet fi3 Required for ALL commercial permits ont; —
`— — TOTA _�--
Olherinapasdonsand Faes
t inspmdMa oulssde of„e,mpl business hours Imnlmrm tl,e,ge Iwo h"'e)
972 W per hnurnKal KdKaled Im�n mum cha,ge tvs fide)
Inyxctexrs Ior•A,Kh r ire ro a1Kn: h
t72 ee pe hour
Adld-141 plan lsr K m4uued rewsms h lasna Imnn'urn
Pec _--- ed,a(ge p,e lye haul art da pa hour
Total Value ton_—_.- i SUln Conuarsnr llmle
tiquired
Ce,yerrw shovnw
-_--.-----.--. - •'nnldnMial A/c 11m.-PI{Ile Man "
piafllrK'nl d and
SI.00 to X5,000.00 - - Minimurn572.50
S5,601.00 to 510,000.00 $7250 for the first$5,000.00 and$1.52 for
each additional$100.00 or fraction thereof,
to and including$10,000.00
510,001 AO to$25,000.00 5148.50 for the first$10,000.00 and$1.SA
for each additional$100.00 or fraction
thereof,to and including$25,000.00
$25,001.00 to 55(1,000.00 for
17•)50 for the first 525,000.00 and$1 45
for each additional$100.00 or fraction
thereof,to and including$50,000.00
$50,000.00 rind up ----- -- 5742.00 for the f ist S50,09- and 51.20
for each additional S100.00 or fraalion
thereof _--.- -�_--------
CITY OF TIGARD 24-Hour -
BUILDING Inspection Line: (503)639-4175
MST
INSPECTICIS Wi313N Business Line: (503)639-4171
BUP
Received Date Requested —1 AM------. PM BUP _—
Location
_d t- Suite MEC
Contact Person _ `T Ph( _) .- 7"-513PLM
Contractor --- ___ Ph( ) — SWR —
RUILDIN_G Tenant/Owner _--__ _ ELC
Footing ELC _
Foundation Access: �; �� ELR
Ftg Drain ---- —
Crawl Drain
Slab Inspection Notes: SIT _.
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ------- --- ---
Insulation
Drywall Nailing ---- -- - --- �.___ —
Firewall
Fire Sprinkler — - -- - ----- - ---
Fire Alarm
Surp'd Ceilirnd - - --`
Roof _
Other: -
Fine!
PASS PART FAIL =^
_PLUMBING —__— -- — -- —
Post&Beam —�
Jnder Slab --- - - --
FF ough-I n
VV iter Service ---- �—
Sanitary Sewer
Rain gains — --
Catch Basin/Manhole
Storm Drain — -
Shower Pan
Other: _ —
Final
T FAIL — —
&Bearn
Rough-In — -- —
!3mo DP
5m—o�e DempE•a — --- -- -- ---
PART FAIL
PL
TPF';
Service
Rough-In — ----- --— -- --
UG/Slab
Low Voltage —
Fire Alarm
Final Reinspection fee of$—__- _____required before next Inspection. Pay at City Hall, 13125 SW Hell Blvd.
PASS PART _FAIL
SITE_ _ Please call for reinspection RE_ ____._ F-1 Unable to inspect-no access
Fire Supply Line
ADAr
Approach/Sidewalk DIft—_3 _ 3/c?3 Inti pector —.—
Other:
Final — 00 NOT REMOVE this insr action record from the Job site.
F'A3.S PART FAIL