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15073 SW 91ST AVENUE-1 I I 14cli m 3 c m 15973 SW 91" Avenue MECHANICAL PERMIT CITY O F TIGARD IGARD DEVELOPMENT SERVICES PERMIT #: MEC2002-00075 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/19/02 PARCEL: 2 S 111 AD-1370(j SITE ADDRESS: 15073 SW 91ST AVE SUBDIVISION: MALLARD LAKES ZONING: R-4.5 BLOCK: LOT: 003 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATI.RS: "ENT FANS: OCCU,) '.NCY GRP: R3 VENTS W/O PPPL: 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: FIRE DAMPERS?: 30 - 50 HP: ODS S: OUNITS. GAS PRESSURE- 50 + HP: CLO DRYERS:OD FURN < 100K BTU: 1 AIR HANDLING UNITS C OTHER UNITS: FURN —100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: Replace a><isting furnace Owner: _ —_-- _.� FEES HUBBELL, KIMBERLY A Type By Date Amount Receipt 15073 SW 91 ST AVE PRMT CTR 2/19/02 $72.50 2720020000 TIGARD, OR 97224 5PCT CTR 2/19/02 $5.80 2720020000 Phone: Total $78.30 Contractor: COLUMBIA HEATING + COOLING INC PO BOX 230397 TIGARD, OR 97223 REQUIRED INSPECTIONS Mechanical Insp Phone:624-2704 Heating Unt Insp Reg #:LIC 7635 Final Inspection PLM 34-175 This permit is issued sWiject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and P;, other applicable laws. All work will be done in accordance with approved plana. This permit w.1 expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through UAR 952-001-0080. You may obtaiq copies of Vit-.-e rules or dir questll Sim to 10IJN6 by calling (rNn,A19AA-Q1 Per Issue By: cc ZZt c � ( ._ Permittee SignatuEe: fl Call (503) 639-4175 by 7:00 P.M. for Inspections needed the next business day N�ed�anneal Perini<t Application -- V Date • ,receivedy Permit no. -Kioe-)City of Tigard Project/appl.no.: Expire date: CityofTigard Address: 13125 SW Hall Blvd,Tigard,OR Date issued: By?)") Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.. Payment type: band use approval: Building permit no.: 1 &2 family dwelling or accessory 0 Commercial/indusirtal U Multi-family Tenant improvement ❑New construction c$Addition/alteration/replacement 0 Other. t Job address: i ro _,L.,J Ay C" Indicate equipmeot quantitic. i n boxes below. Indicat^the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,o venccad. Tax map/tax lot/account no.: profit. Value$ _ Lot: Block: I Subdivision: •See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: r d ZIP: 7 2^� I Description and location of work on premises: t I t Fee(ea.) lotil Est.date of completion/inspection: -TrvxDescription Qty. Res.onl Rett,only `Tenant improvement or change of use: �' Is existing space heated or conditioned?U Yes U No Air conditioning unn plan _CFM Air con iuomng(sue plan required) Is existing space insulated?❑Yes U No Alteration of existing IWAC system of er compressors Business name: State holler permit no Oi u d'1.1 iJ r� t 1_i[=L�j_,.��l r_ ,, - r�/ 1-11' 'Ions_ 13TU/11 Address:— ;{ n 7 �,(v i t� T •ir smo a clampers/duct smoke detectors _ City: c - IStawt4 JZ111. d'-/ 7 1 Tcat�urnp(stir fan required) Phone: (�, -,�- �• d Fax: I E-mail: nsta ac urnac umer S,''c" CCB no.: �(C ��'j Including uc or vent liner U Yes U No nstaI Urep ace/relocate lieaters-suspen e , City/metro lic.no,: /2 7 a wall.or floor mounted Name(please rint): crr ora- iance RtFet ter than- furnace e gerat un: Absorption units BTU/H Name: Chillers_ .. HP Coin m ressorsHP .t1 ronmenta :x Aust and vent at din: ('ity: Slate: ZIP: Appliance vent Phone: L - Fax E-mail. ryerexhaust t [foods.Type res. itc en azmat hood fire suppression system Name: t 1-tiI UU1 b LL Exhaust fan with sin le duct(bath_fans) Mailing address: Ic' , 7 A-y G �x Aust s stem a anTrom rcoun or City: �� State: rZ ZIP: cj�L7d.j Fuelp p ng and sir bol on lop to outlets) Type LI'li NG __ nil Phone: I E-mail: uc I pin each additional ditiona over 4 outlets roceis pi ping(scematicrequire ) _ Name. Number til outlets Other 165d applianceequipment:or Address: 0ecorativefireplace City: State: ZIP: saes-type Phone: I E-mail: . oo.s tove- �letsove Applicant's signaturebate: ftTc—r L.Namc (.prnt): _l _ Other: --`v Nnt all Jurisdictions accept creta(cards,please iall jurisdiction for more tnrormaudxt Notice:i his permit application Permit fee.....................S Minimum fee................$ U Vasa U MiraleK'ard - Ctedtt cud number / / expires if a permit is not obtained Plan review(al _ %) % ,pl�, wit-�in IRO days ager it has been State surcharge(8%)....S Nurse ni ca�oi r u i nwn on credits— accepted as complete. g � P P a j TOTAL .... ..................$ L Cr ho r aiEnature AiWunl aa�lnl�ta'tOrCOMt n CITY lel=' TIGARD���� --_PLUMBING PERMIT NT SERVICES PERMIT#: PLM2002-00077 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 15073 SW 91ST AVE DATE ISSUED; 3/6/02 SUBDIVISION: MALLARD LAKES PARCEL: 2S111AD-13700 BLOCK: LOT: 003 ZONING: R-4.5 CLASS OF WORK;ALT --- ___ JURISDICTION: TIG TYPE OF USE: SF GARBAGE DISPOSALS: ��'—"-- WASHING MACH: MOBILE HOME SPACES: OCCUPANCY GRP: R3F3ACKFLOW PREVNTRS: STORIES: FLOOR DRAINS; FIXTURES WATER HEATERS: 1 TRAPS: SINKS: LAUNDRY TRAYS: CATCH BASINS:LAVATORIES: URINALS: SF RAIN DRAINS: GREASE TRAPS; TUB/SHOWERS: OTHER FIXT'.,t\ES: WATER CLOSETS: SEW-'-R LINE: ft DISHWASHERS: WATER LINE: ft RAIN DRAIN: ft Remarks: Replace existing gas water heater with same. Owner: FEES HUBBELL, KIMBERLY A Type E7=te ipt15073 SW 91ST AVE Amount ReceiptTIGARD, 9 972 V PRMT 3/6/Oc5PCT $72.50 27200200000 3/6/02 $5.80 27200200000 —� Phone 1: Total $78.30 Contractor: COLUMBIA HEATING+ COOLING INC PO BOX 230397 8900 SW BURNHAM ST STE E-110 TIGARD, OR 97281-0397 REQUIRED INSPECTIONS Phone 1: 624-2704 Rough-in Insp Reg #: LIC 76359 Final Inspection PLM 34-175PB This permit is issued subject ;o the regulations contained in the Tigard MU liripal Code Specialty Codes and all other applicable laws. All work will be done in accordance with State of OR. This permit will expire if work is not started within 180 days of issuance, or if work is Suspended plans. speeded for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001 5 -0001 Utility You may obtain copies of these rules or direct questions to OUNC by calling (503 246- 0001-0080. 1987. Issued By: Permittee Signature-` I Call (803) 639-4175 b y 7:00 P.M. for an Inspection needed th� next b nese day MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: _FEE: -� Description: -- - --- Pace —Total $1.00;u$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code _ Qb (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to'00,000 BT;J $1.52 for each additional$100.00 or Includingducts&vents _ 14.00 fraction thereof,to and including 2) Furnace 100,000 BTU+ _ $10 000.00. Including ducts&vents 17.40 $10,001,00 to$25,000.00 $148.50 fur the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 1400 fraction thereof,to and including 4) Suspended heater,wall heater "- $25,000.00. or Floor rnourted heater 14 00 $25,001.00 to$50,000.00 $379.50 for the firs:$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or 680 fraction thereuf,tc and including 6) Repair units $50 000.00. _ 12 15 $50,001.00 and up $74?.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air ` $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. _ footnotes below. Com • •• 7)<3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 1400 — 8)3-15 HP;absorb Value Total unit 100k to 500k BTU Description: Qt Ea Amount 2560 Furnace71[0 100,000 BTU,including 955 9)15-30 HP;absorb ducts&vents unit.5-1 mil BTU 35.00 Fumace> 100,000 BTU Including 1 170 10)30-50 HP;absorb ducts&vents unit 1-1.75 mil BTU 52.20 _Floor furnace indudinj vent _ 955 11)>50HP:absorb Suspended heater,wall heater or — 955 unit •1.75 mil BTU _ 87.20 floor mounted heater 12)Air handling unit to 10,000 CFM Vent not Included in applicance 445 — 1000 permit 13)Air handling unit 10,000 CFM+ Re air units _— 805 17 20 3 hp;ahsorb.unit, 955 14)Nan-portable evaporate cooler to 100k BTU _ Y_ 10 00 3.15 lip;absorb.unit, V 1,700 101k to 500k BTU 15)Vent fan connected to a singled _— 6 80 15-30 hp;absorb.ur11t,501k to 1 2,310 16)Ventilation system not included In mil.BTU appliancepermit1000 30-50 hp;absorb,unit, – 3,400 17)Hood served by mechanical exhaust 1.1,75 mil.BTU 1000 >50 hp;absorb.unit, 5,725 18)Domestic Incinerators 11,75 mil.BTU 1740 Air he ldlin unit to 1(',000 cfm ' 858 19)Commercial or Industrial type Incinerator Air handling unit>10,000 cfrn 1 170 69.95 Non-p rtable evaporate cooler 656 20)Other units,including wood stoves Vent fan connected to a single duct 446 10.00 Vent system not Included In 656 21)Gas piping one to four outlets appliance—permit 540 Hood_served by mechanical exhaust 656 22)More than 4-per outlet(each) _Domestic incinerator 1 170 1.00 Commercial or Industrial indnerator q 590 Minimum PetTnll Fee$72.S0 sUBTOTAI $ Other unit,Including wood stoves, 656 Inserts,etc. _ _ 8%State Surcharge $ Gas piping 1-4 outlets 380 Each additional outlet _ 63 25%Plan Review Fee(of subtotal) $ _ _ — ------ Required for ALL commercial permits only TOTAL COMMERCIAL Z TOTAL RESIUENTIAL PERMIT !!!I!!! S VALUATION: Other Insoectlons sn�,� w: "-- – 1 Inspections outside of normal business hours(minimum ciiarge-Iwo hours) $72 50 per hou, 2 Inspections for which no fee Is specifically Indicated (minimum charge-half hour) $72.50 per hour 1 Additional plan review required by changes,additions or revisions to plans(minimum charge-one-half hour)$72 50 per hour *State Contractor Boller Certification required for units 3-200k B'J. "Residential AIC requires site plan showing placement of unit, l:\date\furmsvnech-fees.da 1n:11 nn Plumbing Permit ApplicatiolUc 000 7 7777 received: ?/(,� Permit no: City of Tigard Building permit no.: Address:: 13125 SW Hall Blvd,Tigard,OR 9722 Expiredate: Ciry of T get Phone: (503) 639-4171 Fax: (503) 598-1960 aBy:}'✓6 Receipt no.: Case file no.: Payment type: Land use approval: - - — t U Multi-family U Tenant improvement U 1 &2 family dwelling or accessory U Commercial/industrial U Other: ❑New construction ❑Addition/alteration/replacement 0 Food service - - - M113=g Ilm=111 i INGQt . Fec(ea. total •� �/1 S 1lcuription Q ) Job address: U _' _ - Ncr. ! and 2-family dNcllra�0n1T Bldg.no.: Suite no.: (includes 100 ft.fureach11610 connection) Tax map/tax lot/account no.: _ SFR(1)bath Lot: Block; Subdivision: SFR(2)bath --— e SFR(3)bath Project name: _ LA Each additional bath/kitchcn City/county: 'C ZIP: 5ileutllltles: Descri n and locatio work on premises: Catch hasin/area drain — J Drywells/leach line/trench drain list,date of completion/inspec 'n': F ting drain(no.lin.ft.) t Manufactured home utilities -- Buviness name: co u I N \ , 1 . Manholes connector — Address: C�. 60 a Sanita sewcr(no.lin.ft.) State: O LIP: 9 7 L 2 rY City: - Storm sewer no.lin.ft.) _ -- Phone: Fax: E-mail: Water service(no.lin.ft.) CCB no.: '7(e S �V Plumb.bus.reg.no: Fixture or Item: City/metro lie.no.: i Z,Ll " t 7 g+ •o Absorption valve Contractor's representative signature_ �� _ � ��'� hack fl( w prcvcntcr Print name: 3t Backwater valve Basins/lavatory clothes washer Name: C'' r' k ' - ishwasher Address: -- Drinking fountain(s) City: _ State ZIP: Ejectors/sum Phone: 6,)L-1 - Z-7f, Fax: ji, "''"I Ex tank Fixture/sewer sewer ca Floor drains/floor sinks/hub Name(print): _ _ Garl+a c dis sal Mailing address: Hosc bibb _ State: ZIP: cc ma er City: Phone: Fax: E-mail: In(erceptorlgreasr!tea Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as pvr ORS Chapter 447. Suri! Owner's signature: I'' _ Tubs/shower//shower pan Urinal Name: Water c oset Address City: Water heater State: ZIP: s -- Tott Phone: Fax: E-Mail: Minimum fee.................$ _.—._-- F&Htetlone eccep credit cu +,plea+e cell)urldicUon for m�xe Infcxmaliai NMice: This permit eppliceUonPlan review(at _ %) $O Mestercerd expires if a permit is not obtainedState surcharge(8%)....$Um within ISO days after It has beenTOTAL n� ...............accepted es complete.e of c Iden u shown on radii cam- $ 44446IR I60rCOMl Ce adder dRnenue �_ _ Amount PLUMBING PERMIT FEES: PRICE TOTAL Now 1 and 24amhy d vellings only: FIXTURES (individual) r- UTY �ea AMOUNT (includes all plumbing fixtures in PRICE I TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connectior�___... One 1)Lath $249.20 Tub or Tub/Shower Comb. 16.50 Two 2Zbath $_350.00 Shower Only 16.60 Three 3 bath _ $399.00 Water Closot 16.60 SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _ Garbage Disposal 16.60 ___ ____TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/FloorSink r' 16.60 PLEASE COMPLETE: 3" 16.60 4" 16 60 - -- -- Water Healer O conversion O like kind 16.60 __ Quante h Wurk Pertormed Gas piping requires a separate mechanical Fixture Typa: New Moved Replaced Removed/ Capped emit. --- �---- - MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 Combinaticn _ Root Drains 16.60 Shower Only Drinking Fountan 16.60 Water Closet - Urinal Other Fixtures(Specify) 16.60 Dishwasher _ Garbage Disposal _ Laundry Room Tray _ Washing Marhine _ Floor Drain/:link: 2" Sewer-1st 100' 55.00 3" - Sewer-each additional 100' 46.40 4" _- Water Service-1st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures (Specify) Stone 8 Rain Drain-1st 10T 55.00 Storm q Rein Drain•each additional 100' 46.40 - Commercial Back Flow Prevention Device 46.40 - Residential Backflow Prevention Dfivice' 2755 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 62.50 Requested Inspections _ er/hr COMMENIS REGI,RDING ABOVE: Rain Drain,single family dwelling 65.25Grease Traps 16.60 ---------- - - -QUANTITY TOTAL Isometric or riser diagram Is required It -{ _ Quantity Total Is >b ' -- -' 'SUBTOTAL 72 8%STATE SURCHARGE - /t "PLAN REVIEW 25%OF SUBTOTAL -- Paqulred only If fixture gl total Is s - TOTAL I 5 *Minimum permit fee is$72 50 r 8%stale swchaip--,ercepl i eab nh.d Ba'Aflow Pmvon6an Device,which Is=96 25 4 8%Mate surcharge ..All Now CommerclM Buildings require 2 sols of titans with Ifomelrlc or riser dlagrsm for plan review, I:klsts\funris�plm fees dor 12/26/01 CITY OF TIGARD 24-Hour -- BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BLIP _ Received ---Date Requested-­-("; �'� AM PM BLIP Location —___ 15(-S 7.3 C7/ „c,te �? No �—buitE MEC Contact Person Ph( ) PLM G'CU�7 7 Contractor Ph( ) SWR BUILDING Tenant/ ner ELC Footing Foundation ELC Ftg Drain FInspectioeWotes: ress: Crawl Drain ELR Slab SIT Post$ Beam -a_-��� -- Shear Anchors Ext Sheath/Shvar Int Sheath/Shsar _ Framing -- Insulation - — - ----- Drywall Nailing --- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling ---------- --- _ _ Roof --Other- Final ther Final --- -- —" --- PASS PART FAIL - PLUMBING _ Post&Beam — - — Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole J - -- - Storm Drain — Shower Pan ,1 Other: _P PART FAIL -- --- — _ _ MECHANICAL—-� Post 8 Beam ------ - ---�-- — - _ Gas Lin© �i --- _-_.------ ...-__— Smoke Dampers A PART FAIL ECTRICAL - - - Service Rough-In — UG/Slab --- _ —_--�_ -._---- ---- Low Voltage Fire Alarm --- — __ ------ ---- - ----- Final r PASS PART_ FAIL L� Reinspectlon fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _SITE Please call for reinspection RE: _ _ ❑ Unable to inspect-no access Fire Srtpply Line ---- ADA b1 Approach/Sidewalk Date InspActor _- Other -- - Ext Final DO NOT REMOVE this Inspection record from the job sits. PASS PART FAIL.