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15845 SW Highland Court
CITYOF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00446
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2511 01
PARCEL: 2S 10DQ-09300
SITE ADDRESS: 15845 SW HIGHLAND CT
SUBDIVISION: SUMMERFIELD N0.6 ZONING: R-7
BLOCK: LOT: 309 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES: _ _BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: �1 „()MES. INCIN:
Fp(;_ 3 15 HP: I .14ML. INCIN:
MAX INPUT: BTU 15 - "0 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP. CLO DRYERS:
FERN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install furnace and A/C. A/C cannot be placed in the required setback
Owner: FEES
FORREST, f3LTTY J TR Type By Date Amount Receipt?
158415 SW HIGHLAND CT PRMT CTR 12/7/01 $72.50 272001000C
TiGARD, OR 97224 5PCT CTR 12/7/01 $5.6J 2720010000
Total $78.30
Phone: ---
Contractor: _ ..
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND,OR 97217 REQUIRED INSPECTIONS___ ___
Mecham, ,I Insp
Phone:503-281-0752 Heating Unt Insp
Reg #:LIC 8897 Cooling Unt Insp
Duct Inspection
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire ii work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon la%, requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set for' i in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rales or direct questions to OUNC by calling
lrn'A19AF;-Q1 AQ
Issue By: y _ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Datereceived: l`� - C Permit no.:
City of Tigard / 7 Project/appl.no.: Expiredate:
Cirvu)Tigard Address: 13125 SW Hall Blvd,Tipird,OR 97221
Phone: (503) 639-4171 Date issued: By:()t Receipt no.:
Fax: (503)598-1960 Case file no.: Payment type:
Land use approval: Ftuddingpermitno.: j
,*-I &2 family dwelling or accessory U Commercial/industrial J Multi-family U Tenant improvement
U New construction U A(I(fition/alteration/replaccntenl U Other:
JO B SITE WfORMATION C(
!oh address: t,4 t `T Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: J Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: "See checklist for important application information and
Project name: Z jurisdiction's fee schedule for residential permit fee.
City/county: 11 ZIP: 9'�ZZt-/
Description and location of work on premises: _ t T
'L�Ji7}CA t'f.t/Z.,j ' Iee(ea.) Total
Est.date ol•completion/inspection: Ik uriplion 011 - Res.only Res.only
Tenant improvement or change of use: �'
Air handling unit CFM
Is existing space heated or conditioned?U Yes U No
Is existin space insulated?U Yes U No ircat (tion existng ing ante etre )
f'�P' Aiterauon of existing HVAC system
rioter compressors -
Busiress name: '�L ti(J �'�oUA.) State boiler permit no.:
�L _ UP Tons BTI U/H
Address: Z 0 i It 4' d' C 'ir smo c dampers/duct stno c detectors
City: State ZIP: Z cat pump(site p an reyulre�` c�j - --
phc.ne: _� I Fax:ZgL• E-mail: Install/replace urnac urner T-
CCB no.: Including ductwork/vent liner j>iYes U No
nsta rep ace re oca►eheaters-suspen e ,
City/metro lic.no.: I ( SU wall,or floor mounted
Name(please print): t�C'1 L �(}'�/J C { C.'Co t�Ji� I Vent for appliance other than furnace
Refrigeration:
Absorption units_ ___ 13TU/14 —
Name: If7 C�;p� A� Chillers HP
---�--- Cain ressors lip
Address: ___
—_ rhv,ronmenta exhaust and rent at o 1:
City: stale: ZIP: _ Appliance vent
Phone: Fax: F-mnil: Drycrexhaim u -
-T oo s,Type res.knc a azmat _
hood fire suppression system
Name: 2cS Exhaust fan with single duct(bath fans)
Mailing address: 5L :+slues s stens a part from t hcatin of
Cit �' State: ZIP: _ ue piping andistribution(up to outlets)
City: —_---. Type: LPG N(3 oil
Phone: Zc L I,t l? mail: Fuel piping cacti additional over 4 out et%
Process piping(schematic rcyutredi
Number of outlets
Name: -Other 11stR appliance—or equip-mint:
Address: IhcorativefirepIL•c
City: Slaw ZIP: � nsert-t _
Phone: I ax. _ I mail: < etov pe etstovc
Mier:
Applicant's signatu".. Date: 12 4,01 Other: _
Name(print):
Nut sit Jutisdictions accept cfe,w cards,please cell ludadictbm ftx afore infot•nation Mini It m ee................$
Notice:this permit application Minimum fee.. ...$
❑Visa ❑MnsletCard .•......... --
— _ expires if a permit is not obtained Plan review(at — %) $
Credit card number:
—�ap within IRU days eller it has been a of cn on creditState surcharge(89'0).. $ 5
- accepted as complete ..
`—Time a ofr n cord P P
S OTA .......................
Crdholdet siltnawre'—_—i _ 1_ 4404617(btlWOM)
MECHANICAL. PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: _ Description: Price -i otai
$1.00 to$5,000.00 Minimum fee$72.50---- Table rna Mechanical Code Qty ;Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Fuace to100,000& 0 BTU
vents 14.00
$1.52 for each additional$100.00 or including ducts R ��.�Z�
fraction thereof,to and Including 2) Furnace 100,000 BTU+
$10,000.03. including ducts&vents_ 1740
$10,001.00 to$25,000.00 $148.°0 for the first$10,000.00 and 3) Floor Furnace
$1 54 for each additional$100.00 or includirip%ent 14.00
fraction thereof,to and including 4) Suspended heater,wall heater
$25,000.00. or floor mounted heater 1400
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 bnd 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. 112 15 _
550,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
0'1.20 for each additi -i$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. _ footnotes below. Ce;,1 •
7)<3HP;absorb unit
ASSUMED VALUATIONS PER_APPLIANCE: to 100K BTU 14.00
Value Total 8)3-15 HP;absorb
unit 100k to 500k BTU _ _ 25.60 _
Description: Qty Ea Amount 9)15-30 HP;absorb
Fuma(,3 to 100,000 B U,Including 955 unit.5-1 mil BTU _ 35.00
ducts&vents 10)30-50 HP;absorb
Furnace>100,000 BTU Including 1,174 unit 1-1.75 mil BTU 52.20
ducts&vents 11)>50HP:absorb
Floor furnace Including vent _ 955 unit-1.75 mil BTU
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater _ _ 10.00
Vent not Included in applicance 445 13)Air handling unit 10,000 CFM+
permit 17.20
Re air units _ _ 805 14)Non-portable evaporate cooler
9 hp;absorb.unit, 955 10.00
to 100k BTU 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 6.80
101k to 500k BTU 16)Ventilation system not Included In
15-30 hp;absorb.unit,5011 to 1 2,310 app. ince permit 10.00
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00
1-1.75 mil.BTU 18)Domestic Incinerators
>50 hp;absorb.unit, 5,725 17.40
>1.75 mil.BTU 19)Commercial or Industrial type Incinerator
Air handling unit to 10 000 cfm 656 69.95
Air handling unit>101.00 cfm� 1,170 20)Other units,Including wood stoves
Non-portable evaporate coolel 858 10.00
Vent fan connected to a single duct 446 21)Gas piping one to four outlets
Vent system not included In 856 _ _ 5.40
appliance permit 22)More than 4-per outlet(each)
Hood served by mechanical exhaust 656 1.00
Domestic Incinerator 1,170 Minimum Permit Fee$72.50 SUBTOTAL: no
;
Commercial or Industrial Incinerator 4,590
Other unit,Including wood stoves, 656 8%State Surcharge $ $p
Inserts,etc.
Gas_plp(nQ 1-4 outlets 36C. 25%Plan Review Fee(of subtotal) $
Each additional outlet _ _ 63 Required for ALL commercial permits only
TOTAL COMMERCIAL f TOTAL RESIDENTIAL PERMIT FEE: 5�� ;
VALUATION: I� _ �
Other InsotGtions and Fees
1 Inspection.outside of normal business hours(minimum charge-two hours)
$72.5r per hour
2 Inspections for which no fee is specifically indicated (minimum charge-half hour)
$72 50 per hour
Additional plan review required by changes add-hnns or revisions to plans(minimum
r:harge-one-heif hour)$72 50 per hour
'State Co.itractor Boller Certification renuired for units>200k BTU.
"Residential AJC requires site plan slo-ving placement of unit.
i:\dsts\forms\merh-fees.dc,c 10/11/00
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15845 S\V Ilighimid (.A
I iaard. Oregon 97224
NV O 21272
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CITY OF 'i IGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
_
Date Requested L'� AM_ ✓� PM
_ — BLD
Location 1 4, �, ,r G - ?- Suite MEC 2Z-Z,1 e—r, `f
Contact Person Ph PLM
Contractor /L, C7:�� Ph ;-> /— C SWR _
BUILDING Tenant/Owner ELC
Retaining Wall ELk
Footing --
FoundationCeS$:
FPS
Fig Drain _ ---
Crawl Drain Insp ction Notes: SGN
Slab .f� ' � ' SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear �� e //
Framing C D 'r'-Z �'i� i_ /.r t �,�s D'e �bL L
Insulation
Drywall Nailing
Firewall -- — `
Fire Sprinkler
Fire Alarm -
Susp'd Ceiling --
Roof --
Misc:
Final
PASS PART FAIL - --_-.--- —...-- ---- --- ___ -_
PLUMBING
Post 'X Beam ----- ---- - - - — --
Under Slab
Tor,Out ----- --- -- --- ---- --- ---
Water Service
Sanitary Sewer --- — - -� — — - --
Rain Drairs
Final .--_- ------------------- -
PASS PART FAIL
MECHANICAL ------�---- -- --_--_.. -.— __
Post& Beam ---- ------- ----__... _ ------ --- -------
Rough In
Gas Line ---—- ---- - ------------ -.
Smoke Dampers
M2PART FAIL
ELECTRICAL ------ -- - -- ----
Service
Rough In ----- ---- ----- - — --�-__---
UG/Slab
Low Voltage --
FireAlarm - --- --- -- ----- - --------_ ---------
Final
PASS PART FAILSITE
Backfill/Grading — - —
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ _ -_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ] ease call for reinspection RE:
Fire Supply Line --_ - ( ] Unable to Inspect-no access
ADA
Approach/Sidewalk
Other Date /�� y Cl Inspector Ext
!�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.