9241 SW HILL STREET I �
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CITY OF
T'GAR D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00461
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/17/02
P ''EL: 2S102DB-07500
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SITE ADDRESS: 09241 SW HILL. ST
SUBDIVISION: CHELSEA HILL NO.2 ZONING: R-4.5
BLCCK: LOT: 052 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APS ' : VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1J� DOMES. INCIN:
3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS'?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Rernarks: Installation of AC. Cannot be placed in the required setbacks.
Owner:
FEES
_
JEANNIE SPICKELMIER Description Date Amount
09241 SW HILL ST. ML•CIII I'rinut Fee 10/17/02 $72.50
TIGARD, OR 97223 IME I1) i'erniit Fee 10/17/02 $0.00
ITAX) 8%StateTax 10/17/02 $5.80
Phone: 503-598-0961 ITAX) 8%statr'fas 10/17/02 $0.00
Contractor: _ Total _ $78.30
TRI-TECH HEATING
6603 NE 137TH AVE
VANCOUVER, WA 98682 _ REQUIRED INSPECTIONS
Final Inspection
Phone: 4,0-801-2002
Reg#: I n l 47 3
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes anc; all other applicable, laws. All work will be done in accordance with approved
plans. This permit will expire if work is net started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION Oregon law requires you to follow rules a6opted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
t503)246-669
j9.
Issued By: _i` �2L � .__ Permittee Signature: - 11,(7�,� �
Call (503) 639-41.75 by 7:00 P.M for inspections needed the next business day
Mechanical Permit Application
Datereceivcd:Q, -/ --F7 L- Permit no. aypJ ale
City of Tigard Proje,:Uappl.no.: Expire date:
City ofTigard Address: 13125 SW Ifall Blvd,'rigard,OR 9722:; Date issued: By1
Phone: (503) 639-4171 Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Lind use approval: _v Nuilding permit no.:
11111111 V y
I &2 family dwelling or accessory U Conuncrcial/i+;dusulal U Multi-I,nnily U Tenant improvement
U New construction U Addition/alteration/replacement U Ocher.
1 ' SITE INFORMATION1 1SCHEDULE
Job address. ; j Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: uite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/lax lot/account no.: profit. Value$
Lot: Block: Subdivision: 'See checklist for important applic^tion information and
Project name:ler?_io,r_i„r2 jurisdiction's fee schedule for residential permit fcc.
City/county: t-s %4- ZIP: 1 t.1 1 h
De%uptiortand loc tion of work on premises: IX a 111151111 Ali LWAI 1 101 111LI I ILI a x1l1
111
Total
Fist.date of completion/inspection: I)tiscriplion Qty. aes.onfy Res.only
'Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U No Air handling unit _ CFM
1 c�-
Is existing space insulacc l"U Ycs uning(site plan required)
!J No A fetation of existing C system
ofcompres
er sors
Business name: 7-(, State boiler permit no.:
Q.L_1.�. �-1Q�y-��r-` _ I4P Tons BT U/11
Addres. ?� a _ �� Fire/smoke6ampers/ductsmo a eteclors
ircan iu
City Stat ZI eat pump(site plan r�•yuired—
Pltone:1,;fit l marl; Insta /r�T eT lw race earner__Ii I U/l
Including ductwork/vcnl liner 'J Yes U No
\
CCB no.: T nsta rcp ace/rc ocate icaters-suspended,
City/metro lic.no.: wall,or floor mounted
Name(please print): t f v 'nl fur appliancil other than f urnace
1 K-(rige
Absorption units _ BTU/H
Name: Chillers_ --- HP
Address: Com .__s_
nY __ HI' I
ronmenla exhaust and veialidal on:
laity: _ � �Slule. ZIP. AFPhance vent
Phone: If: manila orf yerex ausu�t --- __
1 oods, 'ypr res. itc ten/hazrnnt
hand fire suppression system --
Name:' r. Exhaust fan with single duct.bath fans)
Mailing address: -�
Exhaust system apart 1•ro�m Lcating oil
City: ,, talc ZI t ueTplp-Tng and distribution(tip toutlets)
Ty LI'G NC) __ Oil
Phone:'q j Fuel pipm,each additional over 4 outlets
'rocesspiping(schematic-equiretl) _
Nunibcroluutlels -INartic: _ I er st a ppi lanceort•qu ppmenla
Address: _ Decorative fireplace _
City: State:- 7,IP_ _ ns� ert-type
Phone: Fax: E-mail' c stove/pe ctslove
Other:
Applicant's sigera
Ma
n y�, ._- -- - e•
Name (prin): JA& �_
Minimum
Not all jurisdictions accept credit cnida•plena call jurisdiction for more Informatitxt. ll ................$
U Viso U MasterCardMasterCardNotice:This permit application MMinimumm fee..•.............$
expires if a permit is not obtained plan review at _ r I -
credit card numhn: .�----_---_�r--- —��__ ( ) $ —
Expirrs within I RII days after it has(teen State surcharge(9%) ....$
Name of cardholder u shown on credit card S accepted as complete.
TOTAL .......................$
— —Cardholder It Alun _ ___ Amnunt 44114(,17 tMMCOW
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 K 2 FAMILY DWELLING FEE SCHEDULE-
TOTAL VALUATION: PE_R_MIT FEE: Description: Price Total
$1.00 to$5,000,00_ T Minimum fee$72.50 Table 1A Mechanical Code_ J ob (Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace t0 BTU
$1.52 for each additional$100.00 or including ducts
ucctsis&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 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or Including veni _ 14.00
fraction thereof,to and including 4) Suspended heater,wall heater
$25,000.00. _ cr floor mounted heater 14.00
$25,001.00 to$50,000.60 $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: Boiler pleat Air
$1,20 for oath additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp
Minimum Permit Fee$72.50 SUBTOTAL: $ _ 7)100K absorb unit
to 100K BTU 14.00
8%State Surcharge $ 8) 15 absorb
unit 100kk to 500k BTU25.60
t t
-..------ -- - - - 9)15-30 HP;absorb
25/.Plan F,eview Fee(of subtotal) $ unit.5-1 mil BTU 35.00
Required for ALL commercial permits only 10)30.50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE' $ unit 1-1.75 mil BTU 1 52.20
11)>50HP;absorb
- - - unit>1.75 mil BTU 87.21)
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 1o.oi)
Value Total 13)A!, handling unit 10,000 CFM+
Description: al (Fa) Amount 17.20 _
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 f imace including vent 955 16)Ventilation system not Included In
SuspOtaded heater,wall heater or 955 appliance perm't 10.00
floor mounted heater 17)Hood served by mechanical exhaust
Vent not included in appliance 445 10.00
ermit 18)Domestic Incinerators
Repar, units 805 17.40
<3 hp;absorb.unit, 955 19)Commercial or industrial type incinerator
to 100k BTU _ _ 6.995
3-15 hp;absorb.unit, 1,700 20)Other units,including woodstoves
101k to 500k BTU _ 10.00
15-30 hp;absorb.unit,501k to 1 :.110 21)r;as piping one to four outlets
mil.BTU5.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1.75 mil.BTU 1.00
>50 hp;absorb.unit, 51725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU
Air handling unit to 10,f-1 dm 656 8%State Surcharge $
Air handling unit>10,UU(' cfm 1,170
Non=ortable evaporate cooler 656 _ TOTAL F'ESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 448
Vent system not Included in 656 ffj
a Ilance ermit gther Inspections and Fees
Hood served by mechanical exhaust 656 1 Inspections outside of n,rmal 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. _ 3 Additional plan review required by changes,additions or revisions to plans(minimum
Gee I 1 4 outlets 360 charge-one-half hour)$62 50 per hour
Each additional outlet 3 "State Contractor Boller Certification required for units>200k BTU.
TOTAL COMMERCIAL "Residential AIC requires site plan showing placement of unit.
VALUATION: _ All New Commercial Buildings require 2 sets of plans.
I:\dsts\forms\mech-fees.doc 02,11/02
0'ti 19/1994 02:20 503-590-8391
RON ROBINSON PAGE 04
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 630-4171
SUP
Received -.Date Re /() /,1-1 ,
- AM_._.-.._.-__-- PM BUP
Location ------ Suite------ MEC eP2
Contact Person Ph PLM
Contractor ------ SWR
BUILDING Tenant/Owner ELC
Fooling ELC
Foundation Access:
Fig Drain ELR
Crawl Drain
Slab I spection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Spiinkler - ------
Fire Alarm
Susp'd Ceiling
Roof
Other:
r!nal
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Rough-in
Water Service IJV7
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
--
Shower Pan
C!her:
Final
PASS PART FAIL
MECHANICAL__
Post& Beam
Rough-in
Gas Line
Smoke Dampers
I Final
/oSiR>-PART FAIL
TRICAL
Service
Rough-in
UG/Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of$ required before next inspection. Pay at City H&II, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE. Unable to inspect-no access
Fire Supply Line
ADAInspector - Ext Approach/Sidewalk Date
Other
Final DO NOT REMOVE this Inspectio record from the job site.
PASS PART FAIL