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9259 SW Hill Street
CITY Or TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ---
�J BUP
Date Requested AM ' PM BLD
Location_ &-o �d _ _ Suite MEC '
Au
Contact Person l
_ 1 _ Ph / PLM
Contractor �lX - �� 'e��07UAZA—, Ph SWR
BUILDlNG� Tenant/Ownel ELC -- -- —
etaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain — SGN
Crawl Drain Inspection Notes: ----
Slab ----------- — -- SIT
Post&Beam -
Ext Sheath/Shear
Int Sheath/Shear
Framing
---------------------------Insulation
Drywall
Drywall Nailing --- ---.--_..__
Firewall - --_
Fire Sprinkler ---- ---- --- -- ------- - - -
Fire Alarm
Susp'd Ceiling
Roof
.sc ___ ----- --- --- ------- -- ---
Final
PASS PART FAIL -.....
_- —__.._.-_--.-_--_ —_--
PL.UMBING
Post8 Peam _---------------------- --------------_--------____-------- ------____
Under Slab
Top Out
Water Service
Sanitary Sewer v —
Rain Drains
Final - ---�------- —
PASS PARI t-AIL
Posl 8 Ream ------------------ - — - - -----
Rough In
GasLine ----- __ __ - - --- ------- ---- - -------------
Smoke Dampers
PASS PART FAIL
Service
Rough In -- -
UG/Slab
-------------------------------------
I_ow Voltage
Fire Alarm - -- — ------- —---- -- ------------------- ----
Final
PASS PART FAIL _-- -------------_-_--- _—SITE
Dackfill/Grading - ----------" --"----- -- — ---�-- ---
Sanitary Sewer
StorM Drain I j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I j Please call for reinspection RF -_- --- _ [ j Unable to inspect no access
ADA
Approach/Sidewalk Date r Inrpector -
Other
U � Ext
Final
PASS PART FAIL 00 NOT RCMOVE this Inspection recorC from the job site.
CITYOF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00409
..L"" k 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/13/00
PARCEL: 2S 102DB-07600
SITE ADDRESS: 09259 SW HILI_ ST
SUBDIVISION: CHELSEA HILL NO.2 ZONING: R-4.5
BLOCK: LOT: 053 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLER;,:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O AP?L: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES0 - 3 HP: DOMES. INCIN:
GAS 3 15 HP: COVWL. INCIN:
MAX INPUT: BTU 15 - 30 Hp
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN 100K RTU: _ AIR HANDLING UNITS OTHER UNITS: I
FURN >=100K BTU: _= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Replacing wood stove with gas free-standing stove.
Owner: _ FEES �—
FATLAND, BILL S/MARY SUSAN Type By Date Amount Receipt
925'd 3W HILL STREET PRMT CTR 10/13/00 $72.50 272000000C
Tl'-;ARD, OR 97224 5PCT C R 10/13/00 $5.80 :172000000C
Total $78.30
Phone: --
Contractor:
GAS C•-)NCEPTS & CONSTRUCTION
4123 SL 63RD
PORTLAND, OR 97 206 REQUIRED INSPECTIONS
Gas Line Insp
Phone:313-2575 Mechanical Insp
Reg #!:LIC 133149 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and _all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is
not .itarted within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Nctification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246-9189
Issue By: ��, f}� ��.- - ermittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Date received:/,"_ t �U(-. Permitno.:
City of Tigard ProjecG'appl.no.: Expire date:
f'i(v /f if tool Address: 14125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: H'✓:� Iteccipt no.:
Fax: (503) 598-1960 Ca.c file no.: Payment type:
Land use approval: — I Building permit no.:
1A,&2 family dwelling or accessory U Commercial/industrial U Mu:ti-family U'I ni improvement
U New construction U Addition/alteration/replacement U0thcr:--
.1101111 Sift,
1 tS('11EDULE
Job address: l� jyF. Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suitc no.: value of all mechanical materials,equipment.labor,overhead,
Tax map/tax lot/account no.: _ profit. Value$
Lot; Block: Subdivision. - 'See checklist fbr important application information and
I Project name: _ jurisdictien's fee schedule for residential permit f.c.
-ity/county: ZIP: ,---- 1
ULIE
Description and location of work on premises:
Fee(ea.) Total
Est.date of completion/fnspection; IIVAIkscription - 1"v. Res.only Res.only
Tenant improvement or change of use: �'
Air handling unit .-----CFM-----
Is existing space healed or conditioned?U Yes U No _Is existingspace insulated?U Yes U No Aircondiuoning(site plan required)
p� A teration o existing HVAC system
boiler/compressors —
Business name State boiler permit no.:
^ _-- _ HP Tons 13TU/H _
Address: Firelsmoke ampers/ductsmoke detectors
City: State: ZIP: eat pump(su pian required _ -- -
Phone: Fax: - E-mail Insta I rei:.nce urnac urne�er -
- - Including duc:,vork/vent liner U Yes U No
CCB no.: FT3 q ___ ,_______ nstn I/replacelrcloc a eaters-suspen e(l.
City/metro lic.no.: wall,or floor mounted
Name(pleaseprifit): (,_ 1 Vent for a,,lianceot erthan furnace -
efr goal on:
p Absorption units__ li"f(I/f1
Name_ I� c�.�Q -_ Chillers- ---.--_-.--- 11P
AdUress: Com 7ressors _- III'
`� :nv ronmenla ex must and vent Intron:
City: State:()Y'. ZIP: Appliance vent
Phone: Fax: E-mail: urycrcx tai ust-�--------�-
0o s,'rype I/Rhes. ice tcTie azmal
hood fire suppression system _ --
Name: `- Exhaust fan with single duct(bath fans)
Mailing address: :x a act s sw,'1 a Qart fromeatiiT n or AC --
City: State: ZIP: Fuel piping an st ut on(up to 4 outlets)
Type: ---Mi NG _ 0i _
Phone: _ Fax: E-mail: Fuel piping each additional over 4 outlets
' roeesspiping(schematic required)
Name: Number of outlets
_— other If R appliance or equipment:
Address: _ Decorative fireplace
City: -- Slate: ZIP: - Insert-type
Phone. Fax: 1 Entail Woodstove/pellet stove
Othcr:
Applicant's signature:
fn
Not all Jurisdictions accept credit canis.please call Jutiroliction for more information Permit fee.....................$ _
U Visa U MasterCard Notice: permit application Minimum fee................$ —.
Credit card number._ _1� expires if o permit is not obtained Plan review(at _ %) $ ---
Expires within 190 days after it has been Slate surcharge(8%) ....$
Name of cardholder as shown on credit card accepted as complete.
f TOTAL .......................$ —
Cadholder sianattrre Amount-- 440-4617(FAXWOM)
MECHANICAL PERMIT FEES
COMMERCIAL_ FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEUULE:
TOTAL VALUATION: FEE: Description �- Price Total
TOT to$5,ALU Minimum fee$72.50 _ � Table 1A Mechanical Code Qty (Ea) Amt
$1.00TU
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 1 is&v is
$1.52 for each additional$100.00 or including ducts&vents _ 14 00
fraction thereof,to and including 21 Furnace 100,000 CtS&vents 17.40
BTU+
$10 000.00. inrludinp duUcts R
$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 riot included in appl,ance 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 Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp"
7)<3HP;absorb unit
to ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 BTU - 14.00
_ 8)3-15 HP;absorb �
-i Value Total unit 100k to 500k BTU 25.60
Description:. Q Ea Amount 9)1�3T)HP,,ySnrb
Furnace to 100,000 BTU,including 955 unit.r 1 mil BTU 35.00
ducts&vents 10)30-50 NP;absorb
Furnace>100,000 BTU including 1,170 unit 1-1.75 mil BTU 52.20 _
ducts&vents 11)>50HP:absorb
Floor furnace Including vent 955 _ unit>1.75 mil BTU 87.20
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent riot Included In applicance 445 13)Air handling unit 10,000 CFM+
Repair units 805 - 14)Non-portable evaporate cool4r
<3 hp;absorb.unit, 955 10.00
to 1ROk BTU 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 680
101k to 500k BTU 16)Ventilation system not Included in
15.30 hp;absorb.unit,501k to 1 2,310 a lian,e permit 10.CJ
mil.BTU17)Hood corvod by mechanical oxhauct
30-50 hp;absorb.unit _ 37-00 10.00
1-1.75 mil.BTU 18)Domestic incinerators
>50 hp;absorb,unit, 5,725 17.40 _
>1.75 mll.BTU 19)Commercial or industrial type incinerator
Air handling unit to 10,000 cfm F44
56 69.95
Air handlin unit>10,000 cfm 7x0 20)Other units,Including wood stoves
Non- ortableeya� to cooler 56 c� • U�p� 10.00Vent fan connected to a singleduct 6 21)Gas piping one to friAltletsVent system not Included In 56 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:
$
Commercial or industrial Incinerator 4,590
Other unit,Including wood stoves, 656 8%State Surcharge $
Inserts,etc. r ,KD
Gas i in 1-4 outlets 360 25%Plan Review Fee!of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL.PERMIT FEE: $i
VALUATION: -_ -----` j�,3�
Cher Inssections and Fees:
1 Inspections outside of Pinnal business hours(minimum charge-two hours)
$72 50 per hour
2 napections for which no fee is specl,9cally Indicated (m4nimum charge hall hour)
$72.50 per hour
3 Additional plan,aview required by changes,additions or revisions to plans(minir-un
charge-one-he,t hour)$72 50 per hour
'Slate Contractor Boller Certification required for units+200k BTU.
"Resldentlai A/C requires site plan,showing placement of unit.
F.\dsts\forms\mech-fees,doc 10/11/00