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12653 SMV Snow B:ush Ct
CITYO1 TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT 4: MEC2001-00447
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSU-D: 12/10/01
PARCEL. 1 S133DA-08200
SITE ADDRESS: 12653 SW SNOW BRUSH CT
SUBDIVISION: AMART SUMMERLAKE NO. 2 ZONING: R-7
BLOCK: LOT: 142 JURISDICT"DN: TIG
CI.ASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/CCMPRESSORS_ HOODS:
_ FUEL TYPES 0 - 3 FiP: DOMES. INCIN:
LPI fv 3 - 15 HP: COMML. INCIN:
MAX INPUT: RTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
ODSTOVES:
rAS PRESSURE: 50 + HP. C
FURN < 100K BTU: AIR HANDLINGOTH UNITS S:
UNIT
---- ---------- R UNITS:
FURN >-190K BTU: — 10000 0ni_ GAS OUTLETS: 1
> 10000 cfm:
Remarks: 20'gas pipe to family room.
Owner: � FEES ---- ------ _
ROBER-A. AMAN Type By Date Amount Receipt
11960,'--,] PACIFIC PRMT CTR 12/10/0 $72.50 272001000C
TIGARD, OR 97223 5PCT CTR 12/10/01 $5.80 272,0010000
Phone:503-620-7955 Total $78.30
Contractor:
AMAN ENTERPRISES INC
PO 3OX 230849
TIGARD, OR 97281 _ REQUIRED INSPECTIONS _
Gas line Insp
Phone:503-620-4534 Final Inspection
Reg#:LIC 101603
This permit .s issued subject to the regulations contained in the Tigprd Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done ;.n accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utilit Notific�,tion Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling
Issue B r Permittee Signature:
Call /503) 639-4175 by 7:00 P.M for inspections needed the next business day
Mechanical Permit Application
-- — Date received: j- ji Permitno.,• -
City of Tigard Project/appl.no.: Expire date_
CtyofTigard Address: 13125 SW Hall Blvd,Tigard.OR 9722; Date issued: Receipt no.:
Phone: (503) 639-4'71
Fax: (503) 598-1960 Case file no.: _ Payment type:
Land use approval: Building permit no.: J
TYPE PERM
'I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U ew construction U Addition/alteration/teplacr;ment U Other.__ _ _
i
Job ddress: 1 b
r,_ 3 / a N dj �, r . Indicate eyuipwent qu tntiucs in boxes below. Indicate the dollar
a5s�� gi�S
Bldg.no.: Suite no.: value of all mechanical materals,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
t.ot: Block: — Suhdt�ision 'See checklist for important application information and
Project name:
�'----- n's fee schedule for residential ponnii Ire•
City/county:., ZIP: 9' 1
Description and ocation of w trk on premises: _ CC
fl*
Fee(eq.) 'lolal
- �{ on (21 . Rev.onl Res.only
Est.date of completion/inspection: 12-/'z,� iv/ -
Tenant improvement or change of use: Air handling unit —CFM
Is existing space heated or conditioned?.(Yes U No it conditioning(site plan require ) _
I';cxislinp space insulaled7,elYcs ❑Noterauonofexlsung Csystem _ —
13rn er compressors
Stat(:boiler permit no.:
Business name: &ajl � f r7 k,. -o 1 s0 Z�+ x s 11; 1 - lip ---.Tons—BTU/14
Address: i S o a H ' it•smoke ampersi duct smoke detectors
City: State: teat pump(site p-Ian requirc�—
-- �' Insta replace urnace urner—_
Phone. TH s' Fax:fs E matt_ _
including ductwork/vent liner O Yes U No
CCB no.: / nsta /rep ace re ocate eaters--suspended,
City/metro lic.no.: — wall,or floor mounted
Name(please print): A 4 W.0, J Vent fur a lianee other than furnace
e genal on:
Absorption units____. BTU/H
� , Chillers HP _
Name: _t E4_- 19�1\,� —— Compressors
Address: (/�l![I ,L� i'� �. c ! Environmentalex ust an rent lotion:
City: � StZIP: q-1 Appliance vent
Phone: r '� Fax: E-mail: )ryerexhausi
ois,Type res. tche lazmut
hood fire suppression system
Name: n6 0 U(t (ir n1, I gid' 1 Exhaust fan%%-fill single duct(bath fans) _
Mailing address: x gust system apart from satin or AC
State: 7.IP: -Fuelp itnp an -A tut on(up 10 outlets)
ti
City: -� lylk _ I.PCi NG Oil
Phone: Fax: E-mail: Fucl piping sac a it ora over 4 outlets
rocessp p np(sc ematicrequired)
Numher of outlets
Name: ter ifsted appliane or equ pmcnt:
A(Idnss: — Decorative fireplace
City: State: ZIP: Insert-type
on stuv pe et stove
Phone: I E-mail: Other: -^
Applicant's signature: J -I Date:i it? e)/
Natne(print): e411 r --------
Permit fee.....................$
--—
Na al.)w:+dic lona accept crtdn cards,plrnae c•n;�iiMhcuon for more Inrormation, Notice:'Iltis permit application
Minimum fee................t �
U Yaa U MasterCard expires if a permit is not obtained Plan review(at — %) $
Cmht card rambet- ___.__ ---.-- — - ithin 180 days it has been
F.xpircn wy State surcharge(846) ....$ —_
-- accepted as complete. ��-
Name or ca older as% owr ori a it—Ti t card s TOTAL .......................$
('anlholder dtrtaturc T Amount 4$0-'617((tltlaMMI
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: I & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: - Prim I Total
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code _T ay (Es) Amt
$5,001.00 to$10,000.00 $72.50 for the first$,j,000 00 and 1) Furnace to 100,000 BTU
$1.52 for each additional 1100.00 or including dues&vents 14.00
fraction thereof,to and Including 2) Furnace 100,000 8TU+
_
$10,000.00. includingducts&vents _ 17.40
$To 001.00 to_$2°,000 00 $148.50 for the first$10,000.00 and 3) Floor Fuma,,e
$1.54 for each additional$100.00 or including wont 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$2.5,000.00 and 5) Vent not Inuuded in appliance permity
$1.45 for each additional$100.00 or _ 6.80
fraction thereof,to and Including 6) Repair units
$50000.00. _ 12.15
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Ai,
$1.20 for each additional$100.00 or For items 7-11,see �� Pump Co.d
fraction thereof. footnotes below. , p
M $ to 1UOKinimum Permit Fee$72.50 SUBTOTAL: 7) 00K absorb unit
BTU 1400
- ---- ----- 8)3-15 HP;absorb
8%State Surcharge $ unit 100k to 500k BTU 25.60
25%Plan Review Fee(of subtotal) s 9)15-30 HP;absorb
Required for ALL commercial permits only unit.5-1 mil BTU 35.00
T TOTAL COMMERCIAL PERMIT FEE: S uni 30-50 HP;absorb 52.20
unit 1-1.75 mil BTU _ _
11)>50HP;ahsorb
unit>1,7`mil BTU 87.20
ASSUMED VALUATIONS PER_ UAPPLIANCE: 12)Air handling unit to 10,000 CFM
_ to.uo
Value Total 13)Air handling unit 10,000 CFM+
Defy%ri�on: Q Ea _ Amount 17.20
Furr ace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
dut.ts&vents 10.00
Furnace>100,000 BTU including 1,170 15)Vent fan connected to o single duct
ducts&vents 6.80 _
Floor furnace including vent 955 16)Ventilation system not Included In
Suspended heater,wall heater or 955 appliance p2rmit 1000
floor mounted heater 17)Hood served by mechanical exhaust
Vent not included In applicance+ 445 10.00
permit 18)Domestic incinerators
-Repair units 805 1740
K 3 hp;absorb.unit, 955
to 100k BTU 19)Commercial or industrial type incinerator
69.95
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101 k to 500k BTU 10.00
15-30 hp;absorb.unit,501k to 1 2,310 I 21)Gas piping one to four outlets
mil.BTU _ 5.40
30-50 hr:absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1.75 mil.BTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
21.75 mll.BTU _ _ _
Air handling unit to 10,000 cfm 656 8%State Surcharge $
Air handling unit>10,000 cfm 1 170
Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: 3
Ver;f fan connected to a single duct 446
Vent system not Included in 656
-appliance permit then Ins actions and F
Hood served by mer ianical exhaust 656 _^_ 4 ---e-
1 Ir,�poclions outsideide of of norma business hours(minimum charge-two hours)
Domestic incinerator _ 1,170 $72.50 per hour
Commercial or Industrial Incinerator 4,590 _ 2 Inspections for which r o fee Is specifically indicated (minimum charge-hall hour)
Other unit,Including wood stovet, 656 $72.50 per hour
Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum
:=8s piping 1-4 outlets 360 _ charge-one-half hour)$72 50 per hour
Es ii additional outlet 63 "State :ontractor Soller Certification required for units>200k BTU.
TOTAL COMMERCIAL **Rest fentlai A/C requires site pian showing placement of unit.
VALUATION: _i All New(,urnmerclai Buildings require 2 sets of pians.
i;\dsts\forms\rnech-fees.rloc 08/29/01
1
CITY OF TIGA RD BUILDING INSPECTION DMSt'ON
MST
2.4-Hour Inspection Line: 639-4175 Business Line: 6!9-4171
BIJP
-----,-----Date Requested _� Z - / Z _ AM----PIM r3LD --
Location / ( ' �'Z_ -L� c.)�_� r c Suite C MEC
Contact Berson 1 � — ph PLIV —
-
Contractor _— - Ph SWR �� --
IBUILDING Tenant/Owner ELC
Retaining Wall r ELR
Footing Access: 7 w
Foundation � /, -1-7J �'� L FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation ---
Drywall Nailing
Firewall - -- -- --
Fire Sprinkler
Fire Alarm —
Susp'd Ceiling
Roof - — —.- --
Misc:_ -
Final - - - ----- -
PASS PART _FAIL -_-- --
PLUMBING
F'ost& Beam - -- - -- - -
Under Slab
Top Out
Water Service
Sanitary Sewer - --- -
Rain Drains
Final _ - -------- -- -------
PASS PART FAIL
MECHANICAL
F'ost& Beam - ---- -- -- --- -
Rough In
Dampers
PAS�St PART FAIT_
ELECTRICAL -- - - --_
Service —
ELECTRICAL-__,
Service
-- - - - _
Rough In
UG/Slab
-
Low Voltage
Fire Alam
Final
PASS PART FAIL_
SITE
Backfill/Grading ---- ------- ------..-.._---- ----
Sanitary Sewer
Storm Drain I ]Reinspection fee of$—_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Lire Supply line f 1 Tease call for reinsprsctfon RE: ___4__—__ j Unable to inspect-no access
ADA I
Approach/Sidewalk
OtherGate — S �_ Insf�ecti�r —Y _ Ext
Final
PASS PART FAIL [DO NOT REMOVE this inspection record from the job site.