Fillable Commercial Mechanical Affidavit For Replacing Gas Furnaces Suspended Heaters And Water Heaters (City of Beaverton)

Fill Online, Printable, Fillable, Blank Commercial Mechanical Affidavit For Replacing Gas Furnaces Suspended Heaters And Water Heaters (City of Beaverton) Form

Use Fill to complete blank online CITY OF BEAVERTON (OR) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Commercial Mechanical Affidavit For Replacing Gas Furnaces Suspended Heaters And Water Heaters (City of Beaverton)

On average this form takes 10 minutes to complete

The Commercial Mechanical Affidavit For Replacing Gas Furnaces Suspended Heaters And Water Heaters (City of Beaverton) form is 1 page long and contains:

  • 1 signature
  • 0 check-boxes
  • 34 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Beaverton

BROWSE CITY OF BEAVERTON (OR) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Form B70-1010 REV 2/14
Mechanical Permit No. __________________________ Plans Examiner _________________________________
(Without roof structure engineering or gas piping diagram)
Project Name: __________________________________________ Occupancy: ____________________________
Job Address: ___________________________________________ Type of Construction: _____________________
Suite: _________________________________________________
Contractor: _____________________________________________ Phone: ________________________________ Phone:
I, ___________________________________, Oregon Construction Contractors Board No. ____________, certify the
following is true and reasonably defines the scope of work for this project:
(Check all that apply) Furnace _____ Suspended Heater _____ Water Heater _____ VAV _____ AHU _____
1. The existing gas fired furnace, suspended heater or water heater (to be removed) has an input rating of_______________
Btu’s.
2. The proposed gas fired furnace, suspended heater or water heater (replacing the existing unit) has an input rating of
_______________ Btu’s. The proposed unit’s btu input rating must be equal to or less than the existing unit.
3. The proposed AHU has a rating of _______________ cfm. The proposed unit’s cfm rating must be equal to the existing unit.
Where required by the Oregon Mechanical Specialty Code, provide smoke detector shutdown.
4. The existing gas fired furnace, suspended heater water heater, VAV or AHU (to be removed) has a total weight (weight
includes water for completely filled water heater) of _______________ pounds.
5. The proposed gas fired furnace, suspended heater, water heater, VAV or AHU (replacing the existing unit) has a total weight
(weight includes water for completely filled water heater) of _______________ pounds. The proposed unit’s weight must be
equal to or less than the existing unit.
6. The proposed gas fired furnace, suspended heater, water heater, VAV or AHU will be placed in the same location as the
existing unit being replaced.
7. The installation shall comply with the current adopted edition of the Oregon Mechanical Specialty Code.
8. The proposed work shall not be concealed until inspected and approved.
This affidavit does not eliminate the need for: unit support and attachment details (vertical and lateral); an engineered lateral design for
suspended units weighing over 75 pounds; plans and details for unit locations; unit cut sheets; SEER/EER ratings, etc. If multiple units
are involved list them below:
Existing Unit Btu Input or cfm/Weight: ____________/___________ New Unit Btu Input or cfm/Weight: ____________/___________
Existing Unit Btu Input or cfm/Weight: ____________/___________ New Unit Btu Input or cfm/Weight: ____________/___________
Existing Unit Btu Input or cfm/Weight: ____________/___________ New Unit Btu Input or cfm/Weight: ____________/___________
In addition, I understand the following is required:
A completed Mechanical Permit application and a copy of all the applicable information shall be available
on the job site for all inspections.
Signature: _________________________________________________________ Date: _________________
CITY OF BEAVERTON
Community Development Department
Building Division
12725 SW Millikan Way / PO Box 4755
Beaverton, OR 97076
Phone: (503) 526-2493 Fax: (503) 526-2550
General Information (503) 526-2222
BeavertonOregon.gov
COMMERCIAL MECHANICAL AFFIDAVIT FOR REPLACING GAS FURNACES, SUSPENDED HEATERS, GAS
WATER HEATERS, VAV AND AIR HANDING UNITS
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Commercial Mechanical Affidavit For Replacing Gas Furnaces Suspended Heaters And Water Heaters (City of Beaverton)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 2 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document