Permit CITY OF TIGARD MECHANICAL PERMIT
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` f COMMUNITY DEVELOPMENT Permit#: MEC2009-00585
T1G ARI? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2009
N5 7xW4 Parcel: 1 S134AA01800
Jurisdiction: Tigard
Site address: 10180 SW NIMBUS AVE J1A
Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project: City Edge Community Church
Project Description: Install bath fan.
Owner: FEES
ROBINSON, CONSTANCE A & Description Date Amount
ROBINSON, LYNN ET AL, BY KG INVESTMENT Single Duct Exhaust (Bathrooms, Toilet, 11/03/2009 $23.32
MGMT, 10240 SW NIMBUS AVE #L3 Utility Rooms)
PHONE 12% State Surcharge - Mechanical 11/03/2009 $10.80
Minimum Fee Adjustment - Mechanical 11/03/2009 $66.68
Contractor:
GUILD CONSTRUCTION INC
PO BOX 674
BEAVERTON, OR 97075
PHONE: 503 - 957 -1173
FAX: 503 - 291 -1532
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue. Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans. Vent Systems: Total $100.80
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. �1
Issued By: ao y' (� 0 /�" Permittee Signature: \ 0 n App
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application RECEIVED , :4� ':rolz` i Ic �ci�i .
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-r 4; City of Tiga r ` (I Dateive �t PermitNo.: Q�q „^,cr' S
t ° 13125 SW Hall Blvd., T OR 97223 1 2009 1 ”` r
C „ Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD
I I I G A R' D Date Ready/By: .1 ri ® See Page 2 for
1 1._.4= = Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF 'CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: 1 0 b0 S tAJ Allg ►I,t, y ,¢ p
requires site plan showing placement ) 46.75
City /State /ZIP: i q ;1 Q 1 Fumace 100,000 BTU (ducts /vents) 46.75
f Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: TA, Project name: " C J / tD902. '. Heat pump 61.06
Cross street/directions to job site: $4// S ►zrry 50 6 , µ („, _ Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION' OF WORK ' , ' Water heater 23.32
Gas fireplace 33.39
0 i 00o ,C•44.1 Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
ErPROPERT,Y OWNER ❑ TENANT
Other: 23.32
Name: 4 6 14.4. vroici. 44141,..0.• • Environmental exhaust and ventilation
Range hood/other kitchen
Address:
i02&k "I Aim v St ,4 , 4_,.. „...5 . l..../ Z equipment 33.39
City /State /ZIP: 2 _ —e5V " Clothes dryer exhaust 33.39
°� � Single -duct exhaust (bathrooms,
Phone: ( 9,8 _ 9 ?8 Fax: ( ) toilet compartments, utility rooms) 1 23.32
E wPPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: /i� ���1 e, Fuel piping
Contact name: (� ( e J e of $14.15 for first four; $4.03 for each additional
Address: /0 S'D L Gas heat etc.
S gf''J it/��I �4� A(�' S. Gas heat um
P P
City /State /ZIP: ) /wee o r Wall /suspended/unit heater
(0 7
Phone: 95 -, Fax: : ( ) Water heater
Fireplace
E -mail: Range
. CONTRACTOR Barbecue
/ Clothes dryer (gas)
Business name:
(�'U ✓� -�✓ 1�c.., Other:
Address: /0505 5(A) Wi 04 4 .s • Jd / MECHANICAL PERMIT FEES*
City /State /ZIP: S ubtotal
� / 0 � Minimum permit fee ($90.00)
Phone: ) Q Fax:( )
— 3t98� Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee)
TOTAL PERMIT FEE ( CO. E°
This permit application expires if a permit is not obtained within 180
Authorized signatur days after it has been accepted as complete.
Print name: - Q��— Date:
* Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permits ermitApp.doc 10/01 � 440 -4617 (II /02/COM/WEB) l 2 - n.,�
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: 'Permit Fee: .
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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