Permit •
CITY OF TIGARD MECHANICAL PERMIT
a
Iy
' n COMMUNITY DEVELOPMENT Permit #: MEC2010 00420
T t G AR L7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/26/2010
Parcel: 1S133AD02200
Jurisdiction: Tigard
Site address: 10730 SW 130TH AVE
Subdivision: Lot: 0
Project: Westgate Baptist
Project Description: Type I hood system with duct and fans.
Owner: FEES
WESTGATE BAPTIST CHURCH Description Date Amount
12930 SW SCROLLS FERRY RD Permit Fee 08/26/2010 $449.31
TIGARD, OR 97223 Plan Review 08/26/2010 $112.33
PHONE: 12% State Surcharge - Mechanical 08/26/2010 $53.92
Contractor:
CUSTOM METAL FAB INC
50602 BIRCH AVE
SCAPPOOSE, OR 97056
PHONE: 503 - 543 -3170
FAX: 503 - 543 -3171
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -3 Occupancy Load:
Stories: 2
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 $615.56
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: make up air
Duct Work: unit
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
Uti • 1 otification . - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. u ma obtain a copy of the rules
• direct questions to • - . • ailing 503.246.6699. or 1.800.332.2344.
I _ ued By: , #1 // 7 41 ,/ / Perm ittee Signature:
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 FOR OFFICE USE ONLY
City of Tigard REC WED R r g ,?,if 10 k Permit No.: te„.0.o /D -iv
13125 SW Hall Blvd., Tigard, OR 97223 C I: W 0 (2..,_ �
2
Phone: 503.639.4171 Fax: 503.598.1960 6 i Date/By:
Review 1 Other Permit: Olt�
� /�
T I G A R D Inspection Line: 503.639 1 - t - • - Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard - or.gov Notifed/Method: Supplemental Information
Cm( A 'Si '
TYPE OF WOR' r_ -1° > �f - •y LcLv � �, COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ® Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, apd profs
Value: $ 44000.00 (/4 txt)
CATEGORY OF CONSTRUCTION i
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. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooliug
� '( Air conditioning
Job site address: 12930 SW Scholls Ferry Rd 10 �) aG`� � 1— (requires site plan showing placement) 46.75
City/ State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 46.75
p -. t d Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: 71 6 '> �� Heat pump 61.06
Cross street/directions to job site: 130 ave, Scholls Ferry Rd 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
10' -6" hood system, duct, fans 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
❑ PROPERTY OWNER ® TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: Westgate Baptist Church Environmental exhaust and ventilation
Rd Range hood /other kitchen
Address: 12930 SW Scholls Ferry equipment 33.39
City/State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)524 -3500 Fax: toilet compartments, utility rooms) 23.32
® APPLICANT CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Custom Metal Fab Fuel piping
Contact name: Michael Taylor 5i LL ik WL1 $14.15 for first four; $4.03 for each additional
Address: 50602 Birch Ave Furnace, etc.
Gas heat pump
City/ State/ZIP: Scappoose, OR 97056 Wall/suspended/unit heater
Phone: 763 -'1 2: 4-r \ Fax: : (503) 543 -3171 Water heater
Fireplace
E -mail: ghood @cmfstainless.com Range ,
CONTRACTOR Barbecue
Business name: Custom Metal Fab Clothes dryer (gas)
Other:
Address: 50602 Birch Ave MECHANICAL PERMIT FEES*
City/State /ZIP: Scappoose, OR 97056 Subtotal
Phone: (503) 54-3170 Fax: (503) 543 -3171 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 64901 State surcharge (12 %ofpermit fee)
TOTAL PERMIT FEE
signature: This permit application expires if a permit is not obtained within 180
Authorized
6(0 6/0-12407 days after it has been accepted as complete.
Print name: Beth Glosenger Date: 3 ' 1 Z `) • Fee methodology set by Tri-County Building Industry Service Board
I:\ BuildinglPermits \MEC- PecmitApp.doc 10/01/09 440 -4617T (11 /02/COM/WEB)