Permit 5 h t. CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00366
TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/15/2008
PARCEL: 1S133AD-02200
SITE ADDRESS: 12930 SW SCHOLLS FERRY RD ZONING: R -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WESTGATE BAPTIST
Project Description: Replace roof mounted a/c units with split system. Project Value: $19,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: El VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: 2 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
WESTGATE BAPTIST CHURCH Description Date Amount
12930 SW SCHOLLS FERRY RD
TIGARD, OR 97223 [MECH] Permit Fee 71151200E $353.00
[MECPLN] Plan Rev 71151200E $88.25
[TAX] 12% State Surch 7/15/200E $42.36
Phone: Total $483.61
Contractor:
INTERIOR COMFORT SYSTEMS
17200 SE HEMRICK RD
DAMASCUS, OR 97089 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -558 -9224
FAX 503 -558 -9124
Reg #: LIC 135118
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 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
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-041-0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued y: /L Permittee Signature. i /`�� .. ♦ y
Call 503.639.4175 by 7:00 a.m. for inspection / hat business -ay.
This permit card shall be kept in a conspicuous place on the job site until ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application • Received
A FOR OFFICE USE ONLY �y
City 01 °Tigard Date/By: l ff o IP Permit No. �t b '�
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi 171.
�
Phone: 503.639.4171 Fax: 503.598.1960 / I ,� DateB � Other Permit:
IV,
Inspection Line: 503.639.4175 ,�)I,,,, r. Date Rear y: Juris: 0 See Page 2 for
JLR /V
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK 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, and �rofit.
CATEGOR OF CONSTRUCTION Value: $ l9 00 V
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ommercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LO ATIO,)Y Heating/cooling
)C � ! Air conditioning or heat pump
Job site address: / 2 7 s 3 fL /, P6 (requires site plan showing placement) 14.00
Ci /State/ZIP: l C J Fumace 100,000 BTU (ducts /vents) 14.00
ty / t ` C%( ,--c D f c. 7 7� 3 Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: V Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
L/f) / Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
• in -wall, in -duct, suspended, etc. 10.00
1 Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF IVO Water heater 10.00
Gas fireplace 10.00
ee/� kg e- DO 010 Kn. !I ,,, - � Flue vent for water heater or gas
/ fireplace 10.00
C(1 e o GR 1 j 3 n e/'f c�tl r S t(— Log lighter (gas) 10.00
.cie t n"--S t Wood /pellet stove 10,00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER I ❑ TNT Other: 10.00
Name: W 6 . a J '� J 1 C l r Environmental exhaust and ventilation
O � Range hood /other kitchen
Address: J � j kl. 4 11 j -E cr7 k� equipment 10.00
City/State/ZIP: ' , ,_„y 0 ` 72 23 Clothes dryer exhaust 10.00
- r 7 7 Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
) Other: 10.00
Business name: €j �,� 0 r 4 /� F u el piping
_ PtP 8
Contact name: ' _ = $5.40 for first four; $1.00 for each additional
Address: / Furnace, etc.
/ C7 c) S � >"■ r << Gas heat pump _
City/State /ZIP: ', „ a ,... ) 0 c - 0 Wall /suspended /unit heater
Phone: (5b3) �� s. — ?)__ 2 Y Fax: : (s 3 - 4 -- q/2' Water heater _
Fireplace
E -mail: )
Or 4 b a .1 /� ( C'C', Gym Range
�'
CONTRALTO (, Barbecue
Clothes dryer (gas)
Business name:
�-e Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 1 3 ,(( ' ,,,,,, State surcharge (8% of permit fee)
// l TOTAL PERMIT FEE
/ /�� This p ermit application expires if a permit is not obtained within 180
Authorized signa re: ULJ /L days after it has been accepted as complete.
Print name: ► , 0 . i , _ •o. "j ,, _ i Date: ci J D JI Fee methodology set by Tr - County Building Industry Service Board
i:\Building\Permits \MEC - Permit • pp.doc 12/03 440 -461 T (1 1/02/' OM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total :Valuation Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008-00366
13125 SW Hall Blvd., Tigard, OR 97223 Ch ...e..2 ,I , A i d.c5
--- DATE ISSUED: 7/15/2000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 302009 TIME: 7:00Am PAGE:
SITE ADDRESS: 12030 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE--
PROJECT NAME: WESTGATE BAPTIST
DESCRIPTION: Replace roof mounted a/c units with split system. Project Value: $19,000
OWNER: WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: INTERIOR COMFORT SYSTEMS PHONE #: 503-550-9224
Inspection Request Scheduled For: Date: 3/2,2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 080946-02 503-572-7392 N
Corrections /Comments/ Instructions:
4 /
A I g I I I WI
Or
- / .„ i
, 4.( l , , ,
2 -ASS r APPROVAL D CANCEL NO ACCESS
I.
• FAIL fl CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
(_./I.C- 3/2161 Y )--y
Inspector: Date: Phone #: (503)
CITY OF TIGARD _ • I
BUILDING DIVISION ) ?;.,.................' PERMIT #: MEC2008-00366
G
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 71161200B
Phone: (503) 639-4171 e _4, 1 1 3
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/2/2009 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 12930 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTI sr
DESCRIPTION: Replace roof rnounted alc units with split system. Projeci Value: $19,000
OWNER: WE:STGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: INTFRIOR COMFORT SYSTEMS PHONE #: 503
Inspection Request Scheduled For: Date: 3/2/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 080946-01 503-572-7392 N
Corrections/Comments/ Instructions:
-. .
d PAS n PARTIAL APPROVAL 111 CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 1t4 d?____ ___ Date:/ Phone #: (503) 718-D4)4