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Permit //i added 1p r rcw V` cdw k av P .l , CITY OF TIGARD MECHANICAL PERMIT illi COMMUNITY DEVELOPMENT Permit #: MEC2010 00626 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/02/2010 T 1 ARi7 Parcel: 1S 133AD02200 Jurisdiction: Tigard Site address: 10730 SW 130TH AVE Project: Westgate Baptist Subdivision: Lot: 0 Project Description: Range hood for kitchen & fellowship hall. 12/2 /added fuel piping for range and convection oven. Contractor: DUTTONS REMODELING Owner: WESTGATE BAPTIST CHURCH 16775 SW LAKE FOREST BLVD 12930 SW SCHOLLS FERRY RD LAKE OSWEGO, OR 97035 TIGARD, OR 97223 PHONE: 503 - 572 -7392 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 12/02/2010 $161.16 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/02/2010 $19.34 Occupancy Grp: Occupancy Load: Stories: Project Valuation: $3,500.00 Fuel Air Handlers Fuel Types: Units < 10000 cfm: Gas Pressure: 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 $180.50 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 -0090. You may obtain a copy of the rules or direct questions to 1UNC by calling 503.232.1987 or 1.800.3 . Issued By • .4 _ Perm ittee Signature: J s� � i .- -I � _.-i�� Later i� I Call 1 '5 by 7 :00 a.m. for the next available inspection date. 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 Ui " O NL Y . ° `, City of Tigard Date/By: 0 - Permit No.: r- n r q 13125 SW Hall Blvd., Tigard, OR 97223 4 1eW ' 11111 1 12 ' IO 7�ll�lt1 _�� e _ n , _ Phone: 503.639.4171 Fax: 503.598.1960 " 1 - )V is _ i 1--7 T I G A R D Inspection Line: 503.639.4175 c� . © Date/By: Oth Pe rmit: Date Ready/By: Juris: See Page 2 for Internet: www.tigard- or.gov ,, �1 % A� Notified/Method: Supplemental Information TYPE OF WOR ((<7 (S\ . eP COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ew construction ❑ Addition /alteratio � trair Mechanical permit fees* are based on the value of the work performed. Indicate the v e (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: `�N.09 mechanical materials, quipme , abor, overhead, and profit. CATEGO Y OF CONSTRUCTION Value: 500, RESIDENTIAL EQ IPMENT / SYSTEMS FEES* ❑ 1 - and 2 family dwelling Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 1 ? 30 S. l.) -Nt. Ai d l (requires site plan showing placement) 46.75 City /State /ZIP: -t;' LGkRD 1 o «, s7 zZ3 Furnace 100,000 BTU (ducts /vents) 46.75 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: to 6- S <r cekcs Heat pump 61.06 Cross street/directions to job site: G '' L?2.PL y 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 Flue /vent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 • I kit.-9‘1 ,/ Fg.l.k.pu b Vile trlAst.C. 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: ) l T(2- a Z. erP TiiT G yVit6 ii Environmental exhaust and ventilation Range hood /other kitchen Address: 12C,z,0 c tYau.5 catty (Z equipment i . 33.39 33'31 City /State /ZIP: Z Clothes dryer exhaust 33.39 Gkel, b 6 4. . 5 7 Z Single -duct exhaust (bathrooms, Phone: (3) s',24- /60 Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: Fuel piping Contact name: $14.15 for first four; $4.03 for each additional Furnace, etc. Address: Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range Oj� CONTRACTOR Barbecue / p Clothes dryer (gas) D � Business name: - 0 V .p-b� /.5 n Lsmt)D>rLtmCT l " Other: CryN - � fNC/� 1 f4r' IL 7 Address: t4c:1 `7 S SW tkKe pb12 Q LVb MECHANICAL.PERMIT FEE * "(7 City /State /ZIP: (_ pcKAc- d 5 CCU IZ L o 0 L. 9 7 0 3.5 Subtotal 2 Minimum permit fee ($90.00) I, i/(0 Phone: (613 3) 5 7 2. 73 9 Z Fax: ( ) plan review (25% of permit fee) CCB Iic.: 1 ( ( i 1 7 State surcharge (12% of permit fee) ill, 39 1 TOTAL PERMIT FEE • f1.,.- ! �j This permit application expires if a permit is not obtained within 180 Authorized signature: U days after it has been accepted as complete. Print name: ea ',v /fit `, U f �"ON Date: ii -Z -40 • Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440- 4617T(11 /02/COM/WEB) 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. • 1:\ Building \Permits\MEC - PermitApp.doc 10/01/09 2