Permit CITY OF TIGARD BUILDING PERMIT
1111 2 COMMUNITY DEVELOPMENT Permit #: BUP2011 -00045
Date Issued: 03/01/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S 111 BCO2800
Jurisdiction: Tigard
Site address: 10445 SW CANTERBURY LN
Project: Calvin Presbyterian Church Subdivision: Lot: 0
Project Description: Install interior ADA ramp in middle school youth room.
Contractor: OWNER Owner: PRESBYTERY OF PORTLAND THE
CALVIN PRESBYTERIAN CHURCH
10445 SW CANTERBURY LN
TIGARD, OR 97224
PHONE: PHONE: 503 - 639 -3272
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 03/01/2011 $53.27
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 03/01/2011 $6.39
Stories: 0 Height: 0 ft Plan Review 03/01/2011 $34.63
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm Sheet (up to 03/01/2011 $2.50
Value: $300 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $96.79
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 • dance 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
day TTENTION: • - •on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through OAR • -00 ' ' 0. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ued By: /�� „ Permittee Signature:
Call 503.639.4175 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.
Meehanical Permit Applicat tt
"CEIVED FOR OFFat l: l til: t).1.,
`�
'` City of Tigard D a� PermitNo.: U i S
; , • 13125 SW Hall Blvd., Tigard, OR 97221 AR 1 Plan Review ` '
Phone: 503.639.4171 Fax: 503.598.1960 y tz ,: 11111 Other Permit:
i i ,\ R „ Inspection Line: 503.639.4175 CITY OF TIGARD Date ReadyB . Jam: H See Page 2 for
Internet: www.figard-or.gov BUILDING DIVISION 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 v est dollar) of all
❑ Demolition ❑ Other: mechanical mat- ' , equipment, labor, over ead, profit.
CATEGORY OF CONSTRUCTION Value: $ $300.00
RESIDENTIPMENT / FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ® Other: Church Descrip. on I Qty. Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/c , ling
Job site address: 10445 S.W. Canterbury Lane Air s g
(requifires res site p showing placement) 46.75
City/State/ZIP: Tigard/Oregon/97224 Furnace 100,11 BTU (ducts/vents) 46.75
Furnace 100,000 BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Church Ramp
Heat pump 61.06
Cross street/directions to job site: Highway 99 W Duct work 23.32
Hydronic hot water s - 23.3
Residential boiler (radi • or or
hydronic) 23 t 2
Unit heaters (fuel -type, no - lectric),
in -wall, in -duct, suspended, - c. ' 6.75
Subdivision: Lot no.:
Flue /vent for any of above 3.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
I noticed in my church that there is no indoor wheelchair access from the Flue vent for water heater or gas
middle school youth room to the high school youth room. I will be building an fireplace 23.32
Log lighter (gas) 23.32
ADA wheelchair ramp in the middle school youth room, so that the high school Wood/pellet stove 33.39
room will be accessible by someone in a wheelchair. Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: Calvin Presbyterian Church Environmental exhaust and • ntilation
Address: 10445 S.W. Canterbury Lane Ran equipment 33.39
City/State/ZIP: Tigard/Oregon/97224 Clothes dryer exhaust 33.39
Single-duct exhaust (ba ooms,
Phone: (503)639 -3272 Fax: (503)603 -0703 toilet compartments, uti rooms) • .32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 2 32
Other: 23.:2
Business name: Fuel piping
Contact name: Collin Dorsett $14.15 , r first four; $4.03 for each addi
Address: 15861 S.W. Sundew Dr. Furnace, etc.
Gas heat p
City/State/ZIP: Tigard/Oregon/97223 Wall/sus. - • :. unit heater
Phone: (503) 590 -9311 Fax: : ( ) Water hea
Firepla
E -mail: dnjdorsett@yahoo.com Range
CONTRACTOR Bar. ue
Business name: Self - Eagle Scout Project 0C17/6 , i /4. Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: X aor This permit application expires if a pernut is not obtained within 180
�` days after It has been accepted as complete.
Print name: Collin DO ett Date: 6/3/2010 • Fee methodology set by Tri - County Building Industry Service Board
I:\ Buildug \Permits\MEC- PannitApp.doc 10/01 /09 440.4617r(11/02/coM/WEa)
Materials Required to Complete the Project
Type of Material Cost of Material
2 - 2in. x 4in. x 8 ft. boards (lower ramp). $1.48 each. $2.96
4 - 2in. x 6in. x 20ft. boards (base). $6.76 each. $27.04
3 - 4ft. x 8ft. x 1 1 /8in. sheets of plywood (ramp). $33.97 each. $101.91
3 - 4in. x 4in. x 8ft. posts (handrail support). $7.52 each. $22.56
6 - 2in. x 4in. x 8ft. boards (handrails). $1.48 each. $8.88
12 - 8in. bolts for post attachment. $2.76 each. $33.12
12 - nuts / 24 washers. $10.00
Cans of wood stainer provided by the church from excess supply $0.00
1 box (1 pound) of 2 1/2 inch wood deck screws. $8.69 each. $8.69
1 box (1 pound) of 3 1/2 inch wood deck screws. $8.69 each. $8.69
Carpet remnant for ramp will be provided by church from excess supply. $0.00
Permit application $69.06
Total Cost $292.91
Donations Received
Name Amount
11