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Permit CITY TIGARD MECHANICAL PERMIT ge DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00401 . 13125 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/5/2005 PARCEL: 1 S133AD -02200 SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE ZONING: R -7 SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Duct work only 1st. fl. No. end. Value: $17,500 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: A2 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: 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 [MECH] Permit Fee 7/5/2005 $332.75 TIGARD, OR 97223 [MECPLN] Plan Rev 7/5/2005 $83.00 [TAX] 8% State Surchaq 7/5/2005 $26.62 Phone: Total $442.37 Contractor: INTERIOR COMFORT SYSTEMS 10622 SE 172 REQUIRED ITEMS AND REPORTS BORING, OR 97009 Phone: 135118 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 fIrth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to • UNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: � Permittee Signature: ��Jdi der f Call 503 - 639 -4175 by 7:00 a.m. for inspection at business d .1 This permit card shall be kept in a conspicuous place on the 'ob site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mecianicftl Permit Appllcati FOR OFFICE USE ONLY - . II City of Tigard i �L l V ED Received Date/By: C1' O ' Permit No.rnCC c2 905 -- 00 00 L t/ l 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503. 639.4171 Fax: 503.598.1960 JUL I ® h 200 Plan Review J Other Permit: I j Date/By: y: Inspection Line: 503.639.4175 V ,�/� MI �� ,.,�, t:!I Date Ready/By: ELII El See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGA Notified/Method: Supplemental Information Rl to nlf"r nHVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST few 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 profit. O 0 CATEGORY OF CONSTRUCTION Value: $ j 7 .4-0 RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwellingmmercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND /LOC TION Heating /cooling Job site address: y Air conditioning or heat pump 1�g3 (� J Sc S ( o ` -r P r (requires site plan showing placement) 14.00 City/State /ZIP: 77 a (-or Or . Y7 j. Furnace 100,000 BTU (ducts /vents) 14.00 J Furnace 100,000+ BTU (ducts /vents) _ 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 •Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIP ION OF WORK Water heater 10.00 L Gas fireplace 10.00 D K G i W 0 F- O r. 1. -/DO r /� Or - Flue vent for water heater or gas 0 / fireplace 10.00 L° ^ Log lighter (gas) 10.00 Wood/pellet stove 10.00 • Wood fireplace /insert 10.00 ❑ PROPERTY OWNER ❑ T NANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: V) -1_ - 4 �� a4 j f J / pi r f� ` Environmental exhaust and ventilation Address: ) 77 //�� 4. ....pp �� /� Range hood /other kitchen a J u se '7``2,i,- "�fi1' equipment 10.00 77 4 . City/State /ZIP: , � rW O ( r / Clothes dryer exhaust 10.00 !! [[ 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: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump • City/State /ZIP: Wall /suspended /unit heater Phone: ( ) Fax:: ( ) Water heater f Fireplace E - mail: / n 4 C rr O r ("©M t'OC4 0 CQ. cam /1 P. Range CONTRACTOR ! Barbecue / (' -- Clothes dryer (gas) Business name: N `� e, ,..-1 O /' C OM O r J f , �rietJ I Other: Address: / 7, Q ) \S / I t t R� MECHANICAL PERMIT FEES* City/State /ZIP: / en,` ©, _ ��` ��V77 G 7 0 O ¶ Subtotal Phone: (\�) .1 .i �� ,f ' Fax: (1-o ) s"S•' hJ — 9 / Z 4( Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: / 3 S / 35 / / e7 State surcharge (8% of permit fee) a e ��.Qa TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: f� r r y t7 , Co r h Pa ... Date: � r J % O t -i--- - * Fee methodology set by Tr -County Building Industry Service Board 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 !1 fraction thereof, to and including �( $1 0,000.00. $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 ,t-e $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and C $1.25 for each additional $100.00 or J fraction thereof, to and including $1 00,000.00. Cgt $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. vd Tex • b•. ov I .q3 - . • i:\Building \Permits \MEC- PermitApp.doc 12/03 2 W A ' - OF TIGARD AA E BUILDING DIVISION PERMIT #: C , co , 40 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED Phone: (503) 639 -4171 i A,,,,,\ u, �my p 0 l • Inspection Requests (24 Hrs.): (503) 639 -4175 ,:.. INSPECTION WORKSHEET FOR DATE: / TIME: PAGE: SITE ADDRESS: lQ7-2- S ( '-) CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: 60e ^-e. a { sT OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message (dam LI {Otf I CA - 6— F tti Corrections /Comments /Instructions: AW, iI' l ;a AIL , , PASS 1 I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL EES ASSESSED Inspector: Agagl Date: � 0,C. Phone #: (503) 718- `'" \`' I CITY"oF TIGARD BUILDING DIVISION PERMIT #: MEC2005 -00401 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 702005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/30/2005 TIME: 5 :59AM PAGE: 55 SITE ADDRESS: 10730 SW 130TH AVE MULTI- PURPOSE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: WFSTGATE BAPTIST CHURCH DESCRIPTION: Duct work only 1st. TI. No. end. Value: $17,500 OWNER: VYE: TGATE BAPTIST CHURCH, PHONE #: CONTRACTOR: INTERIOR COMFORT SYSTEMS PHONE #: 13511t3 Inspection Request Scheduled For: Date: 12/30/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 024204 -01 503 -572 -7392 N Corrections /Comments/ Instructions: Or- AI s p • • P S ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I FAIL • ❑ CALL FOR, INSPECTION ❑ ADDITIONAL FEES ASSESSED X11 Inspector: 111! ` Date: Phone #: (503) 718 - 3 CITY OiF, BUILDING DIVISION PERMIT #: MEC2005 -00401 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2005 Phone: (503) 639 -4171 / ,�,d�pnl�u� l6' 1 I # Inspection Requests (24 Hrs.): (503) 639 -4175 __.. . INSPECTION WORKSHEET FOR DATE: 12114/2005 TIME: 1 :01AM PAGE: 41 SITE ADDRESS: 10730 SW 130TH AVE MULTI CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: WESTGATE BAPTIST CHURCH DESCRIPTION: Duct work only 1st. fl. No. end. Value: $17,500 OWNER: WESTGATE BAPTIST CHURCH, PHONE #: CONTRACTOR: INTERIOR COMFORT SYSTEMS PHONE #: 135118 Inspection Request Scheduled For: Date: 12/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 625 Duct work 023447 -01 503 -572 -7392 N Corrections /Comments /Instructions: • anI n PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: gtf4f U Date: I \ hone #: (503) 718 - \ � -