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Permit
CITY OF TIGARD MECHANICAL PERMIT ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00238 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/08/2011 Parcel: 2S110BD00100 Jurisdiction: Tigard Site address: 11511 SW BULL MOUNTAIN RD Project: St James Episcopal Church Subdivision: BULL MOUNTAIN VIEW ESTATES Lot: 4 Project Description: Furnace replacement. Contractor: SUPREME COMFORT HEATING Owner: ST JAMES EPISCOPAL CHURCH 9425 SW COMMERCE CIRCLE #16 PO BOX 23033 WILSONVILLE, OR 97070 TIGARD, OR 97223 PHONE: 503 - 682 -1985 PHONE: FAX: 503 - 682 -1018 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 06/07/2011 $130.46 Class of Work: ALT Type of Const: VB Plan Review 06/07/2011 $32.62 Occupancy Grp: A -3 Occupancy Load: 12% State Surcharge - Mechanical 06/07/2011 $15.66 Stories: Info Process /Archiving - Sm Sheet (up to 06/07/2011 $0.50 11x17) Project Valuation: $2,500.00 Fuel Air Handlers Fuel Types: Natural Gas Units < 10000 cfm: Gas Pressure: Units > 10000 cfm: Furnaces Boilers & Compressors Furnaces < 100K BTU: 1 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 $179.24 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 O C by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: iLsallira-4 014 639.4175 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. 05/31/2011 12:41 503 - 682 -1018 ,�� L C F NC �� PAGE 01 a. .�► . cart " � • 01004::1 Mechanical Permit Application \ FOR C)f'F KE OUSE ONIA Ci of Tigard �' De ceived , R e eivY: 31 f i%1. Pallid No.: LI _ �I— _ • �• 14 ' 1 3125 SW 1-1,111 Rlvd„ Tigard. OR 7 r Plnn Rcvi '�►�i — Phone: 503.718.2.4'39 Fax: 503.5 .0960 ``''1���� 011 Uatc /fay: '�, r 0 0J OtherPcrmit T[G7ARl5 Insptelion l.inc; 5(13.639.417: MA`( 31 2 f)nic Rtly 7. lurk G7 Sec Page 7 (nr Internet: www.ligard nr.gov Nolilic I /Method: /, / - 77 Silpplrmnntnl Information k 'TIGARD - - �Jfv CO MME M - 3 A FEE' SCHItDOLE - 1:(SE•CF1EC_ELIST " TYPE OF NG D`sVl . � �' � .........._.____._.__.__._.__. ........-- ----- ................ --- - -- Mechanical permit lees* are based on the value o'fthe work 7 Ncw construetiOn ® Acid ition /aflerttl inn /replacement performed, indicate the value (roundj'd to the nearest dollar) m all _] f)cuanlilion ❑ Other; mechanical materials, equipment, labor. overhead. and •roft, w ....._ - Vahw: $ 2990 O ._ NSTJ UICTiON • C.A1 EGO'RY t7C C. ... .. .:_„c::: 1 . iPEMS PF.FS"'.. _ ar.�rnrtirrrinL r cutr>vr.rxrrfF rsys I - and 2- family dwelling ® Commercial/industrial ❑ Accessory huildlfg . Far specialInformnrini utecheehlisS ❑ Multi- family ❑ Master builder ❑ Orhl;r: Description , Qry, Ha. Total Heating/cooling: JOB SITE TNFOR1 IATI N • 'ANID' LOCATION` - . — .-- -'-- ...... .,.,......-- - - ---• Job tinnin A:r cone a b site address. 11511 SW Hull Mtn. Rd grans site plan showing plaaccmcnll ,,,,;_ 46.75 •_....._.__..._______....., - ----- ._...,.,.. _...- - --..,_.,- ---- -- Furnace 100,000 OTT (clad, /vent,) 46,75 City/Stater /A': Ti p nrd, OR 97224 ---- " -- _...... _...... - _...,_, Furnace 100,0001 li'l't! (duels /vcius) __ 14.91 Suite /bldg /apt, no.: J Project name: St. James Episcopal Churc Heat pump — — _ __._. .... — (requires site lans I ace m en t) 61.06 cross sweet/directions to job site' Duct work . - , -- 23.32 Flydronic hot water system - 23.32 _...--- - .... ... _ -. Residenti boiler (radiator or — hydronic) 23.32 ....._... _.._ _,_._..,.... ......- •-- ° --- Unit healer? (fuel - type. not electric). in -wall, in -duct, suspended, etc. 46.75 Subdivision I,at, no Flue /vent for any of above 23.32 - ................... Other: 23.32 Tax map /parcel no.: Other fuel appliances: p rSCRII'I'ION,'O.F, GR'K• Water heater - 23. 2 _:. _� „r ...:......:.: Gas firc,lacc 33 . 39 ,' Replace Furnace — _ - -� Flue vent for water heater or gas fire.lacc 23.32 l,n�l ghtcr (gas) - 23,32., . - -- 1 .8.7 Wood clad stave 33.39 Wood lireplaee /insert 23,32 ..--.. • n PROPERTY OWNER © Tt TENANT Chimne /liner /t uc /vent 23.32 ....,.r -. -., -w...w - Other'. 23,32 Name: SI...lsrones i I;: scn al Church 1 P EIIVh'unmental cxhausl and vcntiIhtion: • Address: 11511 SW bull Mtn. Rd. R anRc hood lather kitchen equipment 33 . 39 .,.,..,... __...._.., Oily /,.Slate /ZIP: OR 97224 Clothes dryer exhaust 33.39 ANT CONTACT PERSON A� W „- _..._..._.._._..._.. - _...- .------ -...,...., -- single - duet exhaust (bathrooms, Phgnc'( ) Fax: ( ) � toilet compnrltncnte, utility rooms) . 23.32 ❑ tic /c rnwkpacu liras 23.32 Other: . Business name: same as contractor - -. - -- - - -- Filet piping Contact name: $14.15 for fret four; $4.0.1 far each add itional Furnace, to r .. .._w- - -- Gtla boat pump City /'S1ate /7.1P: - - -, ---- �..,,,,.__._ Wall/suspended/unit heater Phone: ( ) Fnx:: ( ) Water heater Fireplace P .—mail: _.....,._. ... . ............. ... - - - - --. _ _..�_ Ran(e -- CONTRACTOR . 13stncccue Business name: ,Supeme ('nn, Inc, ................_.... -- _. ort C lo t hes dryer „ (ga s . • -- Address: 9425 SW Commerce Cir. #1(i ' ' ” . ME(;HANICAI. PEiRMd'r PEES* • city/State/ZIP: Wilsonvilic, OR 97070 _ Subtotal - - 7 - -- .. .....,. — Minimum permit fee ($90.04) Phone: (503) 682 - 198$ 1 Fax: (503) 682 -1018 -- —__._.......,.,.._... .. . . ...... ...... ...__. Plan review (25 %of permit fee) ('('13 Ito,: 21892 State surcharge (12%1°1' permit lee) ___.___..... - - -- - ..... -- .- Cf - I I PERMIT FEE /� /J — %f ... ..._ — tin v after nscrn • o •... . /2.-- . - %,G1J��,.�� 1 .. -.:- . Print llll n.In,C; Ritndatl • ilp . ,......., ___—___......._ .I)nl'C: 5 /3O /1 I - - - - - -. N TMe l l n et 6r ulnlo lry nacl by TrrCn Vl Is nor nhtalnC +I within tan A trthnri?Cd ,c ieon furr .. _ _ _ Y opted n.t camp[etc. uildinr. In du.clry Service finned I■1)uildniAPcr 'hail +tl`'(Ff'- PrrmilAnn dad IuVIpi /In rlln•a6 I7'F(II /u:! /COM /WEB)