Permit CITY TIGARD MECHANICAL PERMIT
.,'r i, DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00102
a . DATE ISSUED: 4/26/2006
'--�" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 114AA -00100
SITE ADDRESS: 09000 SW DURHAM RD ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Girls locker room & CE2 /Transitions TI. Project Value: $2,000
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
TIGARD - TUALATIN SCHOOL DISTRICT 23J Description Date Amount
6960 SW SANDBURG ST [MECH] Permit Fee 5/27/200E $72.50
TIGARD, OR 97223 [MECPLN] Plan Rev 5/27/200: $18.13
[TAX] 8% State Surchar€ 5/27/200E $5.80
Phone: 503- 431 -4000
Total $96.43
Contractor:
JACOBS HEATING + NC
• 4474 SE MILWAUKIE AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97202
Contact #: PRI 503- 234 -7331
FAX 503- 808 -9108
Reg #: LIC 1441
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 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 -800- .3
/
ilk' z
Issue By ) ao Permittee Si ature: �;.;,,�
Call 503 - 639 -4175 by 7:00 a.m. for in ons that busin f- s day.
This pe 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 - ° hOR•OJ F ICL;USE ONI 1' , 1 ° `
C ity Of.,TI and Received
Permit No..
g Date/B /1 _ , Asps - , .
13125 SW 1 -tall Blvd., Tigard, OR 97223 Plan 11.1
Phone: 503 639.4171 Fax: 503.598.1960 14 0 r Date /B Other Permit.
Ins ection Line: 503.639.4175 iP .l �y
P �_ � �'I_i Date Ready/By lures ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method. Supplemental Information
TY E OF WORK c l »4 I RCIAL FEE* SCHEDULE — USECHECKLIST
El New construction Addition /alteration /replacement nl e�ltttiC�afegtipees• are based on the value of the work
perform di OIj 8'ie value (rounded to the nearest dollar) of all
molition ❑ Other: 0 f)lmechanical mat tals, equipment, labor, profit. .
overhead, and prt.
CATEGORY OF CONSTRUCTION . ` r,
Value: $ p "oZl J Q d • u 2.
A ! E zr • a
❑ 1 - and 2- family dwelling El Commercial /industrial El Accessory building .fd RESID EQUIPMENT %SYSTEMS FEES*
ID Multi-family U D For special information use checklist.
❑ Master builder ❑ Other: Descn
Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
'` � rr Air conditioning or heat pump
Job site address:
96150 SL(} � �� a f� �a (requires site plan showing placement) 14.00
-
City /State /ZIP: r - c r( bp- C q7 -.V( Furnace 100,000 BTU (ducts/vents) 14.00
°' t (c-_.. Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg/apt. no.: Project name: (`4 L Q S Gas heat pump 14.00
Cross street /directions to job site Duct work 14.00
(( rr Hydronic hot water system 14.00
a.� t� �1 Residential boiler (radiator or
hydronic) 14.00
lJ Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no :
Other: 10.00
Tax map /parcel no: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ ( -o - '�h` 'er € + lu � Gas fireplace
for 10.00
r.� l .�( �'c`•t)f�c4 Flue vent or water heater or gas
- e - -e � +
fireplace 10.00
t
� Qy t v I. A. Log lighter (gas) 10 00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
gPROPERTY OWNER . ❑ TENANT Other: 10.00
Name: `-r� :T.,
alt ( ` D a Environmental exhaust and ventilation
ll ` Range hood/other kitchen
Address. ip6 `� ��l t7( ?h equipment 10.00
City /State /ZIP: ` r 4 a� g Clothes dryer exhaust 10.00
C Single -duct exhaust (bathrooms,
Phone: (ij)) 4 3( _ it op 3 Fax: (Fj1)3 41 ( — + f - p if"( toilet compartments, utility rooms) 6.80
APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
` �( /
Other 10 00
Business name: " j L( q�}f T UZL -r 'GC ( t Fuel piping
( P i p g
Contact name' � (?..p ,r(c $5.40 for first four; $1.00 for each additional
Address: 4A S S VI, Furnace, etc.
P p
Gas heat pump
City /State /ZIP. ( b L_, Wall /suspended/unit heater
Phone. ( )) 010 _ 9 . Fax: : (9p 3) GE 3/ 40 c(7 Water heater
Fireplace
E -mail
Range
`' CONTRACTOR Barbecue
Business name CCU N I�-% / N 6 cl (I �� Clothes dryer (gas)
� Other:
Address. `1 q 7 ti h t LL /u. Ih t c- t 00 MECHANICAL PERMIT FEES*
City/State /ZIP: p L-r eV_ Q 79.6 Subtotal
Phone: (g�3) 2 , 1 _. -7 3 5/ Fax: 655) SC $ — !hog Minimum permit fee ($72.50) / / ] I. 3D
Plan review (25% of permit fee) a9
CCB lie.: �t I/ / State surcharge (8% of permit fee) r . '72-
I ((( TOTAL PERMIT FEE I / 537. pi
Authorized signature: �� - \ t TTC1) This permit application expires if a permit is not obtained within 180
,�` days after it has been accepted as complete.
�
Print name: V ',� Date: - 1(p (0 G * Fee methodology set by Tri- County Building Industry Service Board
I\ Building \Pennits\MEC- PermnAppdce 12/03 440- 4617T(1l /02/COM/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.
•
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Mechanical Permit Application M : ; , K1r � ;; ;It' ,
d �' e ; , 7 ` r FOR'OFFICE USE ONLY
C ... a i Y It y , ,. ry, 't
1 Received
Clt Oft al (� ) P ermit No q ll
13125 SW Hall Blvd., Tigard, OR 97223 0, � _. Plan Review
3 4 ` ���r�CY�� d 2 -
Phone: 503 639.4171 Fax: 503 598.1960 Date/By an Re
Other Permit: Inspection Line: 503.639.4175 p A Q 1 111 i Date Ready/By- / El See Page 2 for
Internet. www.ci.tigard.or.us ( AR Notified/Method - 7 5--- Supplemental Information
C �i S O)'.?., w C' c a ■ _
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���� ",�N � :�� ,� _��;.• '��"""''"�� � ` ° '.:d_,;: :� a�COlY1pNI,ERC3, ° „ � ..;
Mechanical permit fees* are based on the value of the work
New construction Addl ion/re lacement performed. Indicate the value (rounded to the nearest dollar) of all
.0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
e* r , x . . i.,s, ,a,y,, ,,,,,,,; ,; ,,, , y,.. ,.. s : Value $ Z 600
" . i :'-; '} -'' °fir icyV ; 'r` R r "': e"' :;'r 4 '
; � , ; t 6,,' , : � :.t ° = ;a. „ "'w= CAT'EGOR O I t,:, C®PISTRIICTI ON: �,., , a:, ' ._ /,
.�. '��, , ,�.,'.k,. ......,. ..;., xz;,.:, ,,:sra:�a^ >:��_. ^- :��f:�ar „ ,.,.,�?•x ° °M� ��,:- :...., x >^� Jar .:' a � ; ���;..° �' , . .�. , . ., ,�, e ,,,....... . .
t r- i s tRESID'ENTIArEQUIPIVIENT /'SYSTEIVIS F EES»
❑ 1- and 2-family d '.:llm ommercial /industrial
y g �'C� ❑Ac cessory building
For special information use checklist
❑ Multi family ❑ Master builder ❑ Other:
Description Qty Ea Total
�i;+.�'�” :"'`=,s"`'s', ?L�'.:N� ,`�� :� � , .• rx�.� - � z�e: =,z: � �, ' ar -� � - `+ aa,._ t s. °. ^ E : S` 'r',�a:"
t,; _' _ - - ° J013 , TE �INhvRMATIO AND LOCAT ON • ;- z� '
e,- � :;i�= '��:�'� »,''`,� - :. ^,'rs�a =.t,.. �z.. �»rs.•�:r:�.r.� .» aa.,v�. ..a4v�°,.aa� a��.�s .. ., a, "�?:E - .`� ?ai "�,��s Heating/cooling
Job site address: 9000 g (� (.hC V1r� in
Air conditioning or heat pump
(requires site plan showing placement) 14 00
City/State /ZIP: --r-C Q Furnace 100,000 BTU (ducts /vents) 14 00
Suite/bldg. /apt no.: ' I Project name: S CC i� Furn 100,000+ BTU (ducts /vents) 17 90
Gas heat pump 14 00
Cross street/directions to job site: "T a J 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: I Lot :.. Flue /vent for any of above 10 00
Other: 10 00
Tax map /parcel no.: Other fuel appliances
, z , . , $ - „° -'` -` ' `"
. i ,..: • I. e:,. . ".: 71 1- ' '':" ' :,,, .. . ,,;.uN" DESC RII' TIO N,,.. `OF , W OR , ; 7 : ° ,'' "`r o . Water heater 10.00
:=;
o„ F r r
p Gas fireplace 10 00
Met S y■, r i �ka.Cr Flue vent for water heater or gas
O fireplace 10 00
s v.... Z U t ° CL' Log lighter (gas) 10 00
Wood /pellet stove 10 00
Wood fireplace /insert 10 00
. . -- . , ,, _ ��,. _. t .., -: ' ,' =. ", „,a° '1. .. ',,$,7,..,i; Chimney /liner /flue /vent 10 00
ROPERIiY„` , VNER ' i : _ 'g ' > ' i , , TE ' T,` .
F ,�.:.'s ; ' ' '�u��9 ...: , .a7k ^ '„r x ' t�` * �&»to,�°% d+»a}%. -', ,C . i`,=S :.e�Sf
.- 1 _ 1 , ` }� Other: 10.00
Name: ,l ,) 1U wW.+v. v\ Sv�v\ p ` t (A. Environmental exhaust and ventilation
G ^ Range hood /other lcitchen
Address.
f (Q 5c - equipment 10 00
City/State /ZIP: -1-1 U - _ 0 a Clothes dryer exhaust 10 00
Single -duct exhaust (bathrooms,
Phone: is ) L(3 1 Li 6(76 Fax: (5 )3( — 4 G ti'f, toilet compartments, utility rooms) 6 80
f >,: ; . -;s» tc, , q' „ - 6 - 1 - •rta- ,»
,, _ - '4°°,r-, _ ° ,. -' rt Attic craws
r X . p ;pH° °APPLICA ' - °. „ : r v °' : ® a " ; t ace fans 10 00
' / l P
r � � °aro�rt�, - �^s x - ri. � `�.: °a P - .K`a" < . „.., . s+£,:=4a.,,�. a�&aamn. �?. m:� ^; .u�a „ 5 , �:.
�° Other, 10.00
r
Business name: 't J I T u S � .b,3k - J Fuel piping
Contact name: S r .p $5.40 for first four; $1.00 for each additional
Furnace, etc
(
Address: q l/ (j cL 0 5 (, S A y,3b vv- Gas heat pump
City/State /ZIP: 17, C e....46 b l.. " all /suspended /unit heater
Phone” ( S ol .9 3( — 'l C, G .3 Fax: : (5'c.3) Il 3( - l ( p 4 ? W •`• heater
Firep , .ce
E -mail:
Range
a;r,, K< ,m :, ,:; M , ,,:e,; CONTRAC O , , •:' „,4 ,, -,;», , 1 : - .- ; � #. ; , ''” ;^:E n: Barbecue
s� ,- ;','��a"as�...,» �. ,_r " , �., � ,., , - , .-as.� :r .�`�'`�` "• _4sa'�72'�:.» >:�sa , ;r:fi „�
Business name: 0j ' �- 3 \I-12 Cei)or.(4ei,U r ti}' .t ' Clothes drye (gas)
Other
Address. An a, ? - „» „ -,i irit __ ,- - ,t 1
, : : ..IVI• EC &AN ICAI,' PER ..„, = F *.`'
City /State /ZIP: C G Subtotal
__ Phone. s . - b' ' m05 ( Fax: _ Minimum permit fee ($72 50) )2, - - - �J ( Plan review (25% of permit fee) f
CCB lie •
/1 l State surcharge (8% of permit fee)
In r — n TOTAL PERMIT FEE F26,
Authonzed signature Y 1`' -,SI This permit application expires it a permit is not obi ' ed within 130
1� , 1 days after it has been accepted as coin.. etc.
Print name: ' s 1)&0.X' btu j Date: 3 f t o (a * Fee methodology set by Tn- County Building Ind ervtce Board
r \Building\Perrruts\MEC- PermitApp dot e /03 440 -4617T (11 /02 /COM/WEB)
it )
Mechan Permit Application - City of Tigard
Page 2 - Supplemental Information .
Commercial Fee Schedule:
.5�,,,,...'','�'.�'�a =�" ;§s�t- ��«.- �':�i'°i�ce�s„.,, r� " ":"��- ;� ��s "upai;���,",`. .h,,a.;•�p_,. `5,"- �.',.:"a < "�
v:T r a1iva.10 ., 4 Pe t. Fee �, '�µ = €; .._- a ,n;t'=: .
�_ � _ _ — ms s. �� � � �.��_ �� : � �_�. s s
$1.00 to $ ,000.00 Mmimum fee $72.50
$2,001.0 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. 0 to $10,000.00 $141.50 for the first $5,000.00 and r
$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 $100.60
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.
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i:\Bmlding\Pemuts\MEC- PermitApp.doc 12/03 2
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. -
' CITAMETIGARD
BUILDING DIVISION
Ai& PERMIT #: 4 ME (. C , 0 0 05 -
6 00102
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1200
Phone: (503) 639-4171 itasovikl if
Inspection Requests (24 Hrs.): (503) 639-4175 j. e I
,, ---.
INSPECTION WORKSHEET FOR DATE: 1 W3/2006 TIME: 7: 06AM PAGE: 40
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD HIGH SCHOOL
DESCRIPTION: Girls locker room & CEJTransitions TI. Project Value: $2,000
OWNER: TIGARD-TUALATIN SCHOOL DISTRICT 23J, PHONE #: 503-431-4000
CONTRACTOR: JACOBS HEATING + NC PHONE #: 503
Inspection Request Scheduled For: Date: 10/30006 Pour Time: /-) i
c f • CIO
Code # Inspection Description Confirm # Contact # Message
699 Mech3flicai final --ittrEf.7.r—Aertt- I 503-234-7331 N . - b
0376eare CI
Corrections/Comments/Instructions: 4'0 .; Z07 -2-(e)
1 41,
1/1Freffli11/111
a ....
C,1 -----
--.„
R.-‘s I I PARTIAL APPROVAL CANCEL fl NO ACCESS
1 FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
dig 14
Inspector: . If Date: 16 i Phone #: (503) 718- A -7--- 3
-
, - . , • . .
V
CITY-OF:TIGARD
BUILDING DIVISION PERMIT #: MEC2005- 00102
131E5 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2006
Phone: (503) 639-4171 /A
. , t tilil
Inspection Requests (24 Hrs.): (503) 639-4175 ." --..
INSPECTION WORKSHEET FOR DATE: 7/6/2006 't 00AM
TIME: • , PAGE: 47
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD HIGH SCHOOL
DESCRIPTION: Girls locker room & CE2/Transitions TI. Project Value: $2,000
TIGARD-TUALATIN SCHOOL DISTRICT 23J, 603-431-4000
OWNER: PHONE #:
CONTRACTOR:
JACOBS HEATING + NC PHONE #: 5032731
Inspection Request Scheduled For: Date: 7/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 032587-01 503-234-7331 . N
Corrections/Comments/Instructions:
, , Tamp _ Avaio ....41
.. _.
w' w vim — - w r rm. up, 111117 AM
dr
Cg GO frEtal
F6-ei
144 e2
n PASS I -- APPROVAL fl CANCEL n NO ACCESS
0 FAIL M CALL FO" INSPECTION 0 ADDITION L FEES ASSESSED
ib• I
OM!
I nspector: Date: 0 Phone #: (503) 718- Vik-23