Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00061
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/31/2012
Parcel: 1S133AD02200
Jurisdiction: Tigard
Site address: 10730 SW 130TH AVE
Project: Westgate Baptist Subdivision: HAWK'S BEARD TOWNHOMES Lot: 62
Project Description: 60 ft. of gas piping for water heater.
Contractor: B DUTTON CONSTRUCTION INC Owner: WESTGATE BAPTIST CHURCH
16775 SW LAKE FOREST BLVD 12930 SW SCHOLLS FERRY RD
LAKE OSWEGO, OR 9703 TIGARD, OR 97223
PHONE: 503 - 572 -7392 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/31/2012 $78.27
Class of Work: ALT Type of Const: Plan Review 01/31/2012 $19.57
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 01/31/2012 $9.39
Stories:
Project Valuation: $750.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $107.23
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 1 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 OUNC by calling 503.232.198 . :00.3 =. .
Issued By Permittee Signature: ,
Call 503.: - 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
49 FOR OFFICE USE ONLY
. ' •
q 13125 City of Tigard -‘'N v Received
Date/By: ME! WIRMI
, •
114 . SW Hall Blvd., Tigard, OR 97223 -
(.4),1■•
1 Permit No
c\%'\' Plan Review
' " i •• Phone: 503.718.2439 Fax: 503.598.1960,(0,.) ' Date/By: Other Permit:
T I GAR D Inspection Line: Ition L 5039.41 'St-
4 . i „ ,, , ,.,, ,,, i 1 ate Ready/By: Juris 64 See Page 2 for
' Internet: www.ti S.,,.. %
.63 75 gard-or.gov Notified/Method:
\
-\ T ,, Supplemental Information
.., ,v,,,, \ 4„ :.:„ $ , ',.:,,-,;:,,, , Ai to414 fOXIIFP, ttiiki*iit*i 4,Kiis:0-410&thlie,
Mechanical permit fees* are based on the value of the work
0 New construction :Er/Addition/alteration/replent performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, lab r, overhead, and profit.
e
Valu: $ ? c61
,.60,E000',0',, CONSTRUC 7, ,_,.„.
- .-. .. ..,- - .,.., ...- -, .-, --- - ' RESIDENTIAL EQU TitiSYSTF
ID 1 - and 2-family dwelling Zrommercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 11:1 Master builder , El Other: -- ...-. - ..". - :DeSCriptibn , :: , Qty.' . Ea. Total
4( .. 1 . 0,: *"i!Ne ( *.**10 Si l ' Ar r 0 7 *!:q.0 , 00:N4t10 -'- ' - ;t'.`. -- . ,: '-t.'
Job site address: k o r ) 3 a 0 i 301h (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State/ZIP: - t 6 Aya o GG_O N J ' 1 7. ZI Furnace 100,000+ BTU (ducts/vents) 54.91 _
,
Suite/bldg/apt. no.: Project name: .4"‘
It.) GSC6-irr6 Pi n5 C , Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
C ifOitA ft ri t 4 a° Hydronic
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:
7,006400:*, Of':**(:!:, .;,,:irr;:'LAZ4r711, Water heater I 23.32
4 • Gas fireplace 33.39
_ 1/3 krW. 141-1rit1a / (-;--o's 9 tee 1 0QT i Flue vent for water heater or gas
3 1 /I , fireplace 23.32
/ 'Pe- Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
ylitionizTV4ileE. ; :,,‘,AV4 „r* Chimney/liner/flue/vent 23.32
Other: 23.32
--,
Name: '> es c 'cr sr C rtv Q.c14 Environmental exhaust and ventilation:
Range hood/other kitchen
Address: aR 3 O .5 w 5- ti 5 F.- e v g b
.
equipment 33.39
City/State/ZIP: c k G et ( rz: q 72 . / Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (s03) 5 z . 4 35'0-0 Fax: (03 ) S Z (4 14 S' (4 toilet compartments, utility rooms) 23.32 _
04 re; '14i r, ;;(ii0.-+;a:Asloksf.)st!lwir,!, Attic/erawlspace fans 23.32
Other: 23.32
Business name: "b 0 -i-c C `3. c. Fuel piping:
Contact name: 7
t,s ig_ tPcit. -- 0 0 `XTON. $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: t6 S C-ft-K� Forz,t5r gL vb
Gas heat pump
City/State/ZIP: L. A a 6.. .OR. 6 c 7493 5 Wall/suspended/unit heater
Phone: (50S ) .5 D 7... 1 39 7_ Fax: : ( ) . • '-, Water heater
Fireplace
E-mail: 1 I) rtem Barbecue
Business CI 0 YiN-i-t- 1 c_ern Range
i. , NP;"S -, . - ' , "''"4 4, 34 - aiiiiiiAciiii:itt.Ax,r , ,",:e y ,P1 ', Olfr
- , A4 , ', tg
Business name: ,,„.,• 9 i I) 0 crom r OC, 1" ON) r t4. C . Clothes dryer (gas)
Other:
Address: IVIDS SO L-rol,15 -EOlft eST g‘-v-0 irAts : A 7 :47 ,- *EC# 1 0-tcX "Kg ::, 1..44
C ity/State/Z 1 P : L m L
t . < ts c . - , I .:.: glo .•_ . . Subtotal
Crc-> I %
Minimum permit fee ($90.00) - 7 ?r. )
Phone: (5 ) 5 72, P 3i 2.. Fax: ( )
-- - -- - -- ------ ---- - -- -- --- -- - - ... . Plan revid fee) - iti
CCB lic.: (ct 5 IA 6
State surcharge (12% of permit fee) 1, 3"
. • TOTAL PERMIT FE id 7. 2--3
This permit application expires if a permit is not obta ed within 180
Authorized signature: gt ill Q -
days after it has been accepted as complete.
Print name: , 1 ,, -... 0 1-1-6 1 .,..) I Date: / - 2 . ,4 - a * Fee methodology set by Tri-County Building Industry Service Board
1. \ Building \Permits\ MEC-PermitApp.doe 09/09/10 440-4617T (1 1/02/COM/WEB)
. .
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
w;T'otal 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 andincluding
$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.
I: \Building \Permits \MEC- PermitApp.doe 09/09/10 2