Permit IN CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit #: MEC2012 -00338
T I GARO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/28/2012
Parcel: 2S104BD01400
Jurisdiction: Tigard
Site address: 13665 SW FERN ST
Project: Roman Catholic Archdiosece Subdivision: OBRS HEIGHTS Lot: 1
Project Description: Replace 14' of gas piping for new stove.
Contractor: COMSTOCK DEVELOPMENT LLC Owner: ST ANTHONY CATHOLIC CHURCH TIGAR
12020 SW 118TH 9905 SW MCKENZIE ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 579 -5772 PHONE:
FAX: 503 - 579 -5529
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 06/28/2012 $69.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/28/2012 $8.29
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $500.00
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 $77.35
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: New stove
Duct Work:
Fire /Smoke Dampers:
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all othe�
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 1)0 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to ollow 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 . otain .a "opy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ` , /.'
Issued By: Permittee Signature: Agottik,k,
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. ,'1 1
This permit card shall be kept in a conspicuous place on the job site until completion oft e rroject.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Application .. OI rlc[: fist.: ON1_Y
FIE,,,,.,,i,, City of Tigard � �/ . -M Permit Noi-/EC cQ 2 p--4403 g „'
° 13125 SW Hall Blvd., Tigard, OR 97223 J 2 8 2 2 Plan Review
' C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready/By: IIEI ® See Page 2 for •
Internet: www.tigard - or.gov CITY OF TIGAR R 0 Notified/Method: Supplemental Information
• Pull ni.NG PR I!
TYPE OF W _ K COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
- Mechanical permit fees* are based on the value of the work •
❑ New construction gAdditiot( teration/r placement performed. Indicate the value (rounded to the nearest dollar) of all '
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ ,_ e
CA O Y OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
/�! 1- and 2- family dwelling mmercial/indu ❑ Accessory building For special information use checklist.
fl Mu_ lti- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
_ Air conditioning
Job site address: /3.Z 6 SC-0 / Ek..,;(-) (requires site plan showing placement) 46.75
/State /ZIP: —� I c
Furnace 100,000 BTU (ducts/vents) 46.75
City/State/ZIP: l �y,4 0/(.' Furnace 100,000+ BTU (ducts/vents) 54.91
Sui • Idg. t. no.: Project name: 0 Y Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 3 Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
(� �7- Gas fireplace/insert 33.39
► `-- p� /
S !3'I< Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
S Opt) Q7.QS , S 1 Q (� -e. (3 o L,�v -� Wood/pellet stove 33.39
a I Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: S `: - r ..,,' Environmental exhaust and ventilation:
Address: F� Ran hood/other kitchen
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equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Fax: Single -duct exhaust (bathrooms,
Phone:
( ). ( ) toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: CC)6s 7) Other: 23.32
rr Fuel piping:
Contact name: 4.))/;).) • 5 l 2C/( $14.15 for first four; $4.03 for each additional
Address: / Zn 2v 56 0 /tam- Furnace, etc.
l� Gas heat pump
City /State /ZIP: / /, Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue .
Business name: Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal 69 , Q (, •
Phone: ( ) 3' SI/ "7a� Fax: ( ) Minimum permit fee ($90.00)
" ( Plan review (25% of permit fee)
CCB lic.: / 2 3 /7-A State surcharge (12% of permit fee) a
TOTAL PERMIT FEE - '27, ,3_
Authorized signature: This permit application expires if a permit is not obtained within 180
g / days after it has been accepted as complete.
Print name: 011111MIP'la ( • Fee methodology set by Tri -County Building Industry Service Board
I:\Building\Permits�C -P rf /� .d /;� 03/07/12 440-46 7T (11 02/COM/WEB)
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total 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 and including
$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.
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Note: All new commercial buildings require 2 sets of plans.
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I:\BuildingTermitsVr1EC- PermitApp.doc 03/07/12 2