Permit CITY OF TIGARD MECHANICAL PERMIT
E:: COMMUNITY DEVELOPMENT MECHANICAL
MEC2012 -00249
T E GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/19/2012
Parcel: 2S103AA00101
Jurisdiction: Tigard
' Site address: 10865 SW WALNUT ST
Project: Fowler Middle School Subdivision:)0 SUPPLEMENTAL PLAT NO.1: ANNE Lot: 7 -6
Project Description: Science classroom upgrades, replace (4) exhaust fans and add (6) gas shut -offs.
Contractor: CEDAR MILL CONSTRUCTION COMPANY Owner: TIGARD - TUALATIN SCHOOL DISTRICT
19465 SW 89TH AVE ATTN: BONITA MAPLETHORPE
TUALATIN, OR 97062 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503 - 885 -9370 PHONE: 503 - 431 -4000
FAX: 503 - 885 -9368
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/19/2012 $667.75
Class of Work: ALT Type of Const: Plan Review 07/19/2012 $166.94
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 07/19/2012 $80.13
Stories:
Project Valuation: $22,600.00
Fuel Air Handlers
Fuel Types: 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: 4 Vent Systems: Total $914.82
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 . - adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 •u •.tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: xj()Igif- Permittee Signature: /
Call 503.639.4175 by 7:00 a.m. for the next available sp tion date.
This permit card shall be kept in a conspicuous place on the job site til completion of the project.
Approved plans are required on the job site at the tim of each inspection.
Mechanical Permit Applicati ip ECEIVED roll of i id : 11Sl ONLY
City of Tigard Receive ® , Permit No.: il` qV CtVg/a.
° 13125 SW Hall Blvd., Tigard,OR 97223 1 5 Plan Review
' C Phone: 503.718.2439 Fax: 503.598.1960 M AY 2� 12 Date/By: Other Permit:
T 1 GAR D Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction 8 Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equIpytwtt,-MAtor, overhead, an fit
aloe: $ Z2., &CC
CATEGORY OF CONSTRUCTION RESIDENTIAL EQ
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder El. Other: SGf/6e/L Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Cfi
Air conditioning
Job site address: / e e s 6 5 $a G(,0L4/U7 (requires site plan showing placement) 46.75
/� ��//JJ g Z3 - Furnace 100,000 BTU (ducts/vents) 46.75
City/State /ZIP:
�"lt'AI2D 611 ! 7 L Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: II-:‘,046)1( Ai (0,0 � Q. 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
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
a Gas fireplace/insert 33.39
$el CE" Ch AS S7Y.wI v Flue vent for water heater or gas
` ' fireplace 23.32
¢J �= S Log lighter (gas) 23.32
• ,4120 a#95 SWV TOFFS (6) L0047704)1 Wood/pellet stove 33.39
Wood fireplace /insert 23.32
r' PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: 7764W 7 ,Sai►re. 4245XIC7- Environmental exhaust and ventilation: _
Address: / t�pel s *cam �€ r s? , Range hood/other kitchen
"r "'T equipment 33.39
. ity /State /ZIP: 641.20 dJQ - 7zz3 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
,v one: ($ 3) 43 ( -4C Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT jz CONTACT PERSON Attic/crawlspace fans 23.32
Business name: legal ... /6( G/24900 Other: 23.32
Fuel piping:
Contact name: <Le.- co.toge S/ $14.15 for first four; $4.03 for each additional
9 67 Sw j .� ,57. Furnace, etc.
Address: j -7-70e4
Gas heat pump
3
City /State /ZIP: ,a��, j` ,,,, ?7ZO.5 Wall /suspended/unit heater
one: ($b3) ?,L6 - 69573 I Fax: : ( ) Water heater
Fireplace
LL // ,, J /
E-mail: �/ri�CdI'It74C� �Gf d��fiY "`!J /g/�0(�. cavil Range
CONTRACTOR Barbecue
ck Business name: ` C, ti r:>#1.4 1 L.L. Co IJgT4c.tt�ld Clothes dryer (gas)
Other:
Address: i 9LiU �' i 8 ? A ✓ - MECHANICAL PERMIT FEES*
City/State /ZIP tf. Ler-i , Subtotal
Minimum permit fee ($90.00)
tO Phone: ( ) F. • ( )
Plan review (25% of permit fee)
CCB lic.: / .ZO State surcharge (12% of permit fee)
/ /-74 / ' TOTAL PERMIT FEE
�/ This permit application expires if a permit is not obtained within 180
Authorized signature: . F� / /'' �/ /' days after it has been accepted as complete.
Print name: d , G f G y Q Ci
9 Date: Jv Y l i / 2p(2 • Fee methodology set by Tri -County Building Industry Service Board
1: 1Building'PermitAMEC -P- itApp.doc 09/09/10 / 440417T
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.
Note: All new commercial buildings require 2 sets of plans.
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