Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00499
� 111 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/17/2005
PARCEL: 2S102BD -01600
SITE ADDRESS: 09845 SW WALNUT PL ZONING: R -12
SUBDIVISION: FREWINGS ORCHARD TRACT LOT: D -I JURISDICTION: TIG
Project Description: Change out (4) oil to (4) gas furnaces, gas piping. Value: $17000.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: A3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 4 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
TIGARD COMMUNITY METHODIST Description Date Amount
CHURCH [MECH] Permit Fee 8/17/200: $326.00
9845 SW WALNUT [MECPLN] Plan Rev 8/17/200f. $81.50
TIGARD, OR 97223 [TAX] 8% State SurcharE 8/17/200f $26.08
Phone: 503 639 - 3181 Total $433.58
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 - 557 - 2220
Reg #: LIC 72623
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 - 332 -2344.
Issued By: _ i ce / Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
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.
• 07 05 06:58p Tri County/3 p_A
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1 rill. hanical Perinit _ ppiication
Illit 5035570919 P - 1
:
City of
i 325 SW Ha Tigard • Tiprd, OR Receiveday
Date/ByP - •,' 4 5 Permit No.fik.DD05 .. c
) k.,
il Blvd 97":.21 •‘-
Plan Revie0
?hone: 503 639.4171 Fax. 503 598.1960
?crew:
cs, 1 . .......„...,. ,
Date:By: - 'I-7'S Other
inspection Line: 503.639.4175 , '' l' '' .ir.21 • .', .t
Internet www.ci.figard.or.us Date Rea
'Notified/Method:
.L Y - 16..„, S
Y . :.; ": • :' ...-1Eilt,-,7:146:kl'R''''''.;V.
...... C(0NC1 eCt FEE*.'SCEICEDIJLE IISE'CITECKLIST
0 New construction X Adon./alteration/replacement Mechanical permit fees • are based on the value of the work
performed Indicate the value (rounded :o the nearest dollar) of all
0 Demolttion 0 Other:
mechanical materials, equipment. lalioj,
- - '-' ' - ';' - '• ' - ; ' - --' C.A..TE OF COIISTRUCTIeW • - • •: '',- ' -, - . - - i •- ••• ..7. . Value 11 I I
.
0 ' 4S,i):1*4icaltPMENT/ SYSTEMS FEES*
1- and 2-family dwelling XCommercial/industrial 0 Accessory building
For special information use checklist.
El Multi , 0 Master builder 0 Other:
Description 1 Qty. 1 Ea. I Total
.:. : -? :- .s Ii• -''';' Ol'i..siiii :ANa LOCATION • , ..,;,. . Heating/cooling
— ---
Job site address: 5 6W WU 4100D— Air conditioning or heat pump
(requires sue plan showing placement) • 14.00 I
City/State/ZIT-. 18
. Furnace 100,000 311' kdlIC.aiven..5) I - •
Furnace 100,000+ BTU (ducts/ven's) 4 17 90 ...,. •
Suite/bIdg.lapt. no.: Project name. •
.. Gas heat pump 14 00
I
Cross street/directions to job site.
- - 9.
Duct work 14 00
•
C \ ekki . Hydrorpc . • - •oz water system :4 00 .
t C ) ." CIS Residennal boiler (radiator or
t hydronic)
14.00
Unit heaters (fuel not electric),
in-wall, in-duct, suspended, etc
10 00
Flue/vent for any of above - - 10.00
Subdivision: I Lot no.:
Other. 1 1 0 . o a
Tax map/parcel no.:
Other fuel appliances
' C':-. : -....-.' :.• ...'".:` .:: Water heater I 10.00
laCC) (4 ) A CIO P I iz (4-) Gas fireplace
Flue vent for water heater or gas 10.00
I Varr i l i
- if .,•, / Pli ; I. ■ ,
fireplace
I Log lighter (gas) . 10.00
10.00
- 1
. WoocUpellet stove - 10.00
Wood fireplace/insert I 10.00
;,--...,.......- „... ‘,, - -- • : - • - • • ,- „.,,_ . -. •• Chimney/liner/flue/vent I 10.00
:-.7P-_:.• ;:.•:.:': . '!...,.... .F.P ••1 - -.1' e.;, :,1-1 -12 .41A 14 . 1. ,, ,:,- :• . .• 1.c., 4 .• other
10.00 I
Name: i 1 I anftel dietthurch . 1 Environmental exhaust and ventilation
I
Address: '''' f
1 'id . Range hood/other kitchen
equipment 10.00
Cit,,StateiZIP: (° Clothes dryer exhaust I 10 00
Single-duct exhaust (bathrooms,
Phone: coca 1osq-247j I Fax: ( ) toilet compartments, utility rooms) 6.80
,-,-...".'-.;:--•••-7.:,;::.2. -....:--.i.,..-:=,%.-',';.::%.I"z);:at'COitr4'VgElS01,1'.. :: :-..,...,:,:. . Attic/crawlspace fans 10.00
Other:
Business name: Tri Ca.QTfM.p COrdir 1 1 15 ■ Fuel piping 10.00
Contact name: biac, n b‘s 503
49.5 $5.40 for first four; $1.00 for additional_ „
Address: 01a) 6 cia(karna5 Riterti-Jyruci 1 Tumace, etc.
City/State/ZIP: Ciee0/1 0 fq ( tZ c(704 WalVsusoended/unit heater
Pbone: ( a‘-) S7-?29O 1 Fax: : ( bC8 ) 55-7--Cglq _ Water heater I
Fireplace :
E-mail:
Range
.' fi% -,, .. - 1 - .Z13 -1 ,4t*. : " - ;:-::C - 0 . 0i1;4'67 - kfigl e ig , i - 4 ,,, ,..r :" Barbecue
Business name: Tri CoLurV Terry Conli-o) Clothes dryer (gas)
Address:
i Other: I .
1 I l ' ...s •
• ' s. S. . mEciilkt . tin:Eviler FEES*
•?)1C C ) ( P 17105 .. ,,Rivr_te - tri yr
, .• . ,
CiryiStateiZIP: Orarn Criki e cl7V-tD
i f
Phone. (E5:3) 55 - 72c.:' Fax: ( E5_c likor Subtotal r• fir
Minimum permt ee (572 50) _
;ir c..) Plan review (25°4 of perrna fee -- 4 ;
coil lic.: 721 ZS
irg, I • State surcharge (8% of permit fee :•": I. • ..
.
. j lign • ; TOTAL PERMIT FE r: ' 55. . •
.,. tz 7 1 /7 1-7767„0 C
This permit a if a perintirdis as comp not obt
Authorized signature: L. • c..
I Print name: bidr2 Ma...5.0,/1 Date: ICI (OD • Fee methodology set by Tn Building Industry Service : oard
.•'3u doc ':103 4 40.4617 ( : t/O:cONVWEEil
CITY OF TIGARD
BUILDING DIVISION .. A PERMIT #: MEC2005 -00499
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/17/2005
Phone: (503) 639 -4171 ,1
Inspection Requests (24 Hrs.): (503) 639 -4175 _-' . I —
INSPECTION WORKSHEET FOR DATE: 8/31/2005 TIME: 7:03AM PAGE: 58
SITE ADDRESS: 09845 SW WALNUT PL CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACT LOT #: Di TYPE OF USE:
PROJECT NAME: TIGARD UNITED METHODIST CHURCH
DESCRIPTION: Change out (4) oil to (4) gas furnaces, gas piping. Value: $17000.00
OWNER: TIGARD COMMUNITY METHODIST, PHONE #: 503639 -3181
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503 - 557 -2220
Inspection Request Scheduled For: Date: 8/31/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 014659 -01 503-557 -2220 Y
Corrections /Comments /Instructions: C?C C
c
gel
► 4
iv ...ok imp. ■■■•-
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPE ION ❑ ADDITI NAL FE S ASSESSED
Inspector: Date: C one #: (503) 718-
,- ( -