Permit q CITY OF TIGARD MECHANICAL PERMIT
14 a COMMUNITY DEVELOPMENT Permit#: MEC2014-00347
Date Issued: 07/10/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 1026D00100
Jurisdiction: Tigard
Site address: 9905 SW MCKENZIE ST
Project: St Anthony's Church Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 52
Project Description: Adding bath fans in lower restroom area
Contractor: JOHN KLUNE COMPANY LCC Owner: ST ANTHONY CATHOLIC CHURCH TIGAR
12370 SW DUCHILLY CT 9905 SW MCKENZIE ST
TIGARD,OR 97223 TIGARD, OR 97223
PHONE: 503-639-4359 PHONE:
FAX:
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 07/10/2014 $69.06
Class of Work: ALT Type of Const: Plan Review 07/10/2014 $17.27
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 07/10/2014 $8.29
Stories:
Project Valuation: $100.00
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: 2 Vent Systems: Total $94.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you • • ow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 .090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By Permittee Signature: A-
Call 503.639.4175 by 7:00 a.m.for the next available inspectio date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application - FOR OFFICE USE ONI.1
j ! - - t
Received
City of Tigard Date/By: 7 /D / Permit No.: eeJ4/ i 7
111 q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
s Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
I I(i A R I) Inspection Line: 503.639.4175 Date Ready/By: Juris. 61 See Page 2 for
Internet: www.tigazd or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction IR Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Other: mechanical materials,equipment,labor,overhe d,and profit.
❑Demolition �
Value:$ f 40•Oc
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling , Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:,/ Air conditioning 46.75
Job site address: Cf 0 5 F� j ter KL 7.--yr c— Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ' —rtn
/ oh
Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: �f' ..s y 1� e_ 44,e Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
/✓‘3,,,,..c !mot. IF 1-r''1` 4..0 hydronic) 23.32
Unit heaters(fuel-type,not electric),
4 N-cs 5 / in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39 . _
Flue vent for water heater or gas
/t)(-40 DirG (4 At rt )474�" fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
_Chimney/liner/flue/vent 23.32
pi PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: ~ I7�u Range hood/other kitchen
/ `� equipment 33.39
Address: 9 c,.0 Scti e ,/, . zt Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: eria,q-.1..0 toilet compartments,utility rooms) 23.32 .
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
a APPLICANT ($ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: pr L... ..-cam l-
C- $10.15 for first four;54.03 for each additional
Contact name: D-eo/r-.-- WI u , �— Furnace,etc.
Address: 2 3 7O C✓ Gas heat pump
J2 U C rt-r C c 7 ` "�" -, Wall/suspended/unit heater
City/State/ZIP: 7 7 1 .. Water heater
Phone:(523) 6'39'5/3S9 Fax: :(57)3)63", Y3S.-9 Fireplace
3 d, c'q�� t� Range
E-mail: 5 if Xi_ '—t' 'G it-4/f-t L.,...i. Barbecue
CONTRACTOR Gam••-t Clothes dryer(gas)
Other:
Business name: /,,'w<ti.----
MECHANICAL PERMIT FEES*
Address: Subtotal Z09,0,6
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee) /7.a 7
Phone:( ) Fax:( ) State surcharge(12%of permit fee) f CCB lic.: �D \\l4
TOTAL PERMIT FEE 11./42-
This permit application expires if a permit is not obtain 180
days after it has been accepted as complete.
Authorized signature: / — • Fee methodology set by Tri-County Building Industry Service Board
Print name: Py.,,,, /L KrE i-- Date: 7-/a y
I:\Building\PermitsNEC_PermitApp_040113.doe 440-4617T(I l/02/COM/WEB)
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.
1:1 Building\Permits\MEC_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9905 SW MCKENZIE ST, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2014-00347
Jeff Grove
Violation Summary:
Inspector Contractor