Permit �� CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2015-00255
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/06/2015
Parcel: 2S102DA00701
Jurisdiction: Tigard
Site address: 13405 SW HALL BLVD
Project: Tigard Christian Church Subdivision: BARNUM PARK Lot: 9
Project Description: Replacing(2)existing RTU's.
Contractor: HUNTER DAVISSON INC Owner: TIGARD CHRISTIAN CHURCH
1800 SW PERSHING ST 13405 SW HALL BLVD
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/06/2015 $609.33
Class of Work: ALT Type of Const: Plan Review 05/06/2015 $152.33
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 05/06/2015 $73.12
Stories: Investigation Fee 05/04/2015 $180.00
Investigation 12%State Surcharge 05/04/2015 $21.60
Project Valuation: $20,258.00 Info Process/Archiving-Sm$0.50(up to 05/06/2015 $18.00
11x17)
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: Vent Systems: Total $1,054.38
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 no tarted within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow he r e adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo ma .a - a copy of the rules
or direct questions to OUNC by calling 503.232.198yer 1.800.2.2344. 1 • '
Issued By: Permittee Signature: J vy
Call 503.639.4175 by 7:00 a.m.for the next available inspecti ate.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
51,1 Receiv �'! >
City of Tigard Date/By Permit No.
• 13125 SW Hall Blvd.,Tigard,OR 97223 •Plan Rev w 0 Phone: 503.639.4171 Fax: 503.598.1 E C E I V E D Date/By /1\
i4 _ 5 f� Other Permit:
Inspection Line: 503.639.4175
TIGARD Date Ready/By: G Juris:
® See Page 2 for
Internet: www.tigard-or.gov Notifed/Method: ,S
' Supplemental Information
MAY 4 2015 ;^f-c.,l 6,.c WI.
TYPE OF WORK.._, OF TIGARD COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑New construction Addition/altctlr� `®(1#4� 3fVIS{ON Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:S p�( 3 d-S f
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
'3 0` S W 14 e(1 ;� V 1 Air conditioning or heat pump
Job site address: J r71 `J A (requires site plan showing placement) 14.00
City/State/ZIP: T t IC I& CID_ c P-W-3 Furnace 100,000 BTU(ducts/vents) 14.00
1 i �+ 1 Furnace 100,000+BTU(ducts/vents) 17.90
Suite/bldg./apt.no.: Project name:Tl�t;,/ Ck f l C�.46 A C�,i.VC . Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
-V -
Ga` rx l ' Hydronic hot water system 14.00
\ p N A Residenti al boiler(radiator or
hydronic) 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 14.00
Subdivision: I Lot no.:
Flue/vent for any of above 6.80
Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
sO,P1(ALQ -T�)0 Cx 1S r1 A6 (ZUG�'RUP Flue vent for water heater or gas
r 1 p ( fireplace 10.00
(U 1 C' VA' + S Log lighter(gas)_ _ _ 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
'PROPERTY OWNER I ❑ TENANT
Chimney/liner/flue/vent 10.00
Other: I 10.00 I
Name: T Vr k G1'r t S sk aA r `w F tk Environmental exhaust and nd ventilation
Range hood/other kitchen Address: 3 l U s- `V,1 a�` `` equipment
10.00
City/State/ZIP: -D5ef A, be
q (A.A3 Clothes dryer exhaust 10.00
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 6.80
APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
' I — Other: 10.00
Business name: H IA A 4,er Day LSSG/\ Fuel piping
Contact name: JL Nt,c( j - e- $5.40 for first four;$1.00 for each additional
Address: Furnace,etc.
"`' � � " T Gas heat pump
City/State/ZIP: Po r 4..(td, Oa q 1 Li,)'k Wall/suspended/unit heater
Phone:()3) a34 pc ) 1 Fax::( ) �'3 6 I
`2S' Water heater
ter
Fireplace
Email:bR((G�-�-r i-erAtl `SsW-
CGM Range
CONTRACTOR Barbecue
v Clothes dryer(gas)
Business name: cis ct o JtJ
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Minimum permit fee($72.50)
Phone:( ) J Fax:( ) Plan review(25%of permit fee)
CCB lic.: hot t . t//.1 State surcharge(12%of permit fee)
I TOTAL PERMIT FEE
Authorized signature This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 7 4 l t0 P C(0 ,f- Date: 5 V/s * Fee methodology set by Tri-Couny Building Industry Service Board
I:Utuilding\Permits\MtiC-I''ccrmitApp.doc 01/19/07 440-4617T(I 1/02ICtrbl/wlilt) 1 , `,;6e (104-tp •
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13405 SW HALL BLVD, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2015-00255
Inspection Type: Inspector:
699 Mechanical final George Heimos
Result:
FA I L
Comments:
1 . Locked out, provide access. Please leave contact number for someone who can
unlock doors.
Violation Summary:
Inspector Contractor