Permit (46) CITY OF TIGARD MECHANICAL PERMIT
IIIa ''- COMMUNITY DEVELOPMENT Permit#: MEC201800466
-`[G AR D 13125 SW Hall Bivd.,Tigard OR 97223 503.718.2439 Date Issued: 06/21/2018
Parcel: 2S112CC01100
Jurisdiction: Tigard
Site address: 15800 SW HALL BLVD
Project: TIGARD FRIENDS CHURCH Subdivision: None Lot: None
Project Description: Removing&replacing gas furnace.
Contractor: JACOBS HEATING&AIR CONDITIONING Owner: TIGARD FRIENDS CHURCH
4474 SE MILWAUKIE 7130 SW BEVELAND
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503-234-7331 PHONE:
FAX: 503-296-5351
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/20/2018 $176.51
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/20/2018 $21.18
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 06/20/2018 $10.00
11x17)
Stories: Plan Review 06/20/2018 $44.13
Project Valuation: $4,000.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Fumaces<100K BTU: 0-3 HP:
Furnaces>= 100K BTU: 1 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 $251.82
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 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 obtain a copy of the rules
or direct questions NC by calling 503.232.1987 or 1.800.332.2344. %f/y'//}
Issued By`� c ee Signature: 4-1 �"'e!�
Cal19.4175 by 7:00 a.m.for the next available insp tion date.
This permit card shall be kept in a conspicuous place on the job site u II completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatio> � FOR OFFICE USE ONLY
City of Tigard ', Received /57//
�`
g PDate/By:iew " fl Permit NA -, I
13125 SW Hall Blvd.,Tigard,OR 97223 r , -t
JUN 1 9 Z018 Dan By
Phone: 503.718.2439 Fax: 503.598.1960 O Other Permit:
Date/By:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov ,
e G '`£,, , '2,r,-,1 Notified/Method: Supplemental Information
BUliL...-. '. LI...,,_?`if
TYI?E.:Op-'VUR :,,, > : COMMERCIAL >EE* 5C'IIEI'IJLE USE(JUtCKLfST.
Mechanical permit fees*are based on the value of the work
0 New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value: $4,000.00
CATEGORY OF CONSTRUCTION TtESTI)ENTIAL`ECIUIPMENT ISYS LEMS FEES*
0 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION,AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:15800 SW Hall Blvd Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Tigard Community Friend C Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.:25112CC01100 Water heater 23.32
;DESCRIPTION OF:WORR..; Gas fireplace/insert 33.39
Flue vent for water heater or gas
REmove&dispose of existing Gas Furnace.Install New Carrier GF located in the fireplace 23.32
NE Corner of the main chapel area in a closet.As you come in from the back Log lighter(gas) 23.32
Wood/pellet stove 33.39
parking lot it is to the right — Lt KE 4oR L k: c›W k? Q t,cr Wood fireplace/insert 23.32
Sao BTU 4 - IX a,-u Chimney/liner/flue/vent 23.32
Q.POPi`R`' WER" "f 1 ' Other: 23.32 RIYON , ' ' ,
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
TIGARD FRIENDS CHURCH equipment 33.39
Address: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
t.x
APPLICANTC.-1:
Other: 23.32
kr
:1'4(8N* ❑ CONTA.CT'15ERSQN Fuelp•p I to
g•
Business name:Jacobs Heating&Air Conditioning $14.15 for first four;$4.03 for each additional
Contact name:Andrea Bowlds Furnace,etc.
Gas heat pump
Address:4474 SE Milwaukie Ave Wall/suspended/unit heater
City/State/ZIP:Portland,OR 97202 Water heater
Fireplace
Phone:(503)234-7331 Fax::(503)296-5351
Range
E-mail:andreab@jacobsheating.com Barbecue
CONTRACTOR Clothes dryer(gas)
' Other:
Business name:Jacobs Heating&Air Conditioning , MECHANICAL PERMIT FEES* ''
Address:4474 SE Milwaukie Ave Subtotal
City/State/ZIP:Portland,OR 97202 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)234-7331 Fax:(503)296-5351 State surcharge(12%of permit fee)
CCB lic.:1441 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: Cci-D * Fee methodology set by Tri-County Building Industry Service Board
Print name:ANDREA BOWLDS Date:6/11/2018 &L/ '- (�-7f - 3�q --1410
I:\BuildingTermits\tEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) l.� -
,
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15800 SW HALL BLVD, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Mechanical MEC2018-00466
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor