Permit (35) 71 CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit#: MEC2019-00562
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/31/2019
TIGARD Parcel: 2S101 DD00701
Jurisdiction: Tigard
Site address: 6960 SW SANDBURG ST
Project: Tigard-Tualatin School District Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Reconfiguring HVAC duct work and grills to serve new spaces.
Contractor: OWNER Owner: TIGARD-TUALATIN SCHOOL
TIGARD-TUALATIN SCHOOL DISTRICT 23J
DISTRICT 23J 6960 SW SANDBURG ST
6960 SW SANDBURG ST TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-431-4017 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/31/2019 $333.66
Class of Work: ALT Type of Const: Plan Review 07/31/2019 $83.42
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 07/31/2019 $40.04
Stories: Info Process/Archiving-Sm$0.50(up to 07/31/2019 $1.00
11x17)
Project Valuation: $9,500.00
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: Vent Systems: Total $458.12
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
—_ a-Outlets: Other Oes
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. may obtain of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
IMOIssued By: -- •- ignature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
FOR OFFICE USE ONL1
City of Tigard Received `
Iii r 13125 SW Hall Blvd.,Tigard,OR 97223 r Date/By: '/' / ,iA Permit No.: Ire_ �� )
Phone: 503.718.2439 Fax: 503.598.196E V E IvE® Plan Review
Inspection Line: 503.639.4175 Date/By: Other Permit = ii _
I I C;n K U p Date Ready/By: �f�
Internet: www.tigard-or.gov J U L 31 2019Notified/Method:
See Page 2l for
% Notified/Method pp mental information
ryry
1E311
Supplemental
. .a ' ,.... ! A-opt!A �►,.--;.........„ b 3 1` a
:771
❑New construction Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,gd profit.
Value:$ ! 72 cSG-
❑ 1-and 2-family dwelling ErCommercial/industrial
❑Accessory building � ��1�L �1�>��,t".� iGT� ��p:�`_ �
For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description
_ - �-m, � � _ .,. I Qty. I Ea. I Total
A`7¢ 8,° t tTf do --,,,,,,r4 Heating/cooling:
Job site address: Q?GO u) G. A`sL C?,.,. FurnaceAir conditioning i0g 46.75
J /�i/VV 7 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ee 44 n 4 et 7 z L3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name: � wL��/ Heat pump 61.06
� �'� Oe 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: I Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appliances:
t r ,s Water heater 23.32
A w. -4. ; ,4 :. .., #„ 'o1 �y . ' Gas fireplace/insert
*A* 33.39
/ f j�p �. Flue vent for water heater or gas
"_core. esre/uG. i 7 '!(L IDI' - Af+1.7.ret#4._ €12L fireplace
23.32
Ntt, g e4 VA4e . ief- oNhiG______ t.G. � Log lighter(gas) 23.32
PC4C-XtAigeo (TA Z-
!7� Wood/pellet stove 33.39
S V4." Z. Ai .) 5,40.4.4.4ej Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
- ql „^ i = 0. s 23.32
, • .:,t ( n :,A„ 1 ' ". x Other:
Name: � J Environmental exhaust and ventilation:
7-14.4.00,
/�"wLA�:� s D Range hood/other kitchen
Address: te !`6 r 5-0,6„,0 dam` s-e equipment 33.39
7 Clothes dryer exhaust 33.39
City/State/ZIP: 77U�.t.D Q de .77223 Single-duct exhaust(bathrooms,
Phone:( S� toilet compartments,utility rooms) 23.32
ho, . ., y i f; 4,t 7 Fad( ) Attic/crawlspace fans 23.32
- R ' . '— . A.l 7 Other: 23.32
Business name:774,4449 rL�L ,J s De S T Fuel piping:
Contact name: /� $14.15 for first four;$4.03 for each additional
V.,! oft) /11pN/704(LE, Furnace,etc.
Address: ‘,1605-,) X4,040,d4,4,G c♦ Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
— r _- Water heater
Phone:(of) toy_ifo,l , I Fax::( ) Fireplace
/ eP
JJJRangeE marl ONr7MGtr t .04.
Barbecue c
uea w,,, q !',,. ee i- `z` t Clothes dr
yer(gas)
name: 7 �.�t> S' � >>� GV��C // YOher:
� ' tt 'b ;i .. ,,a � ' ,iii:, ,i, x y,
z,Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
CCB lic.:
State surcharge(12%of permit fee)
TOTAL PERMIT FEE
dia., This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name:gt',a ✓ros4a.., I Date: Oeti jig I
I:ABuilding\Perm;ts\MEC PermitApp_040113.doc 4!
440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & MultiFamily Fee Schedule:
$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$50000.00,ond , :,, , y
$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.
,� � .4 x`...„;n 'e. s ` . «y.•. ,, ,.:of*t:'q... .'t' #s«. a>.:. .. "..
1:\Building\Permits\MEC_PennitApp_040113.doc 2 •
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
6960 SW SANDBURG ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2019-00562
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor