Permit (250)INIk
CITY OF TIGARD MECHANICAL PERMIT
.1111 A Permit#: MEC2019-00614
COMMUNITY DEVELOPMENT Date Issued: 08/22/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S111ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: None Lot: None
Project Description: Temporary mechanical for existing gym to remain occupied during school year.
Contractor: TRIPLETT WELLMAN INC Owner: UNION HIGH SCHOOL DISTRICT
PO BOX 160 NO. 3 JT
WOODBURN, OR 97071 00000
PHONE: 503-982-4188 PHONE:
FAX: 503-982-0390
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/22/2019 $191.86
Class of Work: ALT Type of Const: VA Plan Review 08/22/2019 $47.97
OccupancyLoad: 12%State Surcharge-Mechanical 08/22/2019 $23.02
Occupancy Grp: Info Process/Archiving-Sm$0.50(up to 08/22/2019 $3.50
Stories: 11x17)
Project Valuation: $4,500.00
Fuel Air Handlers
Fuel Types: Propane Units< 10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 1 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 $266.35
Hoods: Comm Incinerators: Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
F
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 a.•pted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. y. may obt.in a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 2.2344.
4-
Issued ByGi%' , Permi e
y I . ,r
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 ONLY
Cl of Tigard s--- i Received f ?/(� Permit Nq /C1,-006/4
�,1 b Date/By:iv fC
'" 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
.- Phone: 503.718.2439 Fax: 503.598.1960 A !( 1 U Date/B ei
Other Permit:
1 I
GA R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov S Notified/Method: Supplemental Information
...,.�,. ., ... 1 e{�1 i,1i l ..'441.10 u_ ._ . ..,.._
Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition og Other: r-'q (.4,_,A-, ,t,��
mechanical materials,equipment,labor,overhead,and profit.
l �, Value $ Cy'c�
7'' i,, " ' tic o RY eC sTRUColwl " /...-2', w �"t l)� Q 1Ii'ME1?1'F l sYS. $*
0 1-and 2-family dwelling c0 Commercial/industrial ❑Accessory building For special information use checklist.
El Multi-family ❑Master builder 0 Other: Description 1 Qty. 1 Ea. Total
` H FOR*Tit LOCATE ' P e. Heating/cooling:
, .-:; a.. .2 'M.` .'/ ;, .. ,. ' (�L111 . Air conditioning 46.75
Job site address: I"I C5 iii f, ri Furnace 100,000 BTU(ducts/vents) 46.75
-� /' , Furnace 100,000+BTU(ducts/vents) 54.91
City/State/ZIP:
1 t S t C e/t f )�cCl� Heat pump 61.06
Suite/bldg./apt.no.: Project name: -r-,,,,d ,, j 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
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
v rl t. SCRIPTI I E WORK ' ,` Gas fireplace/insert 33.39
„ v .v %� }} •. - r s, •• T•..x. �.. `''''..1.-- Flue vent for water heater or gas
-rtAvAc, fi2-c-u 1 "�-- 1�.�,>1,i t..Ih,Z f'n ,-.v`;:;'.^, fireplace 23.32
J , -� Log lighter(gas) 23.32
0((AA\-I e.r� Gt LkCC v, Sc.-1)C01 t:/_ Q:`-r Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/clue/vent 23.32
Other: 23.32
ri 1. '. .., -:: .. 2-' r�. -, ....,.n Environmental exhaust and ventilation:
Name: .1_d C) Range hood/other kitchen
1 �C equipment 33.39
Address: i 6 D5,7,0 Cr,N (1.,,j7:71Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: T _ _
�) ( 1 ! 7 c>. 3 toilet compartments,utility rooms) 23.32
Phone:
hone (fin' ) Lj 3 I ytx" Fax:( ) Attic/crawlspace fans 23.32
v r• 23.32
N� he•
404'. fry DµC ACTPE
t
. Fuel piping:
Business name: "rd(...: ,1 g i LJ.1' , �4\. $14.15 for first four;$4.03 for each additional
Contact name: Gl\. C`) 1� I Furnace,etc.
>
j Gas heat pump
Address: 17 1 '7 (`�(t. pr
r V L WalUsuspended/unitheater
Gty7State/ZIP: - - Wafer hearer - - _ --r� Fireplace
Phone:(j0; ) el is C7C`,S"'' Fax: :( )
Range
E-mail: C ty]- `� t` . .e....0 ,,v1 C t2r^� Barbecue
�� - �,, P, a t Clothes dryer(gas)
f Other:
Business name: :_',,)Y''1." I4.L.11YIv ,. ,.<.
Address: I 11 7 /"-- . .'a - 71 4 v , Subtotal
d Minimum permit fee($90.00)
City/State/ZIP:
L✓Q1-x -1'''�, e., Plan review(25%of permit fee)
Phone:(c,)) c i c r,c7 ‹7 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: TOTAL PERMIT FEE
Li 1vl This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: (..,/,,,,� dt Date: n/ci i) 1
1:13uilding\Permits\MEC_PermitApp_040113.doc 440-46I7T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family 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$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:\Building\Pennits\MEC_PennitApp_040113.doc 2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
14650 SW 97TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Mechanical MEC2019-00614
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor