Permit (3) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2020-00010
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2020
Parcel: 2S112CC01100
Jurisdiction: Tigard
Site address: 15800 SW HALL BLVD
Project: Tigard Community Friends Church Subdivision: None Lot: None
Project Description: Push/pull(2)gas furnaces in the same location as existing on the interior of building,and install new twinning kit
control and thermostat.
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 01/23/2020 $246.55
Class of Work: ALT Type of Const: VB Plan Review 01/23/2020 $61.64
Occupancy Grp: A-3 Occupancy Load: 12%State Surcharge-Mechanical 01/23/2020 $29.59
Stories: Info Process/Archiving-Sm$0.50(up to 01/23/2020 $14.00
11x17)
Project Valuation: $6,382.00
Fuel Air Handlers
Fuel Types: Natural Gas Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 4 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 $351.78
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: 4 Other Desc:
Duct Work: 1
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 to OUNC by calling 503.232.1987 or 1.810 32.2344.
Issued By: •ermittee Signature: 'Nab ` • \i1
_ 4 _
Call 503.9.4175 by 7:00 a.m.for the next available inspection d'
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 D Received
= `J g DECEIVE Date/By: 0/7
7e LLI , , Permit No../t/1:--14420„20 �DefUl�t�
IIII v 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review `
Phone: 503.718.2439 Fax: 503.598.1960 6 Date/By: i )1-1. aj 10 Other Permit:
TIGARD Inspection Line: 503.639.4175 JAN 2020 Date Ready/By: i uric: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method://22/2e' 44.: Supplemental Information
CITY OF TIGARD G,,��` �✓�rL .9-
TYPE OF D NG DIVISION COMMERCIAL FEE*`SCHEDULE —USE CHECKLIST
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
D Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$6,382.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑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.: 1 Project name:Tigard Comm Friend Church 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
Other fuel appliances:
Tax map/parcel no.:2S112CC01100 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Push/Pull-Remove and dispose of 2-90%efficient gas furnaces&replace with 2 fireplace 23.32
o
,A77-6 141 VIZ.. rd e u 7'-'41'i,\i' - Log lighter(gas) 23.32
new Carrier 95%efficient gas furnaces in the same location as existing.Install
Wood/pellet stove 33.39
new twinning kit control and thermostat,connecting the new furnaces to the Wood fireplace/insert 23.32
existing flue pipe Chimney/liner/flue/vent 23.32
' Other: 23.32
® PROPERTYOWNER I
0 TENANT Environmental exhaust and ventilation:
Name:TIGARD FRIENDS CHURCH Range hood/other kitchen
equipment 33.39
Address:7130 SW BEVELAND Clothes dryer exhaust 33.39
City/State/ZIP:TIGARD,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
El APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:JACOBS HEATING&AIR CONDITIONING
$14.15 for first four;$4.03 for each additional
Contact name:ANDREA BOWLDS Furnace,etc.
Address:4474 SE MILWAUKIE AVE Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:PORTLAND,OR 97202 Water heater
Phone:(503)234-7331 Fax: :( ) Fireplace
Range
E-mail:ANDREAB@JACOBSHEATING.COM Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:JACOBS HEATING&AIR CONDITIONING Other:
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:( ) 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: 01/0 * Fee methodology set by Tri-County Building Industry Service Board
Print name:ANDREA BOWLDS Date: 10-31-19
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/02/COM/WEB)