Permit ,14 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2020-00107
Date Issued: 02/18/2020
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CB00100
Jurisdiction: Tigard
Site address: 12850 SW GRANT AVE
Project: Broadway Rose Theatre Subdivision: NORTH TIGARDVILLE ADDITION Lot: 43
Project Description: 60 ft. of gas piping for relocating meter.
Contractor: POINT PLUMBING Owner: TIGARD-TUALATIN SCHOOL
4510 SW 182ND AVE DISTRICT 23J
ALOHA, OR 97007 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-265-1708 PHONE:
FAX: 503-268-1567
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/18/2020 $207.21
Class of Work: ALT Type of Const: Plan Review 02/18/2020 $51.80
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 02/18/2020 $24.87
Stories: Info Process/Archiving-Sm$0.50(up to 02/18/2020 $0.50
11x17)
Project Valuation: $5,000.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $284.38
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800 332 2344
Issued By: mittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
City of Tigard RECEIV Date/By: , d D/JL Permit NM' A �p,),j_0y l t ^�
il 1114, 13125 SW Hall Blvd.,Tigard,OR 97223 r C! /
_ Phone: 503.718.2439 Fax: 503.598.1960 FEB 18 202(` Plan Review
Date/By: Other Permit:e�n�,�Cis,�Vf��C�
T 1 G A R D Inspection Line: 503.639.4175 DDate Ready/By: Juris: gJ See Page 2 forJJ J
Internet: www.tigard-or.gov CITY OF TIGAR4-+otified/Method: Supplemental Information
'AUll DING DIVISI N )
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction If,]Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 51 1L).G; % lC`.f7
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 ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: I Z Kt JAL S\1\l G 1Z-/A'1VV . Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -1\4;Al2.0 CA ' oil-1,j; Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
t V k V k ( t ;0 'V - fireplace 23.32
•
Log lighter(gas) 23.32
• LAX T\i,At-' 62A' IN1b-r Wood/pellet stove 33.39
6°P ro t r.,xj "T CP. 4 `2, f7 t 12 t N ) Wood fireplace/insert 23.32
`9 Cti oc-�' O.' T127�l � t Dik Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT $0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: ve `i<yT k)VtJ J t I I'
$14.15 for first four;$4.03 for each additional
Contact name: JedAA6LizAuNiV C'—"J Furnace,etc.
Address: L1151 0 `7 t\-1 i ) Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: T►k OA- a 3 0 1 6 Water heater
Phone: t Fax:: i J Fireplace
ee;;�� s 4
Barbecue
Range
E-mail: ( (CJ, C l�1� Ll/r� 7l IA; 1vL�
��// t CONTRACTOR Clothes dryer(gas)
Business name: r0(�T `) ''✓1gt N Other: I
i ` �}_ , ►,.t C- MECHANICAL PERMIT FEES*
Address: 4 k5 i 0 S11'V c}(NA, ry e
Subtotal
Cin/State/ZIP: 1 b'k�l , q 4 (1A ` t`10 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:ail,' ) j{ .-‘106 Fax:(en;) `' a -• 1%II' State surcharge(12%of permit fee)
CCB lie.: 1 l l o itj ?5 TOTAL PERMIT FEE
V This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized si ature: —w-'»'"""""'"-- * Fee methodology set by Tri-County Building Industry Service Board
Print name: 'VA V Date: 2. (0 u
1:\Building\Permits\MF.C_PermitApp_040113.doc 440-4617T(11/02/COM/WF.B)