Permit •
CITY TIGARD MECHANICAL PERMIT.
Ti I4° DEVELOPMENT SERVICES PERMIT #: MEC2004 -00069
.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/20/2004
PARCEL: 1 S 133AD -02200
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE
SUBDIVISION: ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: A2.1 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 2 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
• GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 5
Remarks: Gas piping w /(5) outlets for HVAC.
Project Valuation: $5000
Owner: FEES
WESTGATE BAPTIST CHURCH Description Date Amount
12930 SW SCHOLLS FERRY RD [MECH] Permit Fee 4/20/200 $141.50
TIGARD, OR 97223 [MECPLN] Plan Rev 4/20/200 $35.38
[TAX] 8% State Surchar€ 4/20/200 $11.32
Phone: Total $188.20
Contractor:
DUTTON'S REMODELING
16775 SW LAKE FOREST BLVD
LAKE OSWEGO, OR 97035 REQUIRED INSPECTIONS
Phone: 503 - 572 - 7392 Gas Line
Final Inspection
Reg #: LIC 111999
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0∎ I throug' •AR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)2.: -6699. , •
Issu By: F1'. Lk ►. Permittee Si natur- t A 4
-Call (503) 63' 5 by 7:00 P.M. for inspections needed the n-x business day
/0.736?., ski 00 774.
FIIOM - Sm-
TGATE BAPTIST CHURCH FAX NO. :503- 524 -4560 Feb. 17 2004 11:00AM P3
r ' 'i;
Mecha �y h 1ica®n 1�olt OFl�IC USE ONLY
nics , �l Received Mechanical M
7 204 bate/L /9 DW Y�Y Permit No.:ll•e"D O bq
City of Tigard FEB 1' Planning .pproval Fluilding
DatcB : Permit No.:
13125 SW Ball Blvd. . G ARU Plan Review Other
Tigard, Oregon 97223G °F TI n N SION Date/B . H - 04' &I Permit No.:
Phone: 503 - 639 -417BUI it-598. -598. - Review Land Use
F i,i'gp l ,, gate /B :. Case No.:
Internet: www.ci.tigard.or.us ; t ! f Contact Ju ris.:
a ■ ' ?' •' „ IA See Page 2 for
24 - hour Inspection Request: 503 - 639 - 4175 - Name/Method: Supplemental Information.
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1.I New construction ❑ Demolition Mechanical permit fees'" are based on the total value of the work
Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
•-,.:• ;•--..,' ,. ?' , :' . , ,;: mechanical materials, erials a i ment, labor, overhead and profit.
, �,;: y ,.. ; , .,, K�o- a�.ih+�ll �':A7i` 'C�,, ":l�?Jii'sOFi�O�S�sE�X�G�X = :.;' , , u
q �
in 1 & 2- Family dwelling 'Conunercialf1ndustrial value: $ , See Page 2 for Fee Schedule
:OXS.1 10111: �' 00)X, ; , '•`S TI iii Dl % Islip;` ;:
❑ Accessory Building , _� Multi- Family �' � '
E] Master Builder Other l Fee(ea-)
ii .,. _„ , .,., . ..... ... a 1~l. e(ea -) .,
. Description ...
Qty F Total
H a(itf Coo itt
�iw� „r.•;,,,alq.w� 1.04B. r i' ' 1 n Furnace - add -on air conditioning'"' 14.00
Job site address: 10 MO 5i.3 i 30 Gas heat pump . , 14.00
Suite ##: Bldg. /Apt. #: Duct work 14.00
Project Name: L i`''S'�'r -ATT kZ, RPTVSC C KIN/G1� Iiydronichotwatersystem 14.00
Cross street/Direetions to job site: •
Residential radiator boiler
C itOL(,S I✓'tF2 RY ‹B (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
• (in wall, in -duct, suspended, etc -) 14.00
Flue/vent (for any of above) 10.00
Subdivision: I Lot #: Repair units 12.15
Tax map /parcel #: Water 10.00
� .: ; ai:. ,Pima L. '�!Ijli, I„ . ..,�, %,. i ,i ?', " tr a!n,•a•'y�i '�'1,,T Vi {;
, : , .- ..kr,i, i,a� .lid,! „ct•:,;LIESGf?.NIO... .. J Gas fireplace J 10.00
. . her.; u ta.. ces ::.r.
P
i^ T, ' ., 61 •-- 1 K.U&I a o ►LD,c.1c, So Dc: o, Flue vent (water heater /gas fireplace) 1.0,00
Log lighter (gas) 10.00
l
Wood/Pellet stove ' 10.00
-pi . 61..1 � wf S Wood fireplace/insert 10.00
V Chimney/liner /flue/Vent 10.00
s ,., . ,, , . • 4 "V �': �y'��y�'5 �.ytp,��
s a . . yi, ?i ri! ,. 7 s n { gyU : a erns .r. e' wr nN till .i,,i a Other: 10 -0(1
P�l % ,',1 ' ■ :� � `e .i�a . .,, . � '�,Gr: n,. h�':''.�'t�!1 �-"ai - ' m . � ,ki fl8i!:,'- ,_,!5!.i:. +il:. L.. 1:
...... Name: Range �:.'` E��' tronciicnifal- FS1iuRati. � �eAWa `:':'T.- :;'::;;'{:;=::;,';:. -.
(, j -�_/Z Q ga ris I Ctfutcc ii
g hood/otl�er kitchen equipment 10.00
Address: i a • . b _ 0A-1,‘ Clothes dryer exhaust 10.00
City /State /Zip: 1--, ,‹¢. 1 oeiz g 7Z
Single duct exhaust
Phone: ° o3 S'z W 3S° Fax: so 3 Sze? gt5d b (bathrooms, toilet compartments, .
,<; 5!'!T:>:;:; ti Er! Aye{ o 0
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,.. �.� .1?<M� ..,,,::.��.:,�r::, ::.�, a. h�. "�F..'.� `l .�Ili�C1, utility 6
Name: ke) e-5 - h-cir arel -ts C' Grto e A-t - Attic/crawl space fans 10.00
Other:
Address: to 7 $0,... 4.
.s. .
City /State /Zip: -rt 6 Cie b p Oa t 7 3 * *($5.40 for first 4, $1.00 each additional)
Phone: 5o3 S7'/ , 46 C5-0 I Fax: So 3 Sze/ L/666 Furnace, etc- I **
Gas heat pump
E-mail: unit heater **
j;c � ; ,...,. il :,.•o;r.. y ,.,., x, .;- '•�',le- " ?, L' i. 1; p,° ,ts: ISIM IM f , -
. ,9' 4a1'�'iIIF';:uti.. _00 iolt_:v2r ?if.' . ".•y;t�l�iil- "L•NIINI,II: Water heater
Business Name: 1),.., ; r a il - , R 41-A. e• MI ry Fireplace **
Range **
Address: t c,7'75 st,3 (- p -t F vQ...ti 4 ecVD HBQ **
City /State /Zip: Uft- Lc 050 isC-o i Orzar j'>03 S Clothes dryer (gas) ** -
Phone: � S7Z, 7392 Fax: Other. **
CCB Lin #: ((5 5- C Total;
y • : . `.M echani cal Perntltt Fees! 1 ::.
Authorized r • Subtotal: $ ' ti 1.)
Signature: Date: - i( 9 Minimum Permit Fee $72.50 $
t l b t7 - Plan Review Fcc (25% of Permit Fee) $ .37. ) a
(Please print flame) State Surcharge (8% of Perr_ Fee) $ i 1 . 3 1 -
TOTAL PERMIT FEE 1 $ I E) , to
Notice; This permit application expires if a permit is not obtained within 'Fee methodology set by TM-County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ( 7/ ( a e \ AM PM BUP
Location
en ?-yD (c11 130 Suite MEC � • ' X
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
•
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 4
Roof
Other: Win Final MILIMIIMIW Ei r t l)
PASS PART FAIL r pirir PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service ( V
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
'ampers
Fin
4 010 PART FAIL
RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125.SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL