Permit CITY TI GA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00210
„ 13125 SW Hall Blvd., Tigard,;OR 97223 503 - 639 -4171 DATE ISSUED: 5/17/2005
PARCEL: 2S110AC -01700
SITE ADDRESS: 11305 SW BULL MOUNTAIN RD ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Mechanical TI. Project Value: $28,832
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: A3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 4 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: 4
GAS OUTLETS:
Owner: FEES
CHRIST THE KING Description Date Amount
LUTHERAN CHURCH [MECH] Permit Fee 5/17/200E $486.65
11305 SW BULL MTN RD [MECPLN] Plan Rev 5/17/200E $121.66
TIGARD, OR 97224 [TAX] 8% State Surchaq 5/17/200E $38.93
Phone:
Total $647.24
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone: 692 - 1565
Reg #: LIC 5193
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 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: 3 _1 .i , Permittee Signature
Call 503 - 639 -4175 by 7:00 a.m. for inspections that n:- Id .
This permit card shall be kept in a conspicuous place on the job sit: til comple '•n of the project.
Approved plans are required on the job site at the time of each inspection.
' Meg o SS evil 112&
a icaTPerm><t A _ n ,, ® `FOrR r FFI( E' USE ONLY
City of Tigard E Received 1, permit No i. Date/By: :64 ,� : f 0 0i , 1 D
13125 S W Hall Blvd., Tigard, OR 97223 / lir Plan Revie
Phone: 503.639.4171 Fax: 503.598.196 AA\l 2005 a Date/By: ;/� other Permit:
i i-' O 4 2�U5 ' i l,�
Inspection Line: 503.639.4175 �
Date Ready/By: /Methd: S See Page for
Internet: www.ci.tigard.or.us CITY OF TICARD Notified/Metho Supplemental Information
■ SION
'°' a !i� n u „''a a . g u 'Yf?' x s r^.. : ' „x Q s i .'.Y_ "":�•" «s'�fi's' � +s». tiA la7,. z :rs , Y.. � x� '� + .�.,� ..n � .�'.�.�, . _..:.,�.. .g`...'8.^�.. »°�.`��' :`` "+ ,�t
Other:
❑ New construction I Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
�Y� 4 ' w t : � +: :.� _,,:77.5-w-.. nw-r :. .. ., ` ��,, vt, 3 k R i Value: $ n(
`" s2.,, i .:,: Sr`3c '. 4 `'3 ' raa -_ 4. . AS1 =P f`i+ r `.y ';7''' T uL s` , � V �
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❑ 1- and 2- family dwelling Commercial/indusirial 1::1 Accessory special Accessory building ` .r s ecial reformation use checklist.
'
❑ Multi - family 1 ❑ Master builder ❑ Other:
• Description I Q
1r _ �" ,, x a n� a;<.i� Qty. I Ea. I Total • S yY^•�Pa.: Kt`oa 3iIYA�Fxa?ks. W
::��.�. � „�,r >•.r._.� �. �.�,�,.T�(�-;�s.��,3�i;: HeatinWcooling
Job site address: i t3o5 3W 2LL-_ f b)CA I IJ Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/ State/ZIP: 1'1 (b / pp, 9 -72 Z5 Furnace 100,000 BTU (ducts/vents) 14.00
Fumace 100,000+ BTU ( 17.90
Suite/bldg./apt. no.: I Project name: �µ� r � �N
� 6. Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system _ 14.00
Residential boiler (radiator or
hydronic) 14,00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
.` : }: , .� t.•':;i:: �z :`�yi „� °�.':. < <..`.satv:: �•.h. - ;; .t
Y � >� ,�` °^,.�`�� >n , . en€ +,���'.:�:r,��a��.' 0
�s ifDESC ZIP r O . W ORK ' t . : W a at , f Water heater 10. 0
w�`^ � � C�?"x - �`;;��.. - - . 'f*§.�..:,�= 5's,za_, �,...�..:.x< ..u* =v...: _... �. .,.. Y1�x.: c , .s`.e'�,. -. 2 �
�VSN f
/U� ' .r'SL4 LE c 9 % /` 5
Gas fireplace
water heater or gas
ce 10.00
f{ 9f � � � E � `-'�' �� �I �(w� . Flue vent f
' NE � l 7 / �S itUn , 'A ce � fireplace 10.00
� j p �� L ` I p ` _ rW Log lighter (gas) 10.00
Ii1ddSr, u_ . 4 I )1F 17 9 AIR_ (,U MQ1 ee.OA S i / l �TI111 Wood/pellet stove 10.00
Z ' 3 fireplace/insert 10.00
J TU � • � Z S �-(� Wo od firepla
-4 ,,_ A 1 , •� : - _>4- ,4 ! x �,, •:a.,,,,,, x ,�. n '�A:�, Chimney/liner/flue/vent /liner /flue /vent 10.00
,, �, , �. � > - ;g. fir;- �.;_, - -r.� Y
MOO: ` -;°.v; � � G � +s �4;. r�i^: �R.: ,.�,:,..... � `w �C :: �;�
�' ;• O .-, R.9 T - CO tom ^> -t .Vi .,. 1-
... <.�:'^,�. &�a`�_ J� �a`r., ��`.e,r ., � ,,<, :YC�''*�r "�zi.�z.;.�;'; +�T '��r��.r�,�s,a -��r.. A +,. x'.�.t. =.'^:s ;�. -�'.
- _. other 10.00
Name: Cu,KI57 - f.E F ki W.4 E Zeiq e- Aug- Environmental exhaust and ventilation _
Range Address: 113 ()5 50 '&V i V `t/V K,TrAi i\I Rh eequipmen / other kitchen 10.00
City/ State/ZIP: 1 i rr7� �' -Z-2- -� Clothes dryer exhaust 10.00
/ Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
k i ^+ AWRAkW!=ai. °. `_ If "'rAts:;&-! . . t 1 4 1 ; +. nc = ; :ter^.
: Attic/crawls ace fans 10.00
/ Other: 10.00
Business narfie: A kRvAJ >M8c41,1 ( (441 Fuel piping
Contact name: 1.-ex T g/-1.---It k, $5.40 for first four, $1.00 for each additional
Address: ),)3 6-) < ( , j _-u,"6,--rug R.D Furnace, etc.
Gas heat pump
City/State/ZIP: TVA LATl N , Dg- D (p7, Wall/suspended/unit heater ,
Phone: (SO 3) (,,,c/z - ) 5 b5 I Fax: : ( . ) WI/ / /g 7 / Water heater
- Fireplace
E -mail:
Range
R ' 4 '�' * a -'` .a,.� � 0 ' t -te ", a t Barbecue
:..r .tea,..
Business name: 4 fold M Clothes dryer (gas)
Other:
Address:
, :� -'„ -
. �ac a r ° �r� i
City/ State/ZIP: �[� Subtotal
Phone: ( ) �� �" F es: ( ) i Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 5 /'7 3 I State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1
Authorized s ignature: � / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
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CITY OF TIGARD t.
li BUILDING DIVISION PERMIT #: MEC200G -00210
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/17/2006
Phone: (503) 639 -4171 ' ° a gypig1617iiI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/28/2005 TIME: 7 :08Am PAGE: 66
SITE ADDRESS: 11305 SW BULL MOUNTAIN RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CHRIST THE KING LUTHEREN CHURCH
DESCRIPTION: Mechanical TI. Project Value: $28,832
OWNER: CHRIST THE KING, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 592 -1565
Inspection Request Scheduled For: Date: 7/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012262 -01 503 - 783 -5027 Y
rr g_,3 X7'13 _ C
Co
Corrections/Comments/Instructions:
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4\\ 'AaVtevi 'OCM
Meck64..1 c ok k R IA e• L ®. l C t3 C'_- \ a', OCR
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N PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CAL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
, Inspector: l 4 l .. Date: oS Phone #: (503) 718-