Permit I r IQ CITY OF TIGARD MECHANICAL PERMIT
- i = COMMUNITY DEVELOPMENT Permit #: MEC2012 -00296
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2012
Parcel: 151 26CD00100
Jurisdiction: Tigard
Site address: 9925 SW GREENBURG RD
Project: Crescent Grove Cemetery Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Replace heat pump system Requires site plan
Contractor: SUPREME COMFORT HEATING Owner: CRESCENT GROVE CEMETERY ASS
9425 SW COMMERCE CIRCLE #16 CRESCENT GROVE CEMETERY
WILSONVILLE, OR 97070 9925 SW GREENBURG ROAD
TIGARD, OR 97223
PHONE: 503 - 682 -1985 PHONE:
FAX: 503 - 682 -1018
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/06/2012 $207.21
Class of Work: ALT Type of Const: Plan Review 06/06/2012 $51.80
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 06/06/2012 $24.87
Stories:
Project Valuation: $4,995.00
Fuel Air Handlers
Fuel Types: 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 $283.88
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
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:
1)4/r}74s o Permittee Signature: � 40,
///(((��� 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.
06/04/2012 10:31 503 -682 -1018 SUPREME COMFORT INC PAGE 01 1::./1- Mechanical Permit ApplicatiF E C I'VE 1 „„t.,,,i 1(,: l,,t. t)\1' /'
City of Tigard JUN 0 4 2012 - P c"°" N41 , )IYa•.'%
:N 13125 SW Hall Blvd., Tigard. OR 97223 Pim. Review Other *
Phone; 503.7181439 Fax: 503.598.1960 /.A;� Dine/By:
1 . � , •� r 1 , Inspection Line; 503.639.4175 CITY OF TIGA RD Gate heady/By: 171 See Pop 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notilied/Method: Supplemental Information
' • TYPE OF WORK. COMMERCIAL FEE• SCHU1)bLE — USE Cl1>;CIa1sT _
- Mechanical permit fees* are based on the value of the work
❑ New construction El Addition /alteration /replacement perfnnned. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. and profit
CATEGORY OF CON5TII ICTION Value: $ $4,995 00
.R1MDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial/ industrial 0 Accessory building Forspedal information use chetkliit
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. 1 Total
- JOB SITE INFORMATION AND LOCATION Ilcatittq/cooling:
- Air conditioning
Job site address; 9925 SW Greenburg Rd. (mein, site plan showing placement) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (dneedveets) , 46.75
Furnace-W0 ; 000+ - BTU- (duets//vente) 54.91
Suite/bldg./apt. no.: J Project name: Crescent Grove Cemetery pump
ma site .Ian showin :. incemem 61.06
Cross sued/directions to joh site: `Bs►cturo>it 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) , 2332
Unit heaters (fuel -type. not electric),
in -wall in -duct, suspended. etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32 •
Other: 23.32
Tax map/parcel no.: Other Mel appliances:
. • DESCRIPTION OF WORK • Water heater 23.32
•
Replace Heat Pump System (}as fireplace/insert 33.39
Flue vent for water heater or gas
AS 265 S (re' /4/9-1J fireplace 23.32
Log lighter (gas) _ 23,32
Wood/pellet stove _ 33.39
_Wood fireplace/insert _ 23.32
0 PROPERTY OWNER • I o TENANT. Chimney/liner/flue/vent 23.32 •
Other; 23.32
Name: Crescent Grave Cemetary I " Environmental exhaust and ventilation:
•
Address: 9925 SW Grecnhutg Rd. . Range hood /other kitchen
equipment 3339
City/State/ZIP: Tigard, OR 97213 Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) S e -duct exhaust (bathrooms, toilet armpartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace bons 23.32 -
Business name: same as contractor Other: 23.32 ..
Fuel piping;
Contact name: SILlS for heat then, 54.03 for each additional _
Address:
Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/tmit heater
Phone: ( ) Fax:: ( ) Water heater
E-mail: Fireplace
Range r.
• CONTRACTOR. Barbecue
Business name: Supreme Comfort Inc. Clothes dryer (pis)
Other:
Address: 9425 SW Commerce Cir. #16 MECHANICAL PERMIT FElEy. •
City/State/ZIP: Wilsonville, OR _ Subtotal 409, 06
Minimum permit fee ($90.00)
Phone: (503) 682 -1985 Fax: (503) 682-1010 Plan review (25% of permit fee)
✓ CC :R lie.: 21892 State surcharge (12% of permit fee) '
/ TOTAL PERMIT FEE
'fbh permit applicatio expire if a permit Is not obtained within 180
ffita
Authorized glgne: / - days after It has been accepted as complete.
Print name: Randal Lapp ( Date: 6/4/12 • Fee me hodolcay ott by Tri.Cotmty Building Industry Service Board
1; \13ue10ansIPemmsMEC•Penurnpp.aoc 03/07 /12 44046177'(II /02ICOM/.IIB)
06/04/2012 10:31 503 - 682 -1018 SUPREME COMFORT INC PAGE 02
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: _ Permit Fee:.
$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 tine 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:\ auilding \Pamib \MEC- PermitApp.doc 03/07/12 2
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° Building Division • 7', /,' Y' "
Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: C ab /a -()O€ 9 ( r xpedited Review
Plan Submittal Date: , i f/42 --
To the Applicant:
> If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
le
Pla . 'ng Review (contact G at 503 -718 or `— @tigard- or.gov)
►'� Zo g � 5 Permitted Use Yes L�' No ❑
Land Use Required: Yes ❑ No (explain below)
Notes:
Approved ❑ Not Approved Date: 4/ v
Permit Coo $. R eriez (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
/
Notes:
Routed back to Building Division Date:
I: \CURPLN
06/04/2012 10:51 503 - 682 -1018 SUPREME COMFORT INC PAGE 01
Cr25G.en t Grovg. Lemt tlir
0 1 4 1.25 .5 W Green bu rc� LI. SUPREME COMFORT WC.
9425 S.W. COMMERCE CIR. # 10
rl /21, 0,C � ' 7.2.t3 WILSONVILLE, OR 97070
882 -1985 •
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