Permit CITY OF TIGARD MECHANICAL PERMIT
1111
le COMMUNITY DEVELOPMENT Permit #: MEC2012 00248
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/19/2012
Parcel: 2S 111 ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twatity Middle School Subdivision: PINEBROOK TERRACE Lot: 67
Project Description: Science classroom upgrades, relocate (1) exhaust retum and add (4) gas shut -offs
Contractor: CEDAR MILL CONSTRUCTION COMPANY Owner: TIGARD TUALATIN SCHOOL DISTRICT
19465 SW 89TH AVE 6960 SW SANDBURG RD
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 885 -9370 PHONE: 503 - 431 -4000
FAX: 503 - 885 -9368
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/19/2012 $373.11
Class of Work: ALT Type of Const: Plan Review 07/19/2012 $93.28
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 07/19/2012 $44.77
Stories:
Project Valuation: $11,000.00
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: 1 Vent Systems: Total $511.16
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. y obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: —
L
Call 503.639.4175 by 7:00 a.m. for the next availab = i . pection date.
This permit card shall be kept in a conspicuous place on the job e until completion of the project.
Approved plans are required on the job site at the e of each inspection.
Mechanical Permit Application FoR OFFICI, USE ONLY
City of Tigard a ECE� v te/Byy 5 /f / 7 . , ; Permit No.: Hfd j,.�� '
13125 SW Hall Blvd., Tigard, OR 9 Plan Review
I C . Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
FIG A Ii D Inspection Line: 503.639.4175 M 15 2 012 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
CITY nF TIGARD
TYPE ottraiNG DIV ►MDN COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction yl Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor; overhead, and profit
Value: $ /I MO
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder gather: ,s L.. Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
Air conditioning
Job site address: /16 5 5 G(' 9 7 e- (requires site plan showing placement) 46.75
Furnace 100,000+ BTU
City/State /ZIP: 77 0 t �7 Z�' Furnace 100,000 BTU (ducts/vents) 54.9t 54.91
(dus/ven1
Suite/bldg. /apt. no.: i Project name: TZ'/ 7 1 / /y/ad„6-5-C Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: _ 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
C� Acorn Gas fireplace/insert
ve vent for ns 33.39
5 C/
�r- C'' r� � : Flue vent for water heater or gas
i ' �� ��/ - 1 ��' ieer fireplace 23.32
l fir lace lighter (gas)
• /941.0 (4) t v4 SHOT -aFFs Wood/pellet stove 33.39
/.rte ... ..ten - - Wood fireplace /insert 23.32
1 PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: 7740 %8 7Z g't4.iv SC/yerj? D(.57 /CT Environmental exhaust and ventilation:
Address: (7 sg4 06 .004 ST Range hood/other kitchen
equipment 33.39
•ty/State /ZIP: 7 J 4Z /)/ 7 2.7 3 Clothes dryer exhaust 33.39
(� 3) Zu .6 v sD Fax Single -duct exhaust (bathrooms,
ne: ( ) toilet compartments, utility rooms) 23.32
APPLICANT ❑CONTACT PERSON Attic /crawlspace fans 23.32
Q A ,p Other: 23.32
Business name: / 1 �i/�c.C" '# Fuel piping:
C ontact name: Z-1644144. c C . y $14.15 for first four; $4.03 for each additional_
Address: 01j 7 5- 5bfree s')- Furnace, etc.
p � Gas heat pump
City /State /ZIP: PVT .iz v2, / / 20 Wall /suspended/unit heater
Phone: (5t 3) Z2.4 alb PS'O Fax: : ( ) Water heater
eel) b D e Iowa ` � �
E -mail: �i�� /40/7, 4 09a. C40.7 Range
Fireplace
CONTRACTOR Barbecue
c Bu siness name: e ,... ' l (L („ e 1 3 ‘2P24.. e••'T7V N Clothes dryer (gas)
to Address: 19q65 w $l ehoe der MECHANICAL PERMIT FEES*
City /State /ZIP: /IA 4L-09-7-"„ 0Q 57 6109
Subtotal
Phone: (9 .. Aa7- `f Fax: (503) (.pa " 'FP 35 " Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: / WS Akt / / State surcharge (12% of permit fee)
/� /� //�� TOTAL PERMIT FEE - Ajr� This permit application expires if a permit is not obtained within 180
Authorized signatur ' /' i i days after it has been accepted as complete.
, e Print name: �1
t , 5 A/_ Wrl 0 5 Date: I ^1 2 ® / .� I • Fee methodology set by Tri County Building Industry Service Board
1:\ Building \Permiis'MEC- PermitApp.doc 09/09/10 4404617T (1I /02/COM/wEB)
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 the 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.
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