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Permit CITY OF TIGARD MECHANICAL PERMIT • • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00375 T [GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/14/2012 Parcel: 1 S134CC01700 Jurisdiction: Tigard Site address: 12325 SW KATHERINE ST Project: Mary Woodward Elementary Subdivision: MERESTONE Lot: 13 Project Description: Installation of walk -in cooler and walk -in freezer. Contractor: COMMERCIAL REFRIGERATION INC Owner: TIGARD - TUALATIN SCHOOL 5920 NE GLISAN STREET ' DISTRICT 23J PORTLAND, OR 97213 -3790 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503 - 234 -6445 PHONE: FAX: 503 - 234 -0668 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 08/14/2012 $204.14 Class of Work: ALT Type of Const: VB Plan Review 08/14/2012 $51.04 Occupancy Grp: E Occupancy Load: 12% State Surcharge - Mechanical 08/14/2012 $24.50 Stories: Info Process /Archiving - Sm $0.50 (up to 08/14/2012 $5.00 Project Valuation: $4,900.00 11x17) 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 $284.68 Hoods: Comm Incinerators: Required Items and Reports (Conditions) Woodstoves: Gas Fireplaces: Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Walk in Duct Work: cooler and 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: Permittee Signature: _____ Call 503.639.4175 by 7:00 a.m. for the next available inspe n 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 X FOR OFFICE USE ONLY City of Tigard r - ' i Received 13125 SW Hall Blvd., Tigard, OR 7:' -+ i ^ -' ' � Date/Ely: ? 7 I Permit No ��0�/� 3 s , Phone: 503.639.4171 Fax: 503.598.1960 Pan Bo O ther Permit: 1 0,, , I t� Date/By: l�l♦��. (J Z 64 pa ia_ems Inspection Line: 503.639.4175 J U L 1 7 2012 e ' ' I + Date Rea. /uric: 0 See Page 2 for Internet: www.ci.tigard.or.us No ed/Method: i i I Supplemental Information �- t ' ,r ;+'- '�trp Y 1i 1 �- - � ; *TV-r �, ., �r � � �� /71w � .� ��� � � Y : c ; t , v. br a ,, a - a i f 4 PS • 6z 0-- . ' z W, � ar e ' tfo 'D 3 ' . zr�+g 4'•- 4rcxx�s a o /t t p E.:. IIS ❑ New construction on/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit. 0 :: . a' �' - 1 #t OFt$ iD ' ,e cY - Q ,t. " . >� ,*+ Value: $ ) 4 F C pp / �� 3: 'vats n. - t 4- 4a c a l � a„ `-• .tea. • t.. . D1 1 .. S • 3', N � '��I ., t ,1 1�( jl[. , -- ,:•`t1rS, ._._, ❑ 1- and 2- family dwelling - Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total . t : x z i e Y t e_ • U• o V� l 1 `e e� T i T fi Heating/cooling Job site address: 123 9_5',5 6 3 .x..4 e�, Nc_ 5i-- Air conditioning or heat pump (requires site plan showing placement) 14.00 Ci /State/ZIP: Furnace 100,000 BTU (ducts/vents) 14.00 ty $� ` �� Suite/bldg. /apt. no.: I Project name�altl F urnace 100 000+ BTU (ducts/vents) 17.90 L y� GJ Q.[ - 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: Lot no.: Flue/vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances • ' �' x'r �a* `�a A. .:il C hip t of c V O 4" n y, �r > Water heater 10.00 �� Gas fireplace 10.00 Z �✓ - � / 6 / F f � A [mot L ) ip ft• Flue vent for water heater or gas �rt _` wittt/e_-_. - ' COO . L kW ` `�i j fireplace 10.00 Log lighter (gas) 10.00 r" ° ` e 2 4 _- Wood/pellet stove 10.00 Wood fireplace/insert 10.00 r w , , ©- u 2 , \ � - ,, e Chimney/liner/flue/vent 10.00 , Av g Other: I I 10.00 Name: Environmental exhaust and ventilation Address: - Range hood/other kitchen equipment 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 • Phone: ( ) Fax: Single -duct exhaust (bathrooms, _ ( ) toilet compartments, utility rooms) 6.80 '` * X Y r E 7;'" i r i- *ir y i " `h Attic/crawl ace fans 10.00 1: a , , xisr `At4:'.�c , •.•rw -1 .,. a 9 I6 [b , P - • o ,', ' sP Business name: �� � .rol 4 - 7e04....060eJ c_____ Other: I . 10.00 Fuel piping Contact name: J Zj fi,C C elftps J e L r J - $5.40 for first four; $1.00 for each additional Address: r` Q, 0 / s -z / i w S te^-- - L Gas Furnace, etc. City/State/ZIPQ v / V [ Oft__ ? 2z. 3 WalUsuspesuspe pump nded / unit heater Phone: ( ) e 2 J C{- - Fax:: 5 i 9 .39 L 7 - 06(p g _ Water heater Fireplace E-mail: e r ..�. *A y .r. ,e .. r � w ` . .; p _ .0 'ere ', 4 5 , . PA ' " ' 7,,;', $a • ` Barbecue G •Jn. Business name: `7,q -/ ( /L A .6 d e _ Clothes dryer (gas) �7/ Other: Address: " l- .yt E . City/State/ZIP: Subtotal Phone: ( ) I ax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: ' / State surcharge (8% of permit fee) y 9 �� TOTAL PERMIT FEE To�-3'7.44 Authorized signature: 911c This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: • Fee methodology.set by Tri- County Building Industry Service Board ' i:\ BuildinglPermiuthtEC- PermitApp.doc 12/03 - 440-4617T (1 I /02 /COWWEB)