Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2012 -00429
Ti G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2012
Parcel: 2S111ACO2700
• Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: PINEBROOK TERRACE Lot: . 67
Project Description: New gas piping from existing; 2 each lower level science labs
Contractor: CASCADE MECHANICAL SYSTEMS INC Owner: TIGARD TUALATIN SCHOOL DISTRICT
PO BOX 399 6960 SW SANDBURG RD
ESTACADA, OR 97023 TIGARD, OR 97223
•
PHONE: 503 - 630 -4492 PHONE: 503 -431 -4000
FAX: 503 - 630 -5510
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/16/2012 $207.21
Class of Work: ALT Type of Const: Plan Review 08/16/2012 $51.80
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 08/16/2012 $24.87
Stories:
Project Valuation: $5,000.00
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: 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 Notifica • r. 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 q tions to OU by calling 503.232.1987 or 1.800.332.2344.
Issued B : n Permittee Signature:
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.
Aug. 14. 2012 3:06PM No. 8355 P. 1
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/ay VI h Z Permit No. :,tdi v -o0 '. `
13125 SW Hall Blvd., Tigard, OR 9/22
'� r l Phone: 503.7182439 Fax: 503.598.1960 plan Renew Fe
Other ennl
Date/By ;L[ as i Z -qD�.
T t c A I; f: (ns Line; 503.639 p. , l 1 4 2012 Date Ready/Br Hal el See Page Z for
Internet: w•ww•.(igard - or.gov Notified/Method: Supplemental Information
CITYOF
TYPE OF 111i: 51:J1 5 i V 1 V COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value oldie work
❑ New construct ion [ 'Additiontalteration/rtplacemenl performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, la r, over) cad, and profit.
—
CATEGORY OF CONSTRUCTION Value:3 •
RESIDENTIAL EQUIPMENT /SYSTEMS PEES'
❑ 1- and 2- family dwelling Ercommerciavindustrial ❑ Accessory building Forxpednl infamrn►lan are checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I_ Total
JOB SITE INFORMATION AND LOCATION Reatiny/cooling:
- �� Air conditioning
lob site address; ' y 1'.0 � N > 4 ,y W C' w Ave. _{requires site plan showing placement) 46.75
City/State /ZIP: povita� r / '1 � Furnace 100,000+ BTU BTU ( q Furnace 100,000 s 5
(ducts/vents) rents) 54.91
Suite/bldg/apt. no.: — I Project name: j Y Y 1t 3 r o ,, u ,� Heat Pump
Cross street /directions to job site; J (requires site plan showiaa placement) 61M6
1 Duct walk 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
above 23.32
Subdivision: Lot no.: ^ Flue / for any o f ab
Other: 23.32
Tai map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
1 ,,, ,
�e� Gas fucplace /insert 33.39
r_ t PL ' ` `-v " ` eX S ( Flue vent for water heater or gas
2 e-c-R } ou3 ey- sc l€N.L k S. e fireplace _ 23.32
1 Log lighter (gas) _ 23.32
'r Wood/pellet stove 33.39
Wood fireplacdinsen 23.32
G PROPERTY OWNER TENANT Chimney/liner/flue/vent 23.32
Name: I y Other. 23.32
d Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 3139
City/State/ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
0 APPLICANT ❑ CONTACT PERSON Anic/crawlspace fans 23.32
Business name:
_ J 23.32
Fuel piping:
Contact ntune: sic 15 for first four; 54.03 for each additional
Address: Furnace, etc.
City / State/ZIP: Gas heat pump
Walt/suspended/unit heater
Phone: ( ) 1 Fax: : ( ) Water heater
E-mail: Fireplace
-
Range
CONTRACTOR Barbecue
Business name: ee i 1 e Clothes dryer (gas)
Other.
Address: ( Dy / • MECHANICAL PERMIT FEES*
City/State/ZIP: azi
MORN ; ,Cr—) C)1 7 u ?� Subtotal � r
� c ry _ Q � (_ !_� ago
Minimum permit fee (390.0
Phone: (�-� vJ�
.t' I Fax: V � ' Plan: review (25 /o of permit fee)
CCB lie.: (2_7V, State surcharge (12% ofpermit fee)
n
TOTAL PERMIT FEE Z, O
Authorizer! Si l rc: This gamier application expires era permit is not obtained wi Ma 180
n days liner it has been accepted as complete.
' Print name: 'erl•he n V
I Date: ~' ( t-(_ ( ' Fee methodology set by Tri- County Building Industry Service Board
MuildiogTamiiMIEC- PcnaiUpp.doe O1/07/I2 410- III7T(11 /OVCOM OWED) g5 3 .