Permit CITY OF TIGARD MECHANICAL PERMIT
°' COMMUNITY DEVELOPMENT Permit #: MEC2012 00648
T IGAAD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/25/2013
Parcel: 1 S134DB00300
Jurisdiction: Tigard
Site address: 11065 SW NORTH DAKOTA ST
Project: LDS Church Subdivision: 1998 -067 PARTITION PLAT Lot: 2
Project Description: Add (4) condensing units to existing system.
Contractor: EAGLE MOUNTAIN CONSTRUCTION INC Owner: CORPORATION OF THE
PO BOX 796 PRESIDING BISHOP /CHURCH OF
MOLLALA, OR 97038 JESUS CHRIST OF L D S
50 E NORTH TEMPLE 22ND FL
SALT LAKE CITY, UT 84150
PHONE: 503 - 799 -2893 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/25/2013 $1,109.71
Class of Work: ALT Type of Const: VB Plan Review 03/25/2013 $277.43
Occupancy Grp: A-3 Occupancy Load: 12% State Surcharge - Mechanical 03/25/2013 $133.17
Stories: 1 Info Process /Archiving - Lg $2.00 (over 03/25/2013 $26.00
11x17)
Project Valuation: $40,000.00 Info Process /Archiving - Sm $0.50 (up to 03/25/2013 $41.00
11x17)
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 4
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 4 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: 4
Appliances
Vent Fans: Vent Systems: Total $1,587.31
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 qu ;- ions to ► NC • calling 503.232.1987 or 1.800.332.2344.
i
Issued = : I / Permittee Signature: X
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 o he project.
Approved plans are required on the job site at the time of each inspection.
EKED
Mechanical Permit Applicati I'` `� FOR.Ol l lCI USE ONLY
City of Tigard DEC 1 Received
Date/By: oZ / / Perm No , / U�
13125 SW Hall Blvd., Tigard, OR 97223 0 2012 Y d �o Z r /zo�Q�o2 _4:100, 7
'� C Phone: 503.718.2439 Fax: 503.598.196 Plan Review - r
CITY OF • � RD Date/By 1 , r / ' Other Permit:
T I G A K b Ins Line: 503 CITY 11 t 111E Date Rea. 111 _ huts' ® Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Me J / h s% . I' 776, Supplemental Information
kit, u) A( --5 1
C�
/ 4
TYPE OF WORK / • COMMERCIAL FEE' SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction ® Addition/ alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and Brit.
' Value: $ 10 COO ,
CATEGORY OF CONSTRUCTION • +
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
❑ 1 - and 2- family dwelling %Commercial/industrial ❑ Accessory building For special informalion use checklist
❑ Multi- family ❑ Master builder
® Other: Church Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 11065 SW North Dakota (requires site plan showing placement) 4 46.75
City/State /ZIP: Tigard/Oregon/97223 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: AC Unit Upgrade LL .$ CA / Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: SW North Dakota between 109th and 115th 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
Add cooling to existing systems Gas fireplace /insert 33.39
Flue vent for water heater or gas
(y) L "/ 2 s EA/ S /n/ aiv / Tf' - ,6,C fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39 _
Wood fireplace/insert 23.32
® PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: The Church of Jesus Christ of Latter - Day - Saints Environmental exhaust and ventilation:
Address: 50 East North Temple Street Range hood/other kitchen
equipment 33.39
City/State /ZIP: Salt Lake City/Utah/84150 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
( )
Phone: ( ) Fax: 'toilet compartments, utility rooms) 23.32
O APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: John A. Stark Architect Other: 23.32
Fuel piping:
Contact name: John Stark $14.15 for first four; $4.03 for each additional_
Address: PO Box 23215 Furnace, etc.
Gas heat pump
City/State /ZIP: Portland/Oregon/97281
Wall/suspended/unit heater
Phone: (503) 544 -6840 Fax: : (503) 213 -6181 Water heater
E -mail: jsbellaopus @msn.com Fireplace
Range
CONTRACTOR Barbecue
Business name: e;g a . E N T/-) C -,2 C 7-7U, J Clothes dryer (gas)
Other:
Address: P c d--,c, 7 17 4, MECHANICAL PERMIT FEES'
City/State /ZIP: (\A LI i- i _ r - i 0 2 970 5r Subtotal
Phone: (6)3 ) 7 9 - 4 Al S 3 Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: A9 0," ¢j State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signs e: r This permit application expires if a permit is not obtained within 180
- days after it has been accepted as complete.
Print name: , j S" 1 g'� Date: / z • . J O - 2 /2_. ' Fee methodology set by Tn County Building Industry Service Board
1:\Buildineemits\MEC -P tApp.doc 03/07/12
440.4617T (I I /07/COM/WE8)
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.
I: \ Building \Perrnits\MEC- PermitApp.doc 03/07/12 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11065 SW NORTH DAKOTA ST, TIGARD, OR,
97223
Commercial - Mechanical
615 Mechanical rough-in
04/10/2013 00:00
MEC2012-00648
PART
1. Complete sw unit lines and hookup.
2. Seal outside line wall penetrations with approved material
NOTE ok for cover.
Violation Summary:
Inspector Contractor