Permit 111111 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013 00272
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2013
Parcel: 2S 103AA00101
Jurisdiction: Tigard
Site address: 10865 SW WALNUT ST
Project: Fowler Middle School Subdivision:)O SUPPLEMENTAL PLAT NO.1:ANNE Lot: 7-6
Project Description: Replace walk-in cooler/freezer.
Contractor: CAMERONS INSTALLATIONS INC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
22170 SW MARTINAZZI ATTN: BONITA MAPLETHORPE
TUALATIN, OR 97062 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-692-3368 PHONE: 503-431-4000
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/04/2013 $305.56
Class of Work: ALT Type of Const: Plan Review 09/04/2013 $76.39
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 09/04/2013 $36.67
Stories: Info Process/Archiving-Sm$0.50(up to 09/04/2013 $10.00
Project Valuation: $8,500.00 11x17)
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>=1001K 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 $428.62
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Walk-in
Duct Work: Cooler/Freez
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Nptification -CeCCter. Those rules are set forth in OAR 952-001-0010 through OAR 9 ' -0090. You may obtain a copy of the rules
or dir Et questions to 00 C b calling 503.232.1987 or 1.800.332.2344.
Iss ed By: 1 Permittee Si!-. re:
. fir t!I,11 r
•
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatio FOR oFFlck•us ONLY
City of Tigard IRECEI VEPI Receivyd 3,, 13125 SW Hall Blvd.,Tird,OR 97223 Plan Review / ti �T 'ermit N/../.r a^/� _00.2 7
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review o�rd
JUL 2 2 2013 DateBy �'�• Other Permit:
T I GA R D Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 776.-- Supplemental Information
CITY OF TIGARD
TYPE OF WC]WILDING DIVISION COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
• Value:$ 8 Sod -
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: f 0 8 to S 5t4J (A,7ruk3U C Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: '---r g beta)� ve q 7 Z23 Furnace 100,000+BTU(duets/vents) 54.91
ll �r Heat pump 61.06
Suite/bldg./apt.no.: Project name: Fp W am
L , j z, di Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot no.: —
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
n � C� K—1 a �0�/ Flue vent for water heater or gas
,Vy'",°•�,�, fireplace 23.32
Log lighter(gas) 23.32
Fe t3e2£12- Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation: _
Name: _.{—,41 -9 7--rl.I rrL —I' 5, D, Range hood/otherkitchen
equipment 33.39
Address: Clothes dyer exhaust 33.39
City/State/ZIP: —r-C ��eed�� e. Single-duct exhaust(bathrooms,
`l r^"6�r toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 ❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
I �— Fuel piping:
Business name:
h.
�/Q-B ej �/V rj"�'���o�� $14.15 for first four;$4.03 for each additional
O Contact name: Furnace,etc.
^ Gas heat pump
Address: 2 Z( ! 0 5 (A.) 14/1.men-hQ4s L z
t Wall/suspended/unit heater
•
City/State/Z1P: 14 4,...1L assn,1/4.1 pit 97(34.1.. _Water heater
Phone:(TO (9 Z_35 6 8 I Fax::`ege) L / /508 Fireplace
Range
E-mail: GjC.ggy-tpk--Q. ( J5— p*jTlaset.L ds,sr7 O 5 Barbecue _ .
CONTRACTOR Clothes dryer(gas)
Business name:
Other:
MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCBlic.: ' LI59�3 V/ /y TOTAL PERMIT FEE fi/,jg•42,
This permit application expires if a permit is not obtained within 180
` days after it has been accepted as complete.
Authorized signature: ®� �.,�_ J • Fee methodology set by Tri-County Building Industry Service Board
Print name: 5 C_�,t � pp �'��Date� '2 2 03
I:Building\Permits\MEC_PermitApp_0401 13.doc 'f 44 617r( /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.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
Mechanical Permit Application,.. FOR OFFICE USE ONLY
City of Tigard 9 - f
III 13125 SW Fail Blvd.,Tigard.OR 9723 t, t) l (
- Phone: 503.715.2439 Fax: 503.593.146' Dale By`� S
Plan Review
Date%ay: J Permit No: f-1 66,a4)f j-DD 27
.
Oilier Permit: f /46*/�_et:y...147
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: ions: 0 See Paige 2 for
Internet. www.tigard-or.gov CI I Y Ui.. i l GAP:;./ Notified:Method: Supplemental Information
.
' TYPE OF WORK i COMMERCIAL FEE* SCHEDULE-.USE CHECKLIST
Mechanical permit tees*are based on the value of the work
❑ New construction ® Addition/alteration/replacement performed.Indicate the value(rounded t the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment. b ,overhead,and profit.
Value:$5l 0
l CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPME T/ YSTEMS FEES* •
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For specie!information use check list.
❑ Multi-family ❑ Master builder ®Other:School Description I Qty. I Ea. I Total
JOB SITE INFORATION AND LOCATION Heating/coolie)
M
Air conditioning 46,75
Job site address: Fowler Middle School 10865 SW Walnut St. Furnace 100.000 BTU(ducts:veins) 46.75
City/State/ZIP:Tigard,OR 97223-4952 Furnace 100.000+BTU(ducts/vents) 54 91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Fowler MS Cooler/Freezer Ductwork 23.32
Cross street/directions to job site:SW Walnut and Tiedeman Ave. Hydronic hot water system 23.32
— Residential boiler(radiator or
• hydrunic) 23.32
Unit heaters(fuel-type,not electric).
in-wall,in-duct,suspended,etc 46.75
Flue/vent for any of above 23.32
Other: 23.32 I
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 1 223.32
DESCRIPTION OF WORK i Gas fireplace/insert 33.39 '
Flue vent for water heater or gas
Demo and replacement of existing cooler/freezer units and concrete slab below, fireplace 23 32
Redirect roof drain to new wall adjacent to cooler/freezer,replace rooftop Log lighter Igas) 23 32
Wood/pellet stove 33.39 I
condensing units. Wood lireplace/insert I 23.32
Chimney/liner/flue/vent 23.32
t Other: 1 33.32 I
® PROPERTY OWNER I _ 0 TENANT Environmental exhaust and ventilation: .
Name:Tigard-Tualatin School District Range hoodiother kitchen
equipment 33.39
Address:6860 SW Sandberg Rd. Clothes dryer exhaust 33.39
City/State/ZIP:Tualatin,OR 97223 Single-duct exhaust(bathrooms.
toilet compartments.utility rooms) 23.32
Phone:(503)431-4000 Fax:(503)431-4020 Attic/crawlspace fans 23.32
® APPLICANT 1 ❑ CONTACT PERSON Other: - 23.32 I
Fuel ping:
Business name: DOWA-IBI Group Architects 514.15 for first four:54.03 for each additional
Contact name: Rebecca Stoecker Furnace.etc.
Address:907 SW Stark St. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Portland,OR 97205 Water heater
Phone:(503)226-6950 Fax: :(503)273-9192 Fireplace
Range
E-mail:rebecca.stuecker @dowa-ibigroup.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other: I
Business name:TBD
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZlP: Minimum permit fee($90.00)
Plan review(25%ofpermit fee)
Phone:( ) Fax:( ) State surcharge(12%of pennit fee)
CCB tic.: TOTAL PERMIT FEE
This permit application expires if a permit Is not obtained within ISO
......../L1..--- —. days l og aster it has been accepted as complete.
Authorized signature: ° Ice methodology sat by Tri-(booty Building Industry Service Board
Print name: ��c �G,q �7?.,E -1e —Z Date: --57/2_2.,/i 3
l:•Building Permiis MCC_PermitApp_Ol0113 doe 410-46171 111 02.10?I WEB)