Permit CITY OF TIGARD MECHANICAL PERMIT
111111. COMMUNITY DEVELOPMENT Permit#: MEC2013 00509
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2013
Parcel: 2S102BD00100
Jurisdiction: Tigard
Site address: 12520 SW GRANT AVE
Project: St Anthony Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 52
Project Description: Mechanical work(AHU's,CU,fans,coils,water piping,gas piping,duct work,etc.)for new community center
assembly building.
Contractor: HVAC INC Owner: ST ANTHONY CATHOLIC CHURCH TIGAR
5188 SE INTERNATIONAL WAY 9905 SW MCKENZIE ST
MILWAUKIE, OR 97222 TIGARD,OR 97223
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/29/2013 $10,054.71
Class of Work: ADD Type of Const: VB Plan Review 10/29/2013 $2,513.68
Occupancy Grp: A-3 Occupancy Load: 12%State Surcharge-Mechanical 10/29/2013 $1,206.57
Stories: 1 Info Process/Archiving-Lg$2.00(over 10/29/2013 $12.00
11x17)
Project Valuation: $355,000.00 Info Process/Archiving-Sm$0.50(up to 10/29/2013 $25.00
11x17)
Fuel Air Handlers
Fuel Types: Units<10000 cfm: 3
Gas Pressure: Units>10000 cfm: 1
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 $13,811.96
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Water
Duct Work: 1 Piping, Make
Fire/Smoke Dampers: 1
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 952-001-00.1. You .y obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.801
i
Issued By: / • rmittee Signature: I /
Call 50 �` by 7:00 a.m.for the next available inspection .ate
This permit card shall be kept in a conspicuous place on the job site until comp n of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicatio EC w
' FOR OFFICE USE ONLY
��• Received
City of Tigard Date/By: 9 �d/45 ei.. Permit No.:ME'C�J..,/,_oa s0 q
e 13125 SW Hall Blvd.,Tigard,OR 97223 S E P 1 0 2013 Plan Revie �[/
°: C ' .. Phone: 503.718.2439 Fax: 503.598.1960 Date/By /0/45 2)- Other PermileuPad/2 aoa 6-5'.
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: , , Juris: El See Page 2 for
Internet: www.tigard-or.gov DtJILDI�IG DIVISION Notified/Method/O,'/ t•i/i; i7&' Supplemental Information
TYPE OF WORK CC 1 MERCIAL FEE* SCHEDULE — USE CHECKLIST
i 1 Mechanical permit fees*are based on the value of the work
PNew construction l:i i ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,ov ad and fit
Value:$3< IA)10�
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Ib Commercial/industrial ❑Accessory building For special infornmrion use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 1' - -� 3\i,) V V r v` AA, 5 (requires site plan showing placement) 46.75
City/State/ZIP: -O`t�C `\� Ck�°��'� Fumace 100,000 BTU(ducts/vents) 46.75
1 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no Project name:S t QA A 0� L60.14/. : Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 8' 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: I 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
:4 VOA) I U, r r �I/ a�C 1 I Gas fireplace/insert ent for ale 33.39 _
`-1 -{ v J Flue vent for water heater or gas
V Y �/1 1 l lik` p`� pt t� � Log fireplace 23.32
�J ��1 ` J1 Log lighter(gas) 23.32
Wood/pellet stove 33.39 _
Wood fireplace/insert 23.32
❑ PROPER'''���'''11Y OWNER ( ❑ TENANT Chimney/liner/flue/vent 23.32
/ Other: I 23.32
Name: / Environmental exhaust and ventilation:
Address: ./ Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Phone:( ) Fax:( ) Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
I-1t J n/ 4 Other: 23.32
Business name: V i'!l./ Fuel piping: _
Contact name: at $14.15 for first four;$4.03 for each additional
Address: % % ! In 1---( a■dli Furnace,etc.
nn l� � / Gas heat pump
City/State/Z1P: 1► l 1t U1/(� \ OM"- d'� WalUsuspended/unit heater
Phone:(s--0-3)W b 1.t,%--)-,} Fax::(93)1,1 U a-.U5� --' Water heater
Fireplace
ce
E-mail: .1 Go(Alt L)V Vck(/A LOV p,00✓n Range
CONTRACT R
Barbecue
•
Business name: 1.,4V 0 V 4(I L,, Clothes dryer(gas)
Other:
Address: C`�/� MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fcc($90.00)
Plan review(25%of permit fee)
CCB lic.: J b sC\---) i TOTAL State surcharge(12%of permit fee)
I PERMIT FEE
This Authorized signature: s permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: \ v a . . ' ' Date: 01 /1 0 1 13 * Fee methodology set by Tri-County Building Industry Service Board
I:\BuildingWermits\ EC-Permit Ap•.doc 03/07/12 440-4611 Tr(11/02/COMIWEB)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12520 SW GRANT AVE, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
2014-03-12 00:00:00
MEC2013-00509
PASS - No C of O
Violation Summary:
Inspector Contractor