Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES DATE ISSUED: 10/6/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #: MEC2000 -00396
PARCEL: 2S1 11 AD -08900
SITE ADDRESS: 08785 SW REILING ST
SUBDIVISION: SCHECKLA PARK ESTATES ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of new gas furnace, a/c unit, gas piping and vent for future use. Placement of a/c unit must comply
with standard setbacks.
Owner: FEES
TUCKER - MCCOY, PATRICIA ANN Type By Date Amount Receipt
8785 SW REILING ST PRMT CTR 10/6/00 $72.50 2720000000
TIGARD, OR 97224 5PCT CTR 10/6/00 $5.80 2720000000
Total $78.30
Phone:
Contractor:
ABLE HEATING + COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR. 97223 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 579 -2250 Mechanical Insp
Reg #: LIC 00108535 Heating Unt lnsp
Cooling Unt Insp
Final Inspection
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility N. • I Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ► ay obtain co.'es of these rules or direct questions to QUNC by calling (503)24.-9189.
Is - ue By: � �� , , i Permittee Signature: L Lae
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
/lic - co 3 9 40
Mechanical Permit Application
Al, � Date received: (0- Permit no.:
.1 �
' City of Tigard _ � ty g Project/appl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
/ VI & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COh1MERCIAL VALUATION SCHEDULE
Job address:: a NNIMIIIANOW a Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Ir uite no • value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: 'Block: I Subdivision: *See checklist for important application information and
Project name: „c el jurisdiction's fee schedule for residential permit fee.
City /county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and loca on of work on . mises: 10e u7 oc 3e4l AND COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE
. ..f. C J. 4L ■ t .. r • Fee(ea.) Total
Est. date of completion/inspection: n () Description Qty. Res. only Res. only
Tenant improvement or change of use: / HVAC:
Air handling unit CFM •
Is existing space heated or conditioned? 0 Yes ❑ No - Air conditioning (site plan required) J /t1(,0
•
Is existing space insulated? 0 Yes ❑ No Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
� State boiler permit no.: • Business name: c i G HP Tons BTU/H
Address: ICi! _,/� r r A ir - Fire/smoke dampers/duct smoke detectors
City: • , • State:9 ZIP: 7. c 22 Y Heat pump (site plan required)
•
Phone: - / 3 Z Fax: E J I / Install /replace furnace/burner :?i TU /H 0
ncluding ductwork/vent liner Yes O No 111
0
CCB no.: / S - 33-' Install/replace/relocate heaters— suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace / (p ,%0
CONTACT PERSON Refrigeration:
/,, Absorption units BTU/H
Name: LQ/f fa( / cki)ar n Chillers HP
• Address: Com ?ressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: .. Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type I/ Wres. kitchen/hazmat
hood fire suppression system
Name: ,4' e 4 ,7-4. ( ( e r Exhaust fan with single duct (bath fans) .
Mailing address: 6j , • Exhaust system apart from heating or AC
Fuel piping and . button up to 4 out ets a
City: c [17, ZIP: Type: LPG c .' NG Oil ' rj.Y
Phone: s ��, Fax: E - mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Number of outlets
• . Name. Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert — type
Phone: I Fax: I E - mail: Woodstove/pellet stove
Other:
Applicant's signature: I Date: Other:
Name (print): -
Permit fee $ _7
Not all jurisdictions accept credit cards, please call jurisdiction for more infomtation. .
Notice: This permit application Minimum fee $
0 Visa ❑ MasterCard if a permit is not obtained •
Credit card number: / ! Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ 5 ' \So
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 7 •
$ Cardholder signature Amount 440 -4617 (6/00 /COM)
Commercial Schedule
1 &2 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE
Description -
Furnace to 100,000 BTU . Table to Mechanical Code . Oty Price Total
including ducts & vents 955 1) Furnace to 100,000 BTU
including ducts & vents 14.00
Furnace > 100,000 BTU 2) Furnace 100,000 BTU+
induding duds & vents 17.40
induding ducts & vents 1,170 3) Floor Furnace
Floor furnace
including vent 14.00
4) Suspended heater, wall heater
induding vent 955 or floor mounted heater 14.00
suspended heater, wall heater 5) Vent not included in appliance permit 6.80
or floor mounted heater 955 6) Repair units 12.15
Check all that apply. 'Boiler Heat Air
Vent not included in appliance permit 445 For Items 7 -10, see or Pump Cond Oty Price Total
Repair units 805 footnotes 1,2 Comp
7) <iHP; absorb unit to
< 3 hp; absorb.unit 1ooK BTU 14.00
to 100k BTU 955 took to HP; 00absorb U unit 25.6o
3 -15 hp; absorb.unit 9) 15 30 HP; absorb
unit .5-1 mil BTU 35.00
101k to 500k BTU 1700 10) 30-50 HP; absorb
unit 1 -1.75 mil BTU 52.20
15-30 hp; absorb.unit 11) >50HP; absorb unit >1.75 mil BTU
501k to 1 mil. BTU 2310 67'20
12) Air handling unit to 10.000 CEM
30 -50 hp; absorb.unit 10.00
1 -1.75 mil. BTU 3400 13) Air handling unit ,0,tx10 CFM+ 17.20
• 14) Non - portable evaporate cooler
> 50 hp; absorb.unit 10.00
> 1.75'mil. BTU 5725 15) Vent fan connected to a single dud
6.80
Air handling unit to 10,000 cfm 656 16) Ventilation system not included in
Air handling unit > 10,000 dm • 1170 - 17) Hood s eN finical exhaust 10 .00
Non - portable evaporate coller 656 1000
18) Domestic incinerators
vent fan connected to a single duct 446 17.40
19) Commercial or industrial type incinerator
Vent syst. not included in appliance permit 656 69.95
Hood served by mechanical exhaust 656 20) Other units, including wood stoves 10.00
Domestic incinerator 1170 21) Gas piping one to four outlets
5.40
Commercial or industral incinerator 4590 22) More than 4-per outlet (each)
1.00
Other unit, including ood stoves, inserts, etc. 656
g Minimum Permit Fee $72.50 SUBTOTAL gast gym
Gas piping 1-4 outlets 360 8% SURCHARGE tog Egan
Each additional outlet 63 PLAN REVIEW 25% OF SUBTOTAL
Required for ALL commercial permits only
TOTAL MEM_
Other Inspections and Fees:
1. Inspections outside or normal business hours (minimum charge -Iwo hours)
$72.50 per hour
2. Inspections nor which no lee is specifically indicated (minimum Uharge4hatf hour)
572.50 per hour
Total Valuation Fee 3. Additional plan review required by changes. additions or revisions to plans (minimum
• dwrgeone -half hour) 572.50 per hour
_ 'State Contractor Colter Certification required
$1.00 to $5,000.00 Minimum $72.50 - Residential NC requires site plan s"la"ng placement of unit
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
each additional $100.00 or fraction thereof,
•
to and including $10,000.00
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54
for each additional $100.00 or fraction
thereof, to and including $25,000.00
• $25,001.00 to $50,000.00 • $379.50 for the first $25,000.00 and $1.45
for each additional $100.00 or fraction
thereof, to and including $50,000.00
$50,000.00 and up $742.00 for the first $50,000.00 and $1.20
for each additional $100.00 or fraction
thereof
•
,..
/d-/,/, ._. . _
. ,,,3( AVa61\1/1
1
J -10
N.)b
. i
H
i
I
i • . --- - -- .
— 7
- I or-T(D
fiv
p 9)
Q„\-/
a
7, .
• .eav
U
3 • \
_._
cp(ie
r