Permit CITY OF TIGARD 1 MECHANICAL PERMIT
COMMUNITY DEVELOPMENT ��°� Permit#: MEC201500151
T 1(;A.K D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/30/2015
Parcel: 2S101AA00100
Jurisdiction: Tigard
Site address: 12300 SW 68TH AVE
Project: Landmark Ford Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Replacing(4)RTU's and reconnecting gas piping. 4/6/15,reprinted to correct address and parcel number.
Contractor: AMERICAN HEATING INC Owner: CORLISS, JAMES L&CORA K
5035 SE 24TH AVE LEASE TO: FORD LEASING
PORTLAND,OR 97202-4765 DEVELOPMENT COMPANY
PO BOX 23970
TIGARD, OR 97281
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/30/2015 $474.71
Class of Work: ALT Type of Const: VB Plan Review 03/30/2015 $118.68
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 03/30/2015 $56.97
Stories: Info Process/Archiving-Sm$0.50(up to 03/30/2015 $12.50
Project Valuation: $15,000.00 11x17)
Project
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 $662.86
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 ques• r/�1 C by calling 503.232.1987 or 1.800.332.2344.
Issued By: / t t Permittee Signature: (` met GL/
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.
CITY OF TIGARD MECHANICAL PERMIT
•
s . COMMUNITY DEVELOPMENT Permit#: MEC2015 00151
Date Issued: 03/30/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AA00101
Jurisdiction: Tigard
Site address: 12000 SW 66TH AVE
Project: Landmark Ford Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Replacing(4)RTU's and reconnecting gas piping.
Contractor: AMERICAN HEATING INC Owner: CORLISS, JAMES L&CORA K
5035 SE 24TH AVE LEASE TO: FORD LEASING
PORTLAND, OR 97202-4765 DEVELOPMENT COMPANY
PO BOX 23970
TIGARD, OR 97281
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 03/30/2015 $474.71
Class of Work: ALT Type of Const: VB Plan Review 03/30/2015 $118.68
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 03/30/2015 $56.97
Stories: Info Process/Archiving-Sm$0.50(up to 03/30/2015 $12.50
11x17)
Project Valuation: $15,000.00
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 $662.86
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 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.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard ` 'e a DaLe„3v Ycnnit No.:Y _J +� JS
14 a 13125 SW Hall Blvd.,Tigard,OR 97223 Crr`V G Plan• i
Phone: 503.718.2439 Fax: 503.598.196 �' LL++ Datefgy AL IIM Other Permit:
TI G A R D Inspection Line: 503.639.4175 3 o1C, Date Reaay/By: kris: H See Page 2 for
Internet: www.tigard-or.gov WAR ` 1 Notified/Method: 3/x�j 5 "JZw_ Supplemental Information
TYPE OF WOR1CC1Y ` pNISk0. ' T �"f� •s+ L FEE* SCHEDULE — USE CHECKLIST
`Na Mechanical permit lees*are based on the value of the work
❑New construction ®Addition/alterati cement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit.
Value:$$15,000.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercialindustrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total —
" � JOB SITE INFORMATION AND LOCATION Heating/cooling:
—
G cx �n�s t Air conditioning 46.75 _
Job site addres la2,t.(.k:34..1 (p(p ' ti„� Furnace 100,000 BTU(ducts/vents) 46.75 _
City/State/ZIP:Tigard OR 97223 °� Furnace 100,000+BTU(ducts/vents) 54.91 _
Heat pump 61.06 _
Suite/bldg./apt.no.: Project name:Landmark Ford Replace AC 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 _
Subdivision: Lot no.: Other: 23.32 —
Other fuel appliances:
Tax map/parcel no.: Water heater I 1 23.32 1 —
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Remove and replace like for like(4)roof top gas pack units fireplace 23.32 _
disconnect reconnect gas piping Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 _
PROPERTY O
Other: 23.32 _
El OWNER ❑ TENANT Environmental exhaust and ventilation: _
Name: Range hood/other kitchen
equipment _ 33.39 —
Address: Clothes dryer exhaust 33.39
City/State/Z1P: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) . 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 _
® APPLICANT ® CONTACT PERSON Other: 23.32
Fuel piping:
Business name:American Heating Inc. —
S14.15 for first four;$4.03 for each additional
Contact name:Brandon Hutchinson Furnace,etc.
—
Address:5035 SE 24th Ave Gas heat pump —
WaWsuspended/unit heater
City/State/ZIP:Portland,OR,97202 Water heater
Phone:(503)239-4600 Fax::(503)239-7038 Fireplace
Range
E-mail:b.hutchinson(aJamericanheating.net Barbecue ,
�r �`" CONTRACTOR Clothes dryer(gas)
Other:
Business name:American Heating Inc. MECHANICAL PERMIT FEES*
Address:5035 SE 24th Ave Subtotal
City/State/ZIP:Portland,OR.,97202 Minimum permit fee($90.00)
Phone:(503)239-4600 Fax:(503)239-7038
Plan review(25%of permit fee)
State surcharge(12%of permit fee) _
CCB lic.:33135 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name:Brandon Ilutchinson Date: )• P.0 V3—
I.\Building\Permits\MEC_PermaApp_040113.dot 440-4617f(I1/02/COM/WFB)