Permit (15) CITY OF TIGARD MECHANICAL PERMIT
.11111
1; COMMUNITY DEVELOPMENT Permit#: MEC2017-00436
Tt.BARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2017
Parcel: 2S101AA00100
Jurisdiction: Tigard
Site address: 12300 SW 68TH AVE
Project: Landmark Ford Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Replacing existing split system.
Contractor: AMERICAN HEATING INC Owner: CORLISS,JAMES L&CORA K
5035 SE 24TH AVE PO BOX 23970
PORTLAND, OR 97202-4765 TIGARD, OR 97281
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/29/2017 $232.50
Class of Work: ALT Type of Const: VB Plan Review 06/29/2017 $58.13
12%State Surcharge-Mechanical 06/29/2017 $27.90
Occupancy Grp: B Occupancy Load:
Stories: Info Process/Archiving-Sm$0.50(up to 06/29/2017 $5.00
Project Valuation: $5,900.00 11x17)
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>= 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 $323.53
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Split system
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 c py of a rules
or direct questions to OUNC by calling 503.232.19: : .:i:. 32.2344.
Issued By: C 1-/-s_ P-ermittee Signature: /^G
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 ESE ONLY
City of Tigard RECEIVERwed
5 1„,,7
Pamflldo-:
13125 SW Hall BlvdINII .,Tigard,OR 97223 :y' Alar j 7— {'-t--/3 6
Phone: 503.718.2439 Fax: 503.598.1960 Pian Rem �,
Inspection Line: 503.639.4175
JUN 2017Date/BY: �� Other � e fo Uti t1J
T I G A R D Date Rea , : �+ / t ms El See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGA i r fied/Method_(i/ 1 / ,_ �
f• L}1 )1 �AJl������7K lll�1�� Supplemental Information
1 a
.. .. t. .�' .- .F URRI� .» : 12 1 . - f ll [ '- - - -,
o New construction Mechanical permit fees*are based on the value of the work
®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
* ` TI( fl 1AI�S"RI1Iq Value:$$5,900.00
❑ 1-and 2-family dwelling ®CommerciaUindustrial ❑Accessory building Ford
El Multi-family ❑ ❑Other: Description
Master builder �'�u�°��ton use checklist.
ption
OBIS ]I3f?RIIi13ION FYI? L()CAT)�3 - Heating/cooling: Ea Total
Air conditioning 46.75
Job site address:43395 SW Ave
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/Z1P:Tigard OR 97223 Furnace 100,000+BTU(ducts✓wnts) 54.91
Suite/bldg./apt.no.: I Project name:Landmark Ford AC9 replace Heat pump 61.06
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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
= .,,.',.t,,,.,----- 1P-,,,- ,,,,,--,,',-------,,',':--4.,- W<RI FGas lue vent
33.39
'''''''-:4'"''''''' ' Flue vent for water heater or gas
replace existing split system that serves MAU unit fireplace 23_32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OW1 RIr £4. - +s ` - ❑/TENANT - Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: — equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( )
Attic/crawlspace fans 23.32
„ Y nP-'A!'PLICri3 IT ,, 'corn c r PER Other:
23.32
Business name:American Heating Inc. Fuel piping:
$14.15 for first fair$4.03 for each additional
Contact name:Brad Manchester Furnace,etc.
Address:5035 SE 24th Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland,OR.,97202 Water heater
Phone:(503)239-4600 Fax::(503)239-7038 Fireplace
Range
E-mail: n
brad@amecanheating net
Barbecue
x _ Clothes dryer(gas)
Business name:American Heating Inc. Other:
Address:5035 SE 24th Ave ** Tal - ,
Subtotal
City/State/ZIP:Portland,OR.,97202 Minimum permit fee($90.00)
Phone:(503)239 4600 Plan review(25%of permit fee)
Fax:(503)239-7038 State surcharge(12%of permit fee)
CCB lic.:33135 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: /��2 i�*- �'G � days after it has been accepted as complete
' Fee methodology set by Tri-Canty Building Industry Service Board
Print name:Brad Manchester Date:6-9-17
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