Permit (178) RFC,EIVF:r
City of Tigard • COMNIUNITY DEVELOPMENT DEPARTMENT APR 1 2 2018
. . „
' g Request for Permit Action
TIGARD 13125 SW I Fall Blvd. Tigard, Oregon 97223 • 503-718-2439 www.tigara-or.gov
N
TO: CITY OF TIGARD V 0 1
Building Division 1/4F
13125 SW flail Blvd.,Tigard,OR 97223
Phone: 563-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard or.goy
FROM: Ell Owner J Applicant Contractor El City Staff
ix)one
REFUND OR Name:
INVOICE TO: f Inarvidual'` a /176-*
Mailing Address: 0,2 7 ,
_ .
City/State/Zip:
Phone No :
a )297,2
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
4 CANCEL/VOID PERMIT APPLICATION,
III REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
Et INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
REMOVE/REPLACE C()NTRACTOR ON PERMIT (do not cancel permit),
Permit #: te' 18—aFila2'
Site Address or Parcel #: (22S/120,26/36,72,1/43f,-, ,49-eliP./C ft-17'
Project Name: Ir2,41-V z#17/17-5
Subdivision Name: 44// -747146612:/17V1-0I
EXPLANATION: „4,27/2
KLez- } 4.14/'41;ef?
41,1411' 1
Signature: rn Date: q
Print Name:
Refund Pk Alcy
1, Me city's Community Development Director,Building I-Mticial or(hr Engineer may authorize the refund oh
• Ant fee which was erroneously paid or collected.
• Ni t more than 80';0 id the application or plan review fee when an application is withdrawn cit canceled bet-tire review effort
has been expended
• Not more than 80i,of the application or permit tee for issued permits prior to any inspection requests,
2. Ail refunds will he returneil to the iiriginal payer in the limn of a check yia IS postal set-vice,
3, Please allow 3-4 weeks for processing refund requests; , 9/ , 9,3 /(0
66. 0 — S / ?'2-
,
6 /2 0=7,1
FOR OFFICE USE ONLY
Route to Svs Admint Date Br Route to Records: Date / /,9 BY 41110
Refund Processed: Datesx,e/. By !")", Invoice Processed: Date By
Pt4ntit Canceled: Dates/T 21 Parcel,Tag Added: Date
RoiPerma Acci,so A231 is it
..
" I
TIGARD
City of Tigard
6/1/2018
Gagle's Heating
2789 Pringle Rd SE
Salem, OR 97302
Re: Permit No. MEC2018-00112
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 13145 SW Pacific Hwy
Project Name: O'Reilly Auto Parts
Job No.: N/A
Refund Method: ® Check#228648 in the amount of$493.62.
❑ Credit card "return"receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
0 Trust account"deposit"receipt in the amount of$ .
Comment(s): Per applicant's request as project was awarded to another contractor.
Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
‘ `t0
Dianna Howse
Building Division Services Supervisor
Enc.
i
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2018-00112
13125 SW Hall Blvd.,Ti Date Issued: 02/26/2018
TiC r\1<I) and OR 97223 503.718.2439 9
Parcel: 2S102CB00300
Jurisdiction: Tigard
Site address: 13145 SW PACIFIC HWY
Project: O'Reilly Auto Parts Subdivision: NORTH TIGARDVILLE ADDITION Lot: 33
Project Description: Replace existing split system heat pump with(2)rooftop heat pumps.
Contractor: GAGLES HEATING Owner: CHUNG, HENRY&COMPANY
2789 PRINGLE RD SE BY THOMSON PROPERTY TAX SERVICES
SALEM,OR 97302 PO BOX 06116
CHICAGO, IL 60606
PHONE: 503-581-2972 PHONE:
FAX: 503-581-1376
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/22/2018 $550.91
Class of Work: ALT Type of Const: VB Plan Review 02/22/2018 $137.73
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 02/22/2018 $66.11
Stories:
Project Valuation: $18,000.00
Fuel Air Handlers
Fuel Types: Electricity Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Fumaces: 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 $754.75
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 OUN .y calling 503.23 .1987 or 1 800.332.2344.
•Issued B •y:
Ale/z/ e Signature: _ 111011.
/ Call 503.639.4175 by 7:00 a.m.for the next available inc� tion 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
n City of Tigard etved 1? -
eBy: Permit No.: M �r _ ` l
in 13125 SW Hall Blvd.,Tigard,OR 97223 RECEIVE /•t l7(J '��
C Phone: 503.718.2439 Fax: 503.598.1960 tan Revie
Inspection Line: 503.639.4175 DateBy: p,'2� g �1 Other Permit:pi,/I 1 if� yy
t I t' R. p g g � Date Ready/By: II Juris: See�Pae 2 for �•e•�
Internet: www.ti and-Or. ov FE8Notified/Method'7 i /if' Al i Supplemental Information
ae s y a
` -l:,.wE . _:. a..•.,. ,r+. € '::i.3a o-.,.# ,447,44r� / .u. tNt �1 1 B,I _.,,..4412 t bIt b 5 .
# "` Mechanical permit fees*are based on the value of the work
D New construction ®Addition/alterat . . 0 performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
Al #" i'!'407923,171124110511:611 Value:$$18,000 00
, 4
.. -.. ;••.fit) ... goimii,, rr mt + :...._
0 1-and 2-family dwelling ®Commercial/industrialE i
❑Accessory building For special information use checklist.
0 Multi-family ❑Master builder 0 Other: DescriptionEa. Total
. ' Ae "st #t i 'I 1#px- e- - ,t�#,,: Heating/cooling: Qty.
3. .�s., .. ._•,:. _.. . .:_ x, Air conditioning 46.75
Job site address:13145 SW PACIFIC HIGHWAY Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:TIGARD,OR.97223-5044 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:
Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
.. F , .24; s " t. its`21-:1•2: r =,.o Residential boiler(radiator or
4P. _ ."t' -. "..464 , -;:_ ,,,..*:4,,,,. a :"F 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: 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
e ,E.3 Eta" i f !�t o 1 E rx E Gas fireplace/insert 33.39
...K: ,_v a :c. ,rtw ,€ 3.._t.,. .., v ,A .,r... .z._: Ham.° Flue vent for water heater or gas
REPLACE EXISTING SPLIT SYSTEM HEAT PUMP WITH TWO ROOFTOP fireplace 23.32
PACKAGED HEAT PUMPS c).- "�`0 I,� t) Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32 a [ ;'60110, . . ' # ""4 "il ` '` _, TIF -
Environmental exhaust and ventilation:
Name:O'REILLY AUTO PARTS Range hood/other kitchen
Address:233 S PATTERSON
equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:SPRINGFIELD,MO.65802 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(417)868-4295 Fax (417)574-7153 Attic/crawlspace fans 23.32
ganrnalli
,_. _.,: r b s.r ` ielteth� ,: �,M 2 4, ' �° '... _+"t#t Other: 23.32
Business name:GAGLE'S HEATING,AIR CONDITIONING AND PLUMBING INC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:JEFF BRANCH Furnace,etc.
Address:2789 PRINGLE RD SE Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:SALEM,OR.97302 Water heater
Phone:(503)581-2972 I Fax::(503)581-1376 Fireplace
Range
E-mail:Jeff@gaglesheating.com Barbecue
. ,.,.t �..0 lft ''r' v: .�,�,v.,. 1 ,, '1... .nl_ , Clothes dryer(gas)
LRE
Business name:GAGLE'S HEATING,AIR CONDITIONING AND PLUMBING INC Other
Address:2789 PRINGLE RD SE y_ i..,..._..� ...::: N8 ,._..
Subtotal 550.91
City/State/ZIP:SALEM,OR.97302 Minimum permit fee($90.00)
Phone:(503)581-2972 Fax:(503)581-1376 Plan review(25%of permit fee) 137.73
State surcharge(12%of permit fee) 82.64
CCB lie.:61330 TOTAL PERMIT FEE 771.28
�� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatures---"" --...0""" _ ,dy * Fee methodology set by Tri-County Building Industry Service Board
Print name:JEFF Date:12/26/17
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Meclfanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi Family Fee Schedule:
t
$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