Permit (184) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00057
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2016
Parcel: 2S 111 AD 15900
Jurisdiction: Tigard
Site address: 9044 SW REILING ST
Project: Ramona Subdivision: MALLARD LAKES Lot: 25
Project Description: Adding gas furnace,ductwork,a/c&gas piping for new range.
Contractor: HOLMES HEATING&COOLING INC Owner: RAMONA, BRETT J
821 COLUMBIA BLVD 9044 SW REILING ST
ST HELENS, OR 97051 TIGARD, OR 97224
PHONE: 503-267-9837
PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 01/25/2016 $46.75
Type of Use: SF Furnaces<100K BTU 01/25/2016 $46.75
Class of Work: ALT Type of Const: Fuel Piping 01/25/2016 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 01/25/2016 $12.92
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $120.57
Required Items and Reports(Conditions)
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 ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or 'ect questions to O C c Iling 503.232.1987 or 1.800.332.2344.
.sued
By: Permittee 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 Applicat'
City of Tigard i s , Received I permit No.:
Date/By: 1 1 a5l(a C� �Ca4/CS S
� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
s Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Inspection Line: 503.639.4175 Date/By:
Date Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
MY
t _
x,
r
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value
�1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑ Other: Description Qty. I Ea. Total
t
Heating/cooling:
Job site address:3.a (/g r Air conditioning 46.75
�1 �C S W 5 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: C,_rel, 9 -7 Z Z J, Furnace 100,000+BTU(ducts/vents) 54.91
[ Heat pum 61.06
Suite/bldg./apt.no.: Project name: �.td Duct work 23.32
Cross street/directions to job site: Hydronic hot waters stem 23.32
Residential boiler(radiator or
h dronic) 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 23.32
�x�k�.:': v Air W a.�- : � .max....'
Gas fireplace/insert 33.39
Flue vent for water heater or gas
A t, FU!�!A Ad T';'v i fWG e fireplace 23.32
Log lighter(gas) 23.32
L Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
y Other: 23.32
41-1
Environmental exhaust and ventilation:
Name: j l� U�� Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawls ace fans 23.32
t ,. Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat purnp
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( )
Fireplace
Range
E-mail: Barbecue
Clothes dryer(gas)
/�� Other
Business name: .
Address: 5 Z 1 L 0�li A.y:A Subtotal /p .GS
City/State/ZIP: 5 a , Q N S C�L Minimum permit fee($90.00)
Plan review(25%of pennit fee) �-
Phone:(�� ) _Z� _ T3./"� Fax:( ) State surcharge(12%of pennit fee) -f /,i.9;L_
CCB lic.: L`bTOTAL PERMIT FEE 57
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: u� -1 Fee methodology set by Tri-County Building Industry Service Board
Print name: `l A d "+v l Date: 11 (o
I:ABuilding\Permits\MEC_PermitApp_040113.doc 440-4617T(i i(QJCOMNVEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial &Multi-F mily Fee Schedule:
m; xe- OR
$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.
1:\Building\Permits\MEC PennitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9044 SW REILING ST, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00057
Jeff Grove
Violation Summary:
Inspector Contractor