Permit p CITY OF TIGARD
MECHANICAL PERMIT
71 a ;' COMMUNITY DEVELOPMENT Permit #: MEC2009-00657
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 12/09/2009
Parcel: 2S110BC00600
Jurisdiction: Tigard
Site address: 14615 SW HAZELTREE TER
Subdivision: Lot: 0
Project: Kent
Project Description: Replace furnace.
Owner: FEES
KENT, JUDITH Description Date Amount
14615 SW HAZELTREE TER Furnaces < 100K BTU 12/09/2009 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 12/09/2009 $10.80
PHONE: 503 - 819 -2048 Minimum Fee Adjustment - Mechanical 12/09/2009 $43.25
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR STE 120
TIGARD, OR 97223
PHONE: 503 - 620 -5643
FAX: 503 - 681 -0793
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
I
4P
Issued By: e 1 • I. i Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
i
1, -- DECi'09 /2009 /WED 12 :12 PM FAX No, P.002
Mechanical Permit Applicatio CEIVEt ;e µ� =}ORoFF>«r i,srinl v t
-`e ; > �,' s. City of Tigard R ece ived
y d f permit No.: �
^ 13125 SW Hall Blvd., Tigard, OR 97223 DEC 0 9 2009 plan Review e•� l�
'. = ','' Phone: 503.639.4171 Fax: 503.598.1960 Dine/By; Other Penult:
.atr Inspection Line: 503.639.4175 Date ReadylBy. JUri El See Page 2 rot
Internet: www.tigard or.gov CITY OF DIVISION
Notified/Method: Supplemental Information
BUILDING DIVISION '� l Q
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,� J,r� .�-�g �,l 4:(�r j ! �'s �h'1 �'�' 4 rt � � t..l t 1. � � . � 111 t� t r, 1'm�' �, Ally F0 , �{�, �`n :1�1�11f:if '�
111E- . ; ...:I @, IINI1 S L�= �iI ' 1<:%c.w-'->.* '.. y .,, t i (, � ( + J f F II Iii u
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Mechanical permit fees* arc based on the value of the work
El New construction 1 Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
n l' w- `� gi" I' } i '•�_ } t I `'
;iiA ' 4:riMi l el::: M� [ � - r Value: $
"1t.. •. .:.., 3 ii. 5 3.., ,p .'. 1 1- . , .. a , r `" 3 ,S +- :' .: i t rf it n { ""`kt), ^{' 'L LC - li`},�.�j li S 1:
1- and 2- family dwelling ❑ Commercial/industrial ❑Accessory building PA
For special iriformatron use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
g ma y, a �- a y - 1"''`$1 r L� , , are: t- _. � - .: -
i�F , -rJ.�N%•!)• t t s to��1.,�. ' it_: �¢ L,i t p _/-.: Heating /eoolin
r- Air conditioning
Job site address: ' k \ i S 14A. J1 ( -e i 1 V'V (requites site plan showing placement) 46.75
City/State /ZIP: t , + 1/7- r 61- ' 2 y Furnace 100,000 BTU (ducts/vents) I 46.75 • Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt.no.: 'rojectname:
Heat pump 61.06
Cross Street/directions to job site: Ductwork 23.32
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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23,32
Tax map /parcel no.: i},7 Other fuel appliances
`' t 3". 7 4.' S i- 9 f ' a S r. K T. yA k '4 Water heater 23.32 i
g 7` r, ts� i s 1 n o °[j� ,; r� 1
>.- t.a:f. Y9u__ . + l! E� 1iL !� ) Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
I to. 0 _ r • a ; Log lighter (gas) 23.32
�- . ,. e ,_ ,_ : � Wood /pellet stove 33.39 i
Wood fireplace/insert 23,32
' . a�(;'
„ a,i7i 1.5.„1 t. "ii ylft id s ` , I r , y . , +>�F- . , i y�,� :l q i l Chimney /liner /flue/vent 23.32
�)en � [t. t 1� _ ' � i ,i•F r.f. let L 1 1 11 .4 Other: 23.32
�� ,
Environmental exhaust and ventilation
Address: - Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms.
Phone: ( ) - Zvi k Fax: ( ) toilet compartments, utility rooms) 23.32
S'. 1 0 q� t S ,�1YS l ni i , q a n Attic/crawls p ace fans 23.32 .
j d t 1l�}1� $l�`tli ; ,,t,,�� 1 S jt ka i i t il[ P t f l �[ ! � �},, 'l`�ti' {
�i����1tk� '� %�t�N��l!�M�• �,- yi 0 .a .. �..t�Ct•��h�:i�3tceF�7
Other: 4 23.32
Business name:
Fuel piping .
Contact name: $14.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall /suspended/unit heater
Fax: : ( ) Water heater
Phone: ( ) - Fireplace
E -mail: Range
'•'��gt��� 1
�1!� '111 , 1 i• 1 3 , t 9.0 t 'C r 'S.'r ." t 7, { ,�1 '�'dt S t "` :
,1 't g1•. i 14111 WeIgn t ` i,� i' t ;?;:i i._: 5, , 1 } � v Barbecue
. t 1111 11, . • a eE �„-rd .. r :B,ct u' r-it , ' • . :- Elaitt.ir .'1 •, :hli . ..
Business name: specialty heating & Cooling, Inc. Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Drive W130 I p� ?�1 K all'{ :Wr �s X1.1.1@ 1 1 r �{' 1$ l 11d'r 1L1
i 'r1 N.1 n1 C.x 1 - 4 1 1 144 1 ' } 1 ),,
,�, 7 .` :,!'.t�. f t it ..nta.t a �.t..:xuua .eels 1 t t t 1� t:-�' i.L it
City /State/ZIP: Tigard, Or. 97223 Subtotal
Phone: (503) 620 -5643 Fax: (503) 681 -0793 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee)
TOTAL PERMIT FEE RE .�
1 This permit appnmtion expires Ha permit is not ohteined within 80
Authorized signature: - () / 9/ � days after it has been accepted as complete.
Print name: Andrea Dripps Date 0 * Fee methodology set by Tti- County building Industry Service Board
I:\auileineerrnits C- PermitApp.doc 10/01109 440-4617T (11 /071COM/Wan)