Permit _ : a CITY OF TIGARD
MECHANICAL PERMIT
IN COMMUNITY DEVELOPMENT Permit #: MEC2009 -00647
,, Date Issued: 12/03/2009
T t G A R Q 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103CD05400
Jurisdiction: Tigard
Site address: 11650 SW TERRACE TRAILS DR
Subdivision: Lot: 0
Project: Defrang
Project Description: Replace gas furnace.
•
Owner: FEES
DEFRANG, GARY R CAROLYN M Description Date Amount
11650 SW TERRACE TRAILS DR
TIGARD, OR 97223 Furnaces < 100K BTU 12/03/2009 $46.75
12% State Surcharge - Mechanical 12/03/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 12/03/2009 $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: Natural Gas
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.
Issued By: 4A V1,Q (j Q11)L.1_) Permittee Signature: k9IJ0P
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 1
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.
DF,C /03 /2009 /THU 05:12 PM FAX No, P. 001
Mechanical Permit Application RECEJVE ,4 - :_- t � -,c K . r . ^ rr. ,
Cl Of Ti Received Permit AIo. �� n�wll1/w
' 13125 SW Hall Blvd., Tigard, OR 97223 DEC 0 3 2009 Plan RevReview 0 Z q 7'
Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit:
T , C F A D Inspection Line: 503.639,417 CITY OF TIGARD Date Ready /By: curia: &7 See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISIONr' oti5ed�blethod: 't' (tom Supplemental Information
NfS1u12.� ,),jfiti f 7�I -. -',7) '1a,F `i isafiiF�'m't47mI• mow' '4rr ,' "h I'�Q�.'1r:' ,, :5 I yI C�J -,�7' 161 r�� b1 I - ` M + � l' II'..1- �y i' "' .-' t "__
SL mfr �:�R TJ. • ��
El New construction WI Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
r
m � t t, �� � �' ;�+� .+•*- - .�� ; t:s�x;>�r�r ' , w� } • _ �lr� Value $
. ;l�: �; ..3 1 , , ,r ' � , ' '� v ;�1 �. -ill, �, t, m1 q (, ,; n s .: 1 ' -, � 'I!'1; -' � �' � ���- - -
0 1- an 2- fa dwell ❑ C ommercial / i n dustrial [ ] Accessory bu i ld ing "3 = c l� wlw x�.° x�J.
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other
{�kk ( �_ Description I Qty. I Ea- I Total
iyl '!lil Pt r f� t {t 1�x I r p )' o � jp1: o 6 g A, { � t Heating/cooling
�. l � .��� -� ��� _
Job site addres Defrang, Gary R09377 Air conditioning
tregwres site plan showing placement) 46.75
City /State /ZIP 11650 SW Terrace Trails Dr Fumacc 100,000 BTU (duct tvents) i 46.75
Suite/bldg. /apt Tigard, OR 97223 Furnace 100,000+ BTU (ducts /vents) 54.91
503- 220 -0299 Heat pump 61.06 -- Cross strcct/dii Duct work 23.32 _
- ` M Hydronic hot water system 23.32 _
Residential boiler {radiator or
hydronic) 23.32
Unit heaters (fuel -typc. 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 /pareel no.: Other fuel appliances
7 .,� , U'. 1 cv.0 �i - - a .� , r ' ,, Water
' 1 23.32
• •� __ pp 1 4 t[. 7M of r. p � F ''� yeti 1 p�i,�� €€,- t
1 5i J i1J"1!i,el; a nip4.. � >!' ,"fi�� ; .: �. h:__ � ..J- .' ° l;c��1; 1 r, ^ � s3 ?.; � 3
s Gas fireplace 33.39
1 r - 1 ,, .. A , , / ! Flue vent for water beater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
[ } 2 ? 3 :.' M .:,.`:f �xz� <r x ... M _.eu :a : z , ifi1 r l3 18I� Chimney /line /flue..ent 23.32
�f� .. Rk "- i - , 1F Other. 23.32 1
Defrang, Gary 809377
Name:
11650 SW Terrace Trails Dr Environmental exhaust and ventilation
Range hood/other kitchen
Address:
Tigard, OR 97223 equipment 33.39
City /State /ZIP: 503 -220 -0299 Clothes dryer exhaust 1 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments. utility rooms) 23.32
" , i iT i y c s " ..:rs - s i !_ g_ •.fs - : ; . i = y ' r r P • FT f� �� t ', s '° Attic/crawlspacc fans 23.32
N.5
.- ... , ii ra rT. .,- i'M� _=.ilkii 14 41 3e'g: ..0, "11 re4-44- �C"'"1%r- t ,,
Business man
Other 23.32
Specialty Heating & Cooling, Fuel_ piping
Contact namt 7500 SW Tech Center Drive #130 514.15 for first four; $4.03 for each additional
Address: Tigard, Oregon 97223 Furnace, etc.
(503)620 - 5643 - (503)681 -0793 -Fax Gas heat pump -
City /State/2B Wall /suspended /unit heater
Phone: ( ) I Fax:: ( ) Water heater
J Fireplace Y F
E -mail Range
� ,a{!H4 - ) �[ 1�{} h 'h y, •..� p �.: 1tI .4 ��'� C S'
va r fif?l§ .� ' r £;' . 1 4 1 1 C4C 1 ul:1 -W Z h '.: 1 �{i: V;1 _ 1. 11 �: fr3 Barbecue ..
Business name: specialty heating & Cooling, Inc. Clothes d er °as
Other
Address: 7500 SW Tech Center Drive #130 F 9 I 1, .35" � tvi , } i { , 4'g. ` s'
City /State /ZIP: Tigard, Or. 97223 Subtotal 4
Minimum permit fee ($90.00) lb, i )
Phone: (503) 620.5643 Fax: (503) 681 -0793
Plan review (25% of permit fcc) --•
CCB lie,: 66578 State surcharge (12 %ofpermit fee) la WO
la /3�Oq _ TOTAL PERMIT FEE , c) , RD
Authorized signature: ,., C/ 1114 This permit application expires if a permit is not obtained within 180
days after it has been accepted as coraptete.
Print name: Andrea Dripps Date: • Fee methodology set by Ili- County Building Industry Service 3oard
. I
1, 1Bu11dingSe :miuNN4£C3ermitApp.doc 10/01/09 440- 4617T(1I /O2JCo.M/Wb13)