Permit MECHANICAL PERMIT
CITY OF TIGARD
'• COMMUNITY DEVELOPMENT Permit #: MEC201000262
ri . <s Date Issued: 06/09/2010
TEGAR7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 105 DA 16400
Jurisdiction: Tigard
Site address: 14565 SW KLIPSAN LN
Subdivision: PACIFIC CREST SUBDIVISION Lot: 52
Project: Wilson
Project Description: A/C installation.
Owner: FEES
WILSON, NICHOLAS G /SUNI A Description Date Amount
14565 SW KLIPSAN LN
TIGARD, OR 97223 Air Conditioning 06/09/2010 $46.75
12% State Surcharge - Mechanical 06/09/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 06/09/2010 $43.25
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR #130
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 :a* 4.
Issued By / r / � Permittee Signature: 4111111111111.
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.
JUN /08 /2010 /TUE 12:21 PM pY p q FAX ws FAX No F 001
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Mechanical Perm 1 , s 1 ! t ,il��). i;Z�p ,� ` � FOR OFFICE' u5r ()Nl , h ,4 : w" M r
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ivVe.ii , 4% City of Tiga ; d r . ' r ', _ ' Received
e 0 ot 2010 D°ten3y: , /gm; permit No.: inecau kj - do 1
a 13125 S W Heil Blvd., Tigar ��QQ 9�,Z�� Plan Review
;. " ® Phone: 503.639.4171 PNN0 9e.1 Date/By: Other Permit:
- y - `1'.'.
TIGA" RD' Inspection Line: 503.639.4175 /■ ...O IGak>�R® batel2eady/By: ® See Page 2for
F „ +a k a Internet: WtV�v.tlgard•of,g�6YV/ r IA `2 D t vi SIO Notified/4euiod Supplemental Information
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❑ New construction � � dd i t i onlalteration /replacement Mechanical permit free are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
O Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
i r rt p, n c K {t + +° { } .¢ q 9 Value $
1 I a nd 2-family ff i A 1� ., ° = 11tt' 11 ° 4 14 +' N ,11 k�., r e JJ1 yy le 1 ', to nra rl ' 9 t
t r r• t Vi ii�lel! a , a ' I I „ tr
i y dwelling 0 Commercial /industrial ❑ Accessory building a " � �� :N , :
For special information use checklist,
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. f Ea. Total
1 • !�I .Pe
1 ,:::: i i > r ; 6 t ip m �' / 1 X 11. '° u ' .- €l 1�� I 'g.,'jpp Ileatln /coofin
. 1„) t r,it t .':`' a i. la la ., • _ ,_ , ,,.. r Y .,, , -E,1,. 7 . ',• twrci c ' €'n Iry f.$4 . g g
i Job site address: l (A ,C10 5 l Air conditioning
(requires site plan showing placement) 1 46.75 116 ,1
City/ State/ZIP: Furnace 100.000 BTU (ducts /vents) _ 46.75
Furnace 100.000i- BTU (ducts/vents) 54,91
Suite/bldg, /apt, no.: Project name: (. i 13 ON _Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
- Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 73.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct. suspended, etc._ 46.75
Subdivision: Lot no.: Flue/vcnt for any of above 23.32
Other: 23.32
Tax map /parcel no.: f Other fuel appliances
1
r 11' 1 i1: ':. i l a r . St, attif aNfla " ; i ` , 11 t 'WNW ,� ) h 3 Water heater 23.32 _
It`'•' .t1 i i tiA .gi, i i,1 fu ,,. `1 " 1 .• t' {�r.� ,r, -
Gas fireplace 1 33.39
Flue vent for water heater or gas
a(' fireplace 23.32
Log tighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
RiOl76
qt` at�Tr `:i�r11+6,4°1frp(plut,atial{{�� i , io jjr - Chimne /liner /flue /vent 23.32
k.'4. + l t . fi e !it. l ' ` e rr 11�, € ' � 1 € = 3'/. Other: 233 --
Name: Wilson, Nick Environmental exhaust and ventilation
Address: 14565 SW Klipsan Lane Range hood /other kitchen
Tigard, Or. 97223 equipment 33.39
city /State /ZIP (503)524-6377 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments. utility rooms) 23.32
°� i , ,, a 'r ai t'' ut y'' ;a ` ; Attrawlsp acc fans 23.32
1:i9.,'t 1 u, i�„t~a a . .. r. � �En t : '. i , 1 „�. rl :.. a '� ia l�' 1 --
id h) 23.32
Other: •
Business name:
Fuel piping
Contact name: 814.15 for first four; $4.03 for cacti additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP; Wall /suspcnded/unit heater
Phone: ( ) Fax: : ( ) Water heate
Fireplace
E -mail: Range -
} }
. ; �g ,G 1 i ° k`� I r �8 Y 0 ` 1 1 1 ' 4 I d Sl �r d F t 1 „ � � }'' Barbecue
Businessname s heating C f > ittra`JI ;? �) # o " �P :..d. €Vr . d+I$
at I1 „ y
y g Cooling, Inc. Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Drive #130 S( ° ' Alt 4,.'.,' 0,i "ri ! V.:)►,?!,. ' 1 P ,li` " ° y
City /State/ZIP: Tigard, Or. 97223 Subtotal 1 _
Minimum permit fce ($90.00) ci ).. s%v
Phone: (503) 620 -5643 1 Fax; (503) 681 -0793
I Plan review (25% of permit fee)
CCB lic.: 66578 / l 11 ` _ State surcharge (12% of permit fcc) l0 t W
TOTAL PERMIT FEE _ 0_6, .50
Authorized signature: This permit application expires if a permit is not obtained within 150
1 / days after it has been accepted as complete.
Print name: Andrea Dripps Date: ( .1" , I * pee methodology set by Tri - County Building Industry service Board
1: 113uilding \PermitsMEC-PtmtitApp.doe 10/01/09 440 - 4617T (1: /02/CO50WPB)
JUN /08 /2010 /TUE 12:21 PM FAX No, P, 003
/ � I� U4 !r�-� • /5 a ✓L
SITE PLAN
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PL PL
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STREET
e!�s,
NOTE — Please show the following on the site plan:
Location of Indoor Unit and Outdoor Unit
Indicate how the flue will be run (thru the roof out the sidewall — etc)
Indicate with dotted line how the lineset will be run and approx. distance
Indicate how the condensate will be run
700 SW Tech Center Drive
Sp ecia!ty Suite *130
Tigard, OR. 97223
HEATING & COO ING INC (503) 620 -5643 Fax: (503) 681 -0793
www.sveciatitvheatin, .com
we're not comfortable until you are!