Permit P "' CITY OF TIGARD MECHANICAL PERMIT
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l: COMMUNITY DEVELOPMENT Permit #: MEC2010 -00276
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/16/2010
Parcel: 2S 112CC20300
Jurisdiction: Tigard
Site address: 15672 SW 81ST AVE
Subdivision: GAGE FOREST Lot: 10
Project: Rogers
Project Description: Install A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
ROGERS, DAVE Description Date Amount
15672 SW 81ST AVE Air Conditioning 06/16/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 06/16/2010 $10.80
PHONE: 503 - 580 -3462 Minimum Fee Adjustment - Mechanical 06/16/2010 $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 1.800.332.2344. /
Issued By: /d) y T � � 1 Permittee Signature: 0 . �o"G /e7:1-770 os /
/
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.
JUN /15/2010/TUE 08:36 AM FAX No, P. 002
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Mechanical Permit Application p ; r , , ,l,,. . � i lltil (m'1 I a �r > � t 1
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3125 SW Hall Blvd., Tigard, OR 97223 ',� lam Review/ /d ." r °�'/
Other Permit:
4 ®# Phone: 503.639.4171 Fax: 503.598.1960 ^' 15 2� . ate/By:
° Inspection Line: 503.639.4175 1V Dat Read /B lobs: (,� See Pa
TIGARDI Ins p � Ready /By: g
a4 ua..N.4 Internet: www.ogard- ot.gov t . 1, ""1 tified/Method: �� e 2 for
Supplemental Information
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❑ New construction re 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.
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®'1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
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For special information use checklist.
❑ Multi family t ❑ builder ❑O Description Qty. J Ea. Total
;70 '1,1 I f I!3 e. rail ,p r1u. r m ii!t1.• . _ g ' , ' . 11/1 7 r6fi1 .,,� f 4 vs ?d,Q t {i '47 i',.n '''' :' ' $ 'r Heating, /cooling
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Air conditioning `
Job Site address ' �'j ''1 '� S� �r7 ve , (requires p g placement) f
l► re uires sit lam showing lacamutt 46.75
City /State /ZIP: Furnace 100,000 BTU (ducts /vents) _ 46.75
Furnace 100,000+ BTU(duots /vents) 54.91
Suite/bldg. /apt. no.: f Project name: Heat pump J 6I.06
Cross street/directions to job site: Duct work 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 1
Tax map /parcel no.: Other 11rel appliances
l y� p'tppy� q a aar c Y 1 1 1111 g Water heater 23.32
_
11 i' • i .• 'AP,L !'_.s o, ■ ` s Ho 1 6{ iM i a 3 t ' a SC ee cs c.. n li � !I r j x. 'LE ',7: `. z
Gas fireplace 33.39
Flue vent for water heater or gas
k..-0,_, /lj ' a fireplace
I 23.32
1/ Log Fighter (gas) 23.32
Wood /pellet stove 33.39 •
Wood fireplace/insert 23.32
p l� > _, -. t a k t s try r «,�w� mney /liner /flue /vent 23.32
iii ,i1Htiy� ommitor aigtai , bh , iE l fP oottt r �y,,' � tl l
Other Chi 23.32
Name: Rogers, Dave R10196 Environmental exhaust and ventilation
Address: 15672 SW 81' Ave Range hood /other kitchen
--- equipment _ 33.39
City / State/ZIP: Tigard, Or 97224 Clothes dryer exhaust _ 33.39
(503)580-3462 Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments. utility rooms) 23.32 •
ear° r r i i<t'YI {!e e I �I p tl' !Se ;lei Attie/crawls ace fans _ _ 23.32
} iii! ii e ,t, r,1. ,'�' +>3• 04%. ru� 1i I naNaIVI � raii ,a 0 ,, ." t, rli •i1"' , I Other, p 23,32
Business name:
. Fuel piping
Contact name; $14.15 for first four; S4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fire -lace
E-mail: Range
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Business name: specialty heating & Cooling, Inc. Clothes dryer (gas)
Other: • Address: 7500 SW Tech Center Drive !{130 Ijir 1.1 ii Yc ar cl 5 4( 0` } d "F !
City /State /ZIP: Tigard, Or, 97223 Subtotal
hone: (503) 620 -5643 Fax: (503) 681 -0793 Minimum permit fee ($90.00) ( 7t1
/ Plan review (25% of permit fee) _ �--�—
CC13 lic.: 66578 +' State surcharge (12% of permit fee) /Q ,
TOTAL PERMIT FEE /AO , ed
Authorized signature: 1 - "' :!` !y —, This permit application expires if a permit is not obtained within 180
days after it hag been accepted as complete.
Print name: Andrea Dripps , Date: I :crib 'o • . Fee methodology act by Tn -County Building Industry Service Board
::1auilding \Permits \eC- PermitAppA00 10/01/09 440-- 44617T (11 /02 /COMJwEB)
JUN /15 /2010 /TUE 08 :36 AM FAX No, P. 003
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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
7500 SW Tech Center Drive
Sp ecialty Suite #130
Tigard, OR. 97223
HEATING & COOLING INC. (503) 620 -5643 Fax: (503) 681 -0793
www.snec ialitvheatina.coni
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