Permit „, .Ir CITY OF TIGARD
PERMIT
t
r COMMUNITY DEVELOPMENT Permit #: MEC2010 -00291
T R
IGAD ?; 13125 SW Hail Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/25/2010
Parcel: 2S112CC20200
Jurisdiction: Tigard
Site address: 15680 SW 81ST AVE
Subdivision: GAGE FOREST Lot: 9
Project: Bruce
Project Description: Relocate existing A/C per site plan. Unit must meet 3 minimum rear and side yard setbacks.
Owner: FEES
BRUCE, NANCY Description • Date Amount
15680 SW 81ST AVE Air Conditioning 06/25/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 06/25/2010 $10.80
PHONE: 503-931-2730 Minimum Fee Adjustment - Mechanical 06/25/2010 $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: / / - Permittee Signature: ,eN i9 /c 4 --- T�O”)
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 /24/2010/THU 01:48 PNI FAX No, - P,002
y
Mechanical Permit Application "zrN " 4"4- �� � +NOR OF� -i L ltil: ()NL1 i i v,• s ' ,
1 � w-'S. � r ,.r�,wcm w,:n.x .,niY, , 4ipi'�� w +.a ,! Nut,! � 'Y! '�r�'�`�`'�' r � x ' A �. J Ii. s� 3 1 a . City of Tigard CC. h I - ' Date/By; 4 /Z5/V �i r Permit N n,ME�, O Z 0/0 40,: y
' t 13125 SW Hall Blvd„ Tigard, OR 97223 ' , ^ aSew
Phone: 503.639.4171 Fax: 503.598.1961. A r1 o10 plan R
Dete/ Other Permit:
"''l t' Inspect ion Line: 503,639,4175 't 1 . D ateRead /B Suris S eePa e
tplGnRn � {� Ready /By:
.... .i �! g 2 for
4:A,,F.nty6il Internet: www,tigard or.gov J , ' � l � A ? -tIOti6ed t thud: — 1 ( . Supplemental Information
!! tt'��
• 1 1
f�.l' r �r ji4 7'. 1, i � N 1' { r .r � 9 i Il l' r p l':P IYtI yJ�}i °�" nig �,
vtir„ rill, 4�P "�i!Sl�r��,r� <,.z�sl}. >..i;�sY � l, 's�`."rt. r,�, '' t r.tiiil�m� ,w f Frl,•I, "�3 1�o :as��t it 3ttuln u ' l ash- - „t g
❑ New construction Addition/alteration/411 -meet Mechanical permit fees* are based on the value date work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
't r w� n q tip �ru ; uu r r 7pii �e +' 1 a t s t t, Value: f r�t�N+t � ?r ,1 , 1` l 71 l t 0 • Rra d i 0 g al. , .1 4 i li ' c $ 1 t .
," i�l.' tt�c 1;.; . I , 1 ... : t : re ilvc10 0l , . � , t , , ,.:,. c r • I: t I . -3, 1 �'4' 4' , � . t i tl ,7 +s en r r r .
E (1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building t I Iii WE
rw t a 5rs �.z �9 #3u »�i t�i i iF
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description 1 Qty: I Ea. I Total
!ti r; t x : , v -: , , �, i t
t ! I l' Ii i ii r i1 . ,i 0 t E" ` o .1,,.. a,,.k ' i o m i
1 rdi6iol;r..*Aii 4 , 4 . ., I I y � t u ; i ii Heating/cooling —
� , stuu�itu r r�; ads a. tE ' � L
Job site address; f f a L. r ' b iq conditioning ti e uires site plan showin g placement) f p
4b.75
City /State/Z>P: Furnace 100,000 BTU (duots/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61,06
Cross street/directions to job site: Duct work 23.32
jydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32 ,
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.15
Subdivision: 1 Lot no,: Flue/vent for any of above 23.32
Other: 23.32
Tax maplparcel no.: Other fuel appliances
e et a r4 r7L r a s: 2
c � , pp + � � r ' t f J �' ea. Water heater 23,32
1 i r, .
t l'a tJ ,+ CB A a, 0 8 �- r • , q r K 1 ,
Gas fireplace 33,39
, Flue vent for water heater or gas
t t fireplace 23,32
l •C— I1 * sr . ! I �- -
Log lighter (gas) 23.32
___il jj_„4,_______cT-Q._. t k._9--in 4 Wood /pellet stove 33.39
Wood fireplace /insert 23.32
v� a EP, pr j +r pa it v , Chimney /liner /flue/vent 23,32
ii. i!i. ° 'A5,�' 1211N"'. ; . ' 3 ' -. a.' a ...1 :i,.. i, . 'lr ! l''' ' S il l r Y'1.73 ' .1 1.2io t'{ ` i r1 'i�9f ', 11 Other; 23.32_
Name: Bruce, Nancy R10224 Environmental exhaust and ventilation
Address: 1 5680 SW 81 Ave Range hood /other kitchen
equipment 33.39
City/State/ZIP; Tigard, Or. 97223 Clothes dryer exhaust 33.39
(503)931-2730 Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) , - 23.32
ace fans 23,32
s a "cr' ° ° w N +t��� "1• ' � p + _ j �$ i'P1',5s( crawls
,f)111 iroitli!.. I , e•att o ati �*'c'IS #�" 9CP11 17f1g �i�Fl.r�. rmotm j1 1 fR i , t p
Y � t'�4C t' �i`��lCtdd: 7fiA. r� ,, • [ I' . . .�i,� Attic /
Business name: Other; 23.32 �_
Fuel piping
Contact name: 514.15 for first four; 54.03 for each addition
Address; • V Furnace, etc.
Gas heat pump
City /State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
-
Fireplace
E Range
Business '%41 r � , p �t, r rf ' i. .., Woik i`llrt, iltlt e Barbecue
� ll nttme. N specialty �IJio (�1 g Il S� ..I- i,p,�. �1 1 1��kli:k j.! l.ii {Ik >
�tl,tlla:fJ -- —
heating & Cooling, Inc. Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Drive #130 - "' " ' `�� `` ' `
ire �. nM„ „o ,,. °M.,�
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 fcc)
CCB Iic.:66578 C ' J n State surcharge(12 %ofpemutfee) /Q . ea
�i� -� ` TOTAL PERMS EE /OD r ��
This permit application expires it a permit is not s obtained within 1B0
Authorized signature: days after it has been accepted as complete.
Print name: Andrea Drippy Date: el ' Fee methodology set by Td- County Building Industry Service Board
1:19,02201 alPermit.-1MEC- PermitApp.doc 10/01/09 440- 4617r /COMPvEB)
JUN /24/20110/THU 01:48 PM FAX No, P. 003
S ITE PLAN
PL
IG'
aD
ec5 �:v�q k
PL 1 , 0
PL
L
I > 0 SiA) 4L)e
STREET
A
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 Tigard, OR. 97223
HEATING &COOLING INC. (503) 620 -5643 Fax. (503) 681 -0793
wwW.Spec ialitvheatina.com
ttc) not comfortable until you ure!