Permit CITY OF TIGARD MECHANICAL PERMIT
IN
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00317
*TidAll 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/08/2010
Parcel: 2S109DB02800
Jurisdiction: Tigard
Site address: 13097 SW HAZELCREST WAY
Subdivision: SUMMIT RIDGE Lot: 66
Project: Yatcyshyn
Project Description: A/C installation.
Owner: FEES
YATCYSHYN, GARY & Description Date Amount
MADELINE CHAN TRUST, 13097 SW
HAZELCREST WAY Air Conditioning 07/08/2010 $46.75
12% State Surcharge - Mechanical 07/08/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 07/08/2010 $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 503.246.669 r_1,80 2.2344.
Issued By: L A / �� -- PermitteeSignature: ,
all 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.
JUL /07 /2010 /WED 08:04 AM FAX No, P. 0,02/00
Mecha nical � i .,. � ,,,- ,, , Kti . . w .a, Yr i 4 P I Y ry ;,i',' , Y
1�1)<Cc`1� ]Pelrtri t.App ')l fd 10�)}1 a �Iteoetved vu � `u{ r �()R ( ) lei(' ! lls ONLY
City of Tigard it — ., ,t.,, „ D Y. Yb .
' " 9 .1312 SW Hall Blvd. Ttgerd OR 9 (� 7 2 Plan Review
V e Phone: 503 639 4171 Fax 503 5 60" Datefg Other Permit:
i AiID Inspection: Line 503,639.4175 Date early/ay; Funs: EI sec Pa e -2 for
t. =rte,, Internet: www,tigard- or.gov CIT O TL ARD Notific,vm thxd; j Supplemcntal;lnformation
UILD NG DIVISION
P Y I I r., � 4 , p ..n l f * tip nn q ta ..,i � , .� e n i i fi ,n .,I ss �.1 , �j ( r , ;a �}�� ,�ri Fli
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1] New Construction Lea Addition /altcratton/replaCemerit Mechanical permit fhesa are based on the value of the work
. performed. Indicate the value (rounded to the nearest dollar) of all
III Demolition ❑ Other; mechanical materials, equipment, labor, overhead, and profit,
4 v� t ,,, ... 8 A 01 ' 2 1 t` tl ��" d A l � ,' f P .1 1 : ' Value: $
,T 'it @ t 1 y it 0 P V r
g,'f 1 1? +4 _..,. � ° .; . If...A.t,, ll r & .l rd'i 0*AI* u r • , .,,, ,i h r • Pry, r. ■ . t . a % . «' , pfagitZpraMerriMiarrEi . {,• 1,
i and 2 mily y dwelling ❑ Co aster builder ❑ Oth essory building For special information use checklist.
Multi -family ❑'M stet builder ■ Other escription Qty Ea Total
far ate I< 1:; ll � � , , P z �i°
I � pp Ith�. �, it rw l �. i��p n� t, x � w er , e a t s D
. i.. .i lfa 4 r (, , li ks 4} , , °O ;4414 J Y; '' 9' 0 ,4 / ' ,, 6: d '., A aY 4il )Fl eet i ng / coo li ng . • Air conditioning
Job site - address:
3 11 9 7 S\--) U - (requires site plan showing placement) t 46.75 46,75--
City /State /ZIP: Furnace 100,0001 BTU"(ducts/vents) 46.75
. Furnace 100,0004 BTU (ducts /vents) 54.91
Suite/bldg•/apt, no.; Project name. 1� a-� I .� 9 A/ Heat pump 61.06
Cross street/directions to job site: r Duct work 23.32 _
Hdronic hot water system 23.32
Residential boiler (radiator or
• hydro ) 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:ao; Other Diet appliances
,; a ���,����aa ��,} tas, � u,�,p t Y c p ,� f r r ti l l Water heater 23,32
1•'I( . 4 - d5ii. i i. §QET H t p � 41 y .1 t " ' t I,Af -
Gas fireplace 33.39
Flue vent for water heater or gas
Lta" - 14 l fireplace 23,32
Loa lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23;32 •
a , 1 r �l ,l If' •Se :3.,Aar ;1.ji:a1 ':' R!�a '
E.' ., n41�t ;' %c5` #1 "t 1r Chimnt /liner/flue/vent 23.32
a !' Other 23.32
Name: Yatcyshyn, Gary R10242 Environmental exhaust and ventilation
Address: 13097 SW Hazelcrest Way equipment other kitchen
_ v equipment 33:39
City /State /ZIP: Tigard, Or. 97224 Clothes dryer exhaust 33.39
(408)857 Single -duct exhaust (bathrooms,
!'hones ( ) toilet compartments, utility rooms) 23,32
r
p 1 l'u , i _ r ,i� i-,t �a..: 1 u n 1 t'- Attic/erawls a
.1
,,,,,,tor ma '„I t 4 . , `ll .. .: a t kl td 11. m 0 t g �i ��1 it ta , r 1 I � f r ce'fans 23,32
p
'f Other: 23.32
Business name; `"- -
. .„„.. Fuel piping
Contact name; s14.I5 for first four; $4.03' for each additional
Address: Furnace,.eto.
Qas heat pump
City /State/ZIP :. Wall /su pended/unit heater
Phone: ( )
Fax: : ( ) Water heater
Fireplace
E -mail: Range -
,, " r " J 1' t�� t E',l#� l, a ,rtrr ,, '''7 l %l 1 1 1 f+ 4 P ,^� tt!9>l, Barbecue
f-;a6 Yt gq,PR3 ,:. .i..., `ti,43 i. {.,,al�#I (: , 4 . .t.',, At i W' ni.11 ,..,;,i4 i ,.,.. !I - .lit 4,4
Business tame: specialty heating & Cooling, Inc. Clothes dryer =(gas) .�
Other:
Address: 7500 SW Tech Center Drive #130 aey,�, i�lip r z rz „ I, 1 , t 04'41i r , i : h'
-- I lip ur.v ltei 1 , T t ,il∎ , ! a; te;
City /State /ZIP; Tigard, Or. 97223 Subtotal ` , 'x
Phone: (503) 620 -5643 Pax: (503) 681 -0793 Minimum permit fee ($90.00) e((}, 00
Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee) O t. 5�
- -w— ,. . TOTAL PERMIT FEE ((k) • c
��'. 0� This permit application expires if a permit Is not obtained within 180
Authorized signature: • . 7 days after it has been accepted as complete.
Print name: Andrea Dripps Date: / ( 0 * Fee methodology set by Tri County Building Industry Service Board
1:V3uilding\Permits\MEC -Ferri itApp.d0C 11101/09 44o-41517T (a l /*2ICOMTWEs)
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JUL /07/2010/WED 08 :05 AM. FAX Na, P, 003/003
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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
Suite #130
�� � ��� Tigard, OR 97223
HEATING & COOLING INC. (503) 620 -5643 Fax (503) 68.1 -0793
www. wecialitvheatm .corn
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