Permit :_` MECHANICAL PERMIT
4 r . CITY OF TIGARD
?: ' 2 _:: COMMUNITY DEVELOPMENT Permit #: MEC2010 00376
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/30/2010
Parcel: 2S102CC04100
Jurisdiction: Tigard
Site address: 13695 SW CRESMER DR
Subdivision: Lot: 0
Project: Kouzes
Project Description: Furnace and NC installation. A/C unit must meet minimum 3' side and rear setbacks.
Owner: FEES
KOUZES, ROSS T & Description Date Amount
KOUZES, LISA A, 13695 SW CRESMER DR
TIGARD, OR 97223 Ai Conditioning 07/30/2010 $46.75
Furnaces < 100K BTU 07/30/2010 $46.75
PHONE: 12% State Surcharge - Mechanical 07/30/2010 $11.22
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 $104.72
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: I , /
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.
JUL /28/2010/WED 02:16 PM FAX No. P.002
Mechanical Permit Application , 97223
�� �� ' f O rt O F FI CE US
City Of Tigard Received
�y 13 ataB y; smegimgrAIEMOM
u 13125 SW Hall Blvd., Tigard, OR � o Plan Review
r II l Other Permit:
Phone: 503.639.4171 Fax: 503.598.196t�5�� ` y� C Date DateDate/Sy. c Inspection Line: 503.639.4175 Y�O
f l GAKU` p � edlMe o S gee Pe for
t l
. ' Internet: www.tigard or.gov 4 a �y 0064/Method: Supplemental Information
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4.;1, 1 i ttlrSls..,4 l .i,: a ITIEL ti r e „„,>.M;jif> �N. +li�r,. 2;It. (it.tt. d,. . 1 �� auE+EM 3tu� 'fam�xiktw�c,v , �iaLti.GL!r (1.,.�:`:� Il "-
New construction WAddition/alteration/re , f. Mechanical permit fees' are based on the value of the work
❑ T� p r �' performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; mechanical materials, equipment, labor, overhear and profit.
Yf , r ,1 I + II mlx'��yl
,, ,stn •t�' , z�c�v{'�.e4� � 'fir ,{ l w ' t�. � }' �� �'� f Value: $
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0 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building f a ` I ° t c �' `';i n " �t.''!irtl;dlr
For special Information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description 1 Qty. J E , I Total
• .r as a cu' t- m. , u r + nt Y i nw � t A
aai�r F '' . AIS.L' 1 C •11 " e� o, _tlrYt m Olrar7r{i . 0! , Ir',F�} r„ !,t 9� Air Heating/cooling
) I
trrRO� , Sr 1, :, .ti >? LeIf 17,'u. �„ f AsY�fiN:J�i6!ra irAl
lob site address: ( (c'(c ....G..-.) C',, J21 - t .� (requires site Ian showing placement 46.75 4 10 f
City/State/ZIP: Ceti me c Or
Furnace 100,000 BTU (duota/vents) 1 46.75 tap j �
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name. �jU _Z C' Heat pump 61,06
Cross street/directions to job site: WI 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 _
Tax map /parcel no.: Other fuel appliances
' ,ZINT : ;4j 4 2111211f: iTi 2 :2W 1 ` �LtiM n.i1 t ` 11 3 1 Water heater 23.32
Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32 _ _ -•
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
I artu:r I "r Hla rer •- Chimn /liner /flue/vent 2332
u uII I Iu IIi l i I I , III l II IIII '•D ,�'�, •, 4.„ ..... M , ,. fl ,} ey ,t �l a it . , u.h l .f .tM• l l t r ... Othcr; 23.32
Name: R10277 Environmental exhaust and ventilation
Kouzes, ROSS Range hood/othcr kitchen
Address: 13695 SW Cresmer Drive _ equipment 33.39
City/State /ZIP: Tigard, 0r. 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phonc: ( ) (503)887 -5533 �, toilet compartments, utility rooms) 23.32
:� .! l
fC,1 ! t , i mu , , f f1 2 ,, a IMME i N alr a(at`l grfi tiAM Attic /crawlspacefans 23,32
r u i v s Other: 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: , Wall/suspended /unit heater
ter h
Water ea
Phone: ( ) Fax::( )
Fireplace
E -mail: • Range
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j:: . 'r!, »r : ).t,raf �{ r l� 'It , • , il'i�a'J�uJ4 �� r :t• K . , , . i f�'i" „ a .Kaj � , y sib
Business name: specialty heating & Cooling, Inc. Clothes d er ( es
Other,
1r �, �tx tea + U� T,4' 1 � ,Y. 4.J" 1
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Address: 7500 SW Tech Center Drive #130 ; �Ii ", .n t, y ,,•;
City /State/Z1P: Tigard, Or. 97223 Subtotal €3 , •
Minimum permit fee ($90.00)
Phone: (503) 620 -5643 Fax; (503) 681 -0793 Plan review (25% of permit fee)
CCB tic.: 66578 State surcharge (12% of permit fee) fi )-)s
12-.-_- TOTAL PERMIT FEE 1 '�)-
�I This permit application expires if a permit is not obtained w 180
Authorized signature: vV days after it has been accepted as complete,
Print name: Andrea Drlpps Date: _ r to * Pea methodology set by Tri- County Building Industry Service Board
muudinglPemtitsVN$C- PemlWppslee 10/01/09 440- 4617r(11 /02/COMtWSn)
9.12v 1r /N r•S
JUL /28 /2010 /WED 02:16 PM FAX No, p, 003
SITE PLATT
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STREET
I3,ci5 Su3 Cresme'r Or
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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) E
▪ 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 0130
Tigard, OR 97223
I-tEaTtrrc & COOLING INC. (503) 620 -5643 Fax: (503) 681 -0793
www.svectalitvheatino.corn
were not COn:/urrcblr until yOU Ht!