Permit 4 CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC201000495
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/12/2010
Parcel: 2S103CB03500
Jurisdiction: Tigard
Site address: 13155 SW 124TH AVE
Subdivision: WILLAMETTE NO.2 Lot: 14
Project: Kent
Project Description: Furnace installation with duct work.
Owner: FEES
KENT, ROBERT R Description Date Amount
13155 SW 124TH AVE Furnaces < 100K BTU 10/12/2010 $46.75
TIGARD, OR 97223 Duct Work 10/12/2010 $23.32
PHONE: 503 - 849 -2048 Minimum Fee Adjustment - Mechanical 10/12/2010 $19.93
12% State Surcharge - Mechanical 10/12/2010 $10.80
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.
i
Issued By: Permittee Signature:
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.
OCT /08 /2010 /FRI 08:47 AM i�O FAX No, P, 002
Mechanical Permit A,pplicati ` FOR OFFICE USE ONLY
Received
City of Tigard 01 DateBy: 10 i f _ PertnitNo.: S
4 13125 SW Hall Blvd.. Tigard, OR 9722 ..SIN _ - _.L 10 — DO '
C Phone: 503.639.4171 Fax: 503.595.1960 'C' PRA ,: Other Permit:
Inspection Line: 503.639
TIGARD `� \ R tZ See Page 2 for
Internet: wtwv.tigerd or.gov �\"� � OINi\S Notified/Method: Supplemental Information
rat .. .... ..... ,' OW p
El New construction n 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 Q Other: mechanical materials, equipment, labor, overhead. and profit.
'::' , Value:
..f . �:- .-�
> y
VO agX'iE�9:FEE5
[gl 1- and 2- family dwelling ❑ Commercial/industrial El Accessory building ""
For special Information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
. -,.. 4C r„ SE`'.. r',. : maxi
: ;:.. : _...:: .-.. .
' •.;. .P_9�'C� �` _ - •- 2 Heating/coolig
Job site address: 'e Air conditioning
z 4 (� �;,,) 0 _ ( requires site plan showing placement) 46.75
City/State/ZIP; "r t , r w , G �,2 , '� -' L (1 Furnace 100 000 BTU ductskeets) 46.75
■
_
h I Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt no.: Project name: _ Heat pump 61.06
Cross Street/directions to job site: Duct work NM 23.32
Hydronic hot water system ME 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (Reel -type, not electric).
• in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 1 23.32
Other. 2332
Tax map /parcel no.: Other fuel appliances
..
1 "'r:r::- ;•,,:f4;;',i�fa. _ _ ,,r.,y'•, -+,' ,-y" tF„4i ;Y'crt�'`r ! "�;: :�'!r: -til�a Water heater 23.32
r .... e, Gas fireplace 33.39
4-1 A iv.-A- d"•LCL ,` D t4/1 -rl f,,-) rt'Vtt,.. Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
_ Wood/pcllct stove 33.39
Wood fireplace/insert 23,32
..,.., '.,: _ ,� iN � rry T _: Chimney/liner/flue/Vent 23.32
Fe•','tl� a ,.. �V;� � : ' - .
y . J , . , T,,;';,25:1' ;;,..,
. •.... .. -...• ...... � Other.
Name: 8 (, 1,..„...,,, Environmental exhaust and ventilation
Address: U Range hood /other kitchen
equipment _ 33.39
City / State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) f4 e . "i. g Fax: ( ) toilet compartments, utility rooms) 23.32
- raw p ce fans 23.32
23.32
Business name: Other.
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace etc.
Gas heat . um . -Mill
City /State/ZIP: Wall/suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
.' . ..:..... .: . ..:,,.;,,:.:; :. _ , i.` iii Barbecue
Business name: specialty heating & Cooling, Inc. Clothes dryer (gas)
Other: INN _ MIN
Address: 7500 SW Tech Center Drive #130 " '
City / State/ZIP: Tigard, Or. 97223 Subtotal 20. 0 -7
503 620 -5643 Fax: (503) 681 -0793 Minimum permit fee ($90.00) 0-6 Phone:
(503) ( Plan review (25% of permit fee)
CCB lie.: 66578 State surcharge (12% of permit fee) (c) • d,
TOTAL PERMIT FEE I (W
Authorized si elute: I This permit application expires if a permit u not obtained within 180
. days after it bas been accepted as complete.
Print name: Andrea Dripps Date: I r L b * Fee methodology set by Tri- County Building Industry Service Board
I:1Buiidiol¢rermit MEC•rema,App.dee 10/01/09 440-46 rTr (1 i02/COMtWE8)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13155 SW 124TH AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2010-00495
David Young
Violation Summary:
Inspector Contractor