Permit CITY OF TIGARD MECHANICAL PERMIT
0 COMMUNITY DEVELOPMENT Permit #: MEC2010 00515
T I GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 2S104CA07100
Jurisdiction: Tigard
Site address: 13443 SW HILLSHIRE DR
Subdivision: HILLSHIRE Lot: 71
Project: Thielen
Project Description: Install furnace.
Owner: FEES
THIELEN, JOE C & PAULA J Description Date Amount
13443 SW HILLSHIRE DR
TIGARD, OR 97223 Furnaces < 100K BTU 10/21/2010 $46.75
12% State Surcharge - Mechanical 10/21/2010 $10.80
PHONE: 503 - 352 -5389 Minimum Fee Adjustment - Mechanical 10/21/2010 $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 Notific ' 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 dire uestions to NC • ailing 503.246.6699 or 1.800.332.2344.
Issu d By: f �l��_.� Permittee • i •nature: 71, `
Call 503.639.4175 by 7:00 a.m. for an inspection tha • • - iness 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 /20 /2010 /WED 02:18 PM FAX No. P.002
Mechanical Permit Application FO(2 OIFICE USE ONLY
Iii, City of Tigard e ceiv e eved /040 . ip P ermit Na eL+, , 61-e657
� e R
13125 SW Hall Blvd., Tigard, OR 97223 ( Plan Review
I • Phone: 503.639.4171 Fax: 503.598. ,� -0'�� Date/By: Other Permit:
T I G A RD Inspection Line: 503.639 c� ^ � Date Ready/By: tune: RI See Page 2 for
Internet: www.tigard- or.gov ` V t..S Y�, �ed/Method: supplemental InformaIion
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❑ New construction ddition /alteration/r ent per form e d. permit fees' are based on to the a the weak
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 ID Accessory building "" " "" '" "`' '' ..: _ - .....
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For special information use checklist.
Multi - family ❑ Master builder ❑ Other: Description Qry.1 Ea, Total
OS*II't 0 7.4P1r °...:.....;:�_,00 04h;:':'- _,.ors;: ::: ]ileatinR/cooling
Job site address: 13 Gm 3 454,J (la ( ,/ i "L. _ Air conditioning
(requires site plan showing placement) 46,75
City /State/ZIP; Furnace 100,000 BTU (duets/vents) _ 1 46.75
Furnace 100,000 BTU (duets /vents) 54.91 _
Suite/bldg. /apt. no.: I Project name: Heat pump 61.06
Cross street/directions to job site: Duct wort: 23.32
Hydronic hot water system - 23.32
Residential boiler (radiator or
-
jdronic) 23.32
Unit heaters (fuel -type. not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no,; Flue/vent for any of above 23.32
Other 23.32
Tax map/parcel no.: Other fuel appliances
.r. :;:; yi a+ �� ,; ':,I ;a Water heater _ 2332
,;......_:.,,.o- < _
Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
- L 4 - ..-A /0.._ Log lighter (gas) 23.32
. - Wood /pellet stove 33.39
Wood fireplace /insert 23.32
�p� y ;. °- ti,.a'' ,', :x:,- r .,- - g�j�7, - _ :
r• - rb,,,,t • Chimney/Iiner /flue/vent 23.32
SRPI !':.� :f: ';p +u'/1QF.R :_'A Ku..,c ..' 6!. i.:=: L'':, I:' s�r c:: ,,..,:aa` °:.1 >J- ./'C_'t'A�T'F'i "iri: /:9>'G -r ay -. "�,
_. h ;' ',..a -..... y.. - 23.32
:= -:;<�,:,.:. _ Other:
Name; Thielen, Joe R10403 Environmental exhaust and ventilation
Range hood/other kitchen
Address: 13443 SW Hillshire Drive equipment 33.39 ,
Ciry/State/ZIP: Tigard, Or. 97223 Clothes dryer exhaust 33.39
503 352 - 5389 - Single -duct exhaust (bathrooms,
Phone:( ) toilet com.artments, utili rooms 23.32
l : : !. _ -.... :::; AttiGcr a" fans 23.32
e:....... ... .
.... Other. _ 23.32
Business name: Fuel piping -
Contact name: 514.15 for first four; 54.03 for each additional
Address Furnace, etc. _
Gas heat pump ,
City/State/ZIP: Wall /suspended/unit heater
Phone, ( ) I Fax :: ( ) Water heater
Fireplace
E -mail: Range
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..._tt /• •- U�T ��� - Barbecue
Business name: specialty heating & Cooling, Inc. Clothes dryer (gas)
.. Other:
Address: 7500 SW Tech Center Drive 6130 < <jyQ4ANIC.ALr'ERM1T• ". -
City /State/ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee (590.00) - 94•
Phone: (503) 620 -5643 I Fax; (503) 681 -0793 Plan review (25% of permit fee)
CCB lie.: 66578 State surcharge (12% of permit fee) le - ro
TOTAL PERMIT FEE r EM j
This permit application expires if a permit is not obtained within 180
Authorized signature: 7 , 1 �� dgys after it has Boca accented as complete
Print name: Andrea Dri A Date: o • Fee methodology set by Tri-County Building Industry Service Board
1:1nuildinglPermil14MEC- Pennh.App.doe 10/01/09 44 - 46171' (1I /l2/COM/WEB)