Permit CITY OF TIGARD MECHANICAL PERMIT
0 • COMMUNITY DEVELOPMENT Permit #: MEC2010 -00541
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/28/2010
Parcel: 2S103DD05500
Jurisdiction: Tigard
Site address: 10895 SW GARDEN PARK PL
Subdivision: GAARDE PARK Lot: 38
Project: Demaree
Project Description: Furnace installation.
Owner: FEES
DEMAREE, THOMAS E & JUDITH A Description Date Amount
REVOCABLE LIVING TRUST, BY THOMAS E & Furnaces < 100K BTU 10/28/2010 $46.75
JUDITH A DEMAREE T, PO BOX 23944 12% State Surcharge - Mechanical 10/28/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/28/2010 $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. 1.800.332.2344.
Issued By: . Permittee Signature:
Call 503. • • .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 /28 /2010 /THU 08:58 AM FAX No, P,002
Mechanical Permit A.pplica1RECEV FOR OIIACE USE ONLY
City f Tigard Received
ri g O CT 2 8 2 Date/By: i hie i s /err
• 414 •:�
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' Ph one: 503.639.4171 Pax: 503.598.1960 Date/By: Other Permit:
'HOARD Inspection Line: 5C3.639.4175 crry pF TIGARD bate Ready/By: Mt: et See Page z for
Internet: www.tigard or.gov BUILDIN O N Notified 7,� Supplemental Information
....:.::.. ... �•: ,. ..... . :�'�Q� DIVISI c � °d - 440'SCHED - wGHEQ[Q,I
II) New construction * Addition /alteration/replacement Mechanical permit fees* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition Q Other: mechanical materials, equipment, labor. overhead, and profit.
` ., r .aA GO)Gt�Y'�;"OF`sco 'iQ .Ln u r ,, Value: $.. • SID,1L lEQ11MEN f lYati?S FEES` r
1- and 2- family dwelling Q Commercial /industrial El Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty, Ea. Total
: ..., .: , YQas **":1?v '.0 41000 .a; _ � /] - t i Hradec /c ooling
Job site address, / E- U 4 y �
Air conditioning
v /.^� ` (requires site plan enowinpplscement) 46.75
City /State/ZIP: -' Fumaee 100,000 BTU (ducta/veats) t 46.75 1(0, )5
Furnace 100.000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no._ Project name: a... lcA coc, Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or •
hydronic) _ 23.32
Unit heaters (fuel -typo, 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
� U ttk r � " n l �ri` : y' Water heater 23.32
f ;. ' t�R t DLSL'BTC�� ' IW a`;...,. - F1 r.�. -, -
J �, r Gas fireplace 33.39
_T t '5 �" JL P ,e, al L, 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
'` .1 i . a t ;� s ; t . Chimney/liner /flue /vent 23,32
t it t ... �;e,>irh ,004 : .rl, ; ,,. _ 4 ° i 1 w,' Other: 23.32
Name: Environmental exhaust and ventilation
Demaree, Ed R10425
Range hood/other kitchen
Address:
10895 SW Garden Park PL. equipment 33.39
City /State/ZIP: Tigard, OR. 97223 Clothes dryer exhaust 33.39
503 - 708 - 8753 Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments. utility roomy 23.32 ,
:; ' , ... r •h, , Attic fans 23.32
�r . r�^� fr; •� ^�f�>,V irl '1 f 23.32
Other.
Business name:
Fuel piping
Contact name: S1435 for first four; S4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heatcr
Phone: ( ) Fax: : ( ) Water heater ,
Fireplace
E -mail: _ ...- , . :!;''.!.,:•::,..;.1';,::•!;...''
.. .
�
•::: ..,. Barbecue
, 0 13.tICTp _ _ .
.fix - R ,,::
Business name, specialty heating & Cooling, Inc. Clothes dryer (gas)
Other.
Address: 7500 SW Tech Center Drive #130 2 -: 1 I ICALpER% 1TFEES* „;,':
City /State /ZIP: Tigard, Or, 97223 Subtotal ti fo :15" r .
Phone: (503) 620 -5643 [Fax: (503) 681 -0793 Minimum permit fer ($90.00) 19
Plan review (25% of permit fee)
CCB lie,: 66578 State surcharge (12% of permit fee) 1p,gp
TOTAL PERMIT FEE ‘411.1)..11)
- This permit application expires If a permit is not obtained within 180
Authorized signature i _ days after it bat been accepted as complete.
Print name: Andrea Dripp •' Date: /D +^a 0 • Fee methodology set by Tri -County Building industry Service Board
t lB.2dinOermitstMEC- PermitApo doe 10/01/09 f 440.4617T (11 /02/COro4/WEB)