Permit IN CITY OF TIGARD MECHANICAL PERMIT
S COMMUNITY DEVELOPMENT Permit #: MEC2010 -00562
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/04/2010
Parcel: 2S104BCO5100
Jurisdiction: Tigard
Site address: 12840 SW ASCENSION DR
Subdivision: HILLSHIRE WOODS Lot: 62
Project: Berger
Project Description: Furnace installation.
Owner: FEES
BERGER, TORSTEN & Description Date Amount
ANDERSON, JAMIE M, 12840 SW ASCENSION Furnaces < 100K BTU 11/04/2010 $46.75
DR 12% State Surcharge - Mechanical 11/04/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 11/04/2010 $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 503.246.6699 or 1.800.332.2344.
Issued By: C Permittee Signature: , .
CaII 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.
NOV /03 /2010 /WED 03:38 PM FAX No, P,002
Mechanical Permit Applicati°t ECF,NED F'OR OFFICE usr, ONLY
lig City of Tigard �y . tfl10 Date ived 0 ;f/ Permit No.: m ,3,O 0 —00.5 - u 13125 SW Nall Blvd„ Tigard, OR 97223 S o f A plan Review
Phone; 503.639.4171 Fax: 503.598.1960 1 Other Penult:
Date/By:
Inspection Line: 503.639
TI GAM) � 1 F'�G� ►ate Ready/By: ®See Page 2 for
Internet: www.tigard or.gov C`T 1 2 DNisl� oti&d/tvlethod: Mil Supplemental Information
:,: . . :„ :7 "•i �: ::LQ ? • ' LIST
,. .';'.•� '�'?Y'3dP'E .OP''3 O�
. - %7 — — 00 � X3.. `�j} �E'�a)(1, � ...a
El New construct di t i on/altera t ion/replacemcnt Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead. and profit.
:..,.,,: < a:.• ,.,.� :.... -, a,,,,.';,:, �., �s _K:: - ; s,;: _: :.::. Value: $
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special lnformotlon use checklist.
❑ Multi - family ❑ Master builder 0 Other Description Qty. Ea, 1 Total
_ , ,.,.:ii_. _ _ ,. -_ li.,� ,.\^. ela R _ ;^ �* ;:a.: ;,• Heating/cooling
�- Air conditioning
Job site address:
11c .fa � l„} A �'C c - e„, _ (7 (requires sit plan showing placement) 46,75
City/State/ZIP: Furnace 100,000 BTU ( ducts/vents) _ 1 46.75 '1 ( ,ZS
Furnace 100.000+ BTU (ducts/vents) 54,91
Suite/bldgJapt. no.: Project name: t��Gr Heat pump 61.06
Cross street/directions to job site: V 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 _
,� k„ r 1'` , :';I`y;�7.`7 & f�c; - : Water beater 23.32
• . ;S . .:...l i , .. ;. _ �'. , r'' 'i %. •,.. *. Q�`+R �' i s Q ,,= !••;.. ,o f.t", . 1 ' ,.. a r '
.. + ,,.; ^. „ .': Y .`: ,�� -,,-, - = is , .ri�..,..:., . , ,. _.
On fireplace • 33.39 -
Flue vent for water heater or gas
� fireplace 23.32 _,
Lie_ Log lighter (gas) 23.32 —
Wood/pellet stove 33.39
Wood frreplacc/insert 23,32
�• ,,,. ;; <. o r ., w ; »; Chimney /liner /flue/vent 23.32
® =PBO)a ns,;,r .. :.''[is,�: „vi:' ;:":t ,. sr:� ' a
.:�:..•:..., ..: ,.�.,.,..:.,.. , r �. a..:, .... � _ -' Other:
Name: Environmental exhaust and ventilation
Berger, Torsten R10448 Range hood/other kitchcn
Address: 12840 SW Ascension Drive equipment 3339
City /State/ZIP; Tigard, Or. 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) (503)747 - 6180 toilet compartments, utility rooms) 1 23.32
c: ^ '= . i: .r _ =Ii ' p r, . ;, ` , ' t '" Attic/crawlspace fans 23.32
,. , : > .,. _ 23 32
�- Other;
Business name; -
piping •'
Contact name; $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State/Z1P: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) , Water heater ,
Fireplace
E-mail: Ran
Business name: specialty beating & Cooling, Inc. Clothes dryer as
Other:
Address: 7500 SW Tech Center Drive #130 t r
City/State /ZIP; Tigard, Or. 97223 Subtotat
' Minimum perrnit fee ($90.00)
Phone: (503) 620 -5643 Fax: (503) 681 -0793 Plan review (25% of permit fee) .
CCB lic.: 66578 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
fr 1-1,...— This permit application expires if a permit le not obtained within 180
Authorized Signature: / • d ays after It has been accepted as complete,
Print name; Andrea Dripps Date: ( / (( ) t Fee methodology set by Tri- County Building Industry Service Board
1:1Buildi i0\Petmila rEC- PermitApp.doc 10/01/09 440.46171' (1 I/01C0M4/VE6)
5ivitr - Yoa S