Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00570
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/10/2010
Parcel: 2S102BA02200
Jurisdiction: Tigard
Site address: 9975 SW JOHNSON ST
Project: Stroum Subdivision: Lot: 0
Project Description: Install furnace
Contractor: SPECIALTY HEATING & COOLING INC Owner: STROUM, DON & ANDREA
7500 SW TECH CENTER DR #130 9975 SW JOHNSON ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE: 503 -639 -2466
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Fumaces < 100K BTU 11/09/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/09/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/09/2010 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct que ' • ns to Os • • by ca 'ng 503.232.1987 or 1.800.332.2344.
Issued B a Permittee Signat i 01.411 / C-0 j p
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 /08 /2010 /MON 03:08 PM FAX No. P. 002
Mechanical Permit Application F,)!, OI HC:E USE ONLY
w City of TigTigard Received
E�D Date/By: O Permit No.: /7 U C- ,/O -Q JF74,
a 13125 SW Hall Blvd., Tigard, OR�� ��.l�' 11 plan Review
Phone: 503.639.4171 Fax: 503.89&496D' Date/13y: Other Permit:
1 t L A i 1 Inspection Line: 503.639.4175 a q 1 Date Ready /By: El Set Page 2 for
Internet: www.tigard - or.gov NOV 9 L010 Notified/Method: Supplemental Information
T r�P, `d,•.� "` G,' a! �:.. t't: �>�l" .D�t� "� " u•..
.: _ c cti B 1 ce nt 0 ec e.r ca permit ees arc based on the value o the wor
Mhanil f" f
❑ New construction ditto acement
❑ Demolition O mechanical materials, a value (rounded labor, to head, and all
❑ ,equipment, lab overhead, and profit. .
' Clmfs. IV Oi' 5 ON S '''''d 2gf5N 'Value $
1 - and 2 -family dwe ❑ Commercial /industrial ❑ Accessory building 3 '
For special information use checklist,
❑ Multi - family ❑ Master builder 0 Other: Description I Qty, I Fa. Total
i .. ;f,, '_.^'' p A�gq110 ���t�ttrr,.�.77 pp4�qq''��RC {Y.a.!`.. `�y,+L� . - i ng li ,
;. . ;�, .. ,• t S. t''"��-,:Pt]2?f" 3!"a'[.n.rR':'�'„T ...._. _ ! T �'r, i7C�� � ,� CGr,�;� , ! ; r:' :5; •Yr � `t�� 1'leatl 000�1r1
Yob site address: `/ rl,'�f !� ^ Air conditioning
1 1 (' IA) 1 �1A�1°� f�7 T l
(requires site plan showing placement) 46.75
City /State /ZIP: v Furnace 100,000 BTU (ducts/vents) ( 46.75
Suite/bldg. /apt. no.: I Project name: Furnace 100,000+ BTU (ducts/vents) 54.91
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 -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.:
Flue/vent of above 23.32
Other 23.32
Tax map /parcel no.: Other fuel appliances
i' '.. •.'r. ;a; :r •:..i; .'s';�{� •.;a: ` ;li :�(..y;r �A s:;... r::'' Water heater
„,„.„.....
e..........,_ Ir . . /": '!'7,. .. , • ...." .1; z i ri S yGr �� •,; 23.32
.. : ' �. 1, • � 4 t] 2..3 u•. ryr:.n•a$ ✓' �:1.'. "S .: S.:.I...l
Ges fireplace
3339
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
........:..•., • ., . ...om r �., r4 ,. - = .�,,R,' , T Chimney/liner /fluelvent 23.32
„.„:, :.i: .'. �,..;,^ r / ,' p'rc. rk� .. R..rn p+ r..t.'r/m•'`''6�f$�,.,:w..' , u 1 %:'rA:,--; - -%-1 '�i..� r 4. 'l `•p,K ":. :, iI
l :, .,r ;.._ , :stL.' "'.ma :�� ,r �.r . i t w y,., r�7:.� Other. 23.32
Name: Stroum, Don & Andrea R10468 Environmental exhaust and ventilation
Range hood/other kitchen
Address: 9975 SW Johnson St equipment 33.39
City/State/ZIP: Tigard, Or. 97223 Clothes dryer exhaust 33.39
(503)639 - 2466 Single -duct cxhaust (bathrooms,
Phone ( ) toilet compartments, utility rooms) 23.32
p�} ° 5 i' r : , �} .' Atticfcrawlspace fans 23,32
r it -. r 7 , ..: ° �' r 5 FA w .:. " F: ., w'isn;: i • r: w,.., •,.. t ��t , . � � ° ,. , ui iv
LC.Y Ir r-� L ~. ✓. ' L.).i. v rf r' .M rh1,
Other 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc,
Gas heat pump .
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater —
Fireplace
E -mail: Range
. .r . ^ " <d. :: ,. ll" ;.:/ ? ::, 'a tt fti +� .:a .,, Barbecue
y '2. � ^'r :
,
r .; i:" :.
` . � ,1 .. . ., r. a. ' `u ��.• � ... 1F U?Y,� � ,, � , .. . "� .., � .r;r �i ?. � , i r e � ;p, .�4� : •, � '�
Business name: Specialty Heating and Cooling
�� Clothes dryer (gas)
Other,
Address: 7500 SW Tech Center Dr #130 • - .
City/State/ZIP: Tigard, Or. 97223 _ Subtotal •
Phone: (503) 620 -5643 Fax: (503) 681 -0793 Minimum permit fee ($90.00) 9
Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee) Q go
PERMIT FEE /'O ,
Authorized signature: / / / T t days after it h
expires accepted a sncomplet . / �f(�
within 180
l
Print name: Andrea Dripps Date; / S1 1 1 2 1 ' Fee methodology set by iti- County Building Industry Service Board
t: 8 suildineemita \MEC- Pem,itApp.doc taol/oa 44C-4617T(11/ 2 /COM/WSB)