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Permit CITY OF TIGARD MECHANICAL PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00667 • TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010 Parcel: 2S110DA07800 Jurisdiction: Tigard Site address: 10635 SW LADY MARION DR Project: WATSON Subdivision: ERICKSON HEIGHTS Lot: 39 Project Description: Furnace installation. Contractor: SPECIALTY HEATING & COOLING INC Owner: WATSON, ERIC R & DONNA L 7500 SW TECH CENTER DR #130 10635 SW LADY MARION DR TIGARD, OR 97223 TIGARD, OR 97224 PHONE: 503 - 620 -5643 PHONE: FAX: 503 - 681 -0793 FEES Specifics: Description Date Amount Furnaces < 100K BTU 12/22/2010 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 12/22/2010 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/22/2010 $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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: tip_ ri • 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. • DE0/21/2010/TUE 09:28 AM FAX No, P. 002 Mechanical Permit Application ,,. . FOR OFFICE USE ONLY City of Tigard • 25 SW Hall Blvd 131., Tigard, OR 97223 VF III ECPI r ... 14...bfeived . f Dlte/By: -om mPlan Review . . „ . . . 2--1 / , Permit No.: ....m G , r I :. Phone: 503.639.4171 Fax: 503_598.1960 Other Permit: T IbARD , Inspection Line: 503.639.4175 DEC Date/By 2 1 2010 Date Ready/By: MI g See Page 2 for . Internet; www,tiganl Notified/Method: Supplemental Information CITY OF T1GARn ',:::::' !:.:::. :.': H . ...:: - . . ,,.:';:,'..:.-..,:.'::, .(,. 0.*4004:::t* . Mechanical permit fees* are based on the value of the work 0 New construction iP Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ID Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ ::',....,.: : ..:,... :,:. :,:,::•::::. P. 90f:-'040!)::. .:.:.'i: ...j....:,:',..:.::::::::: .::': ..,...:. ,:- .. :.: . ,... ...-,,, , - ,, • „.' , ., ',...,,, .:,..g4PPi:OP:400, VP1 and 2 dwelling 0 Commercial/industrial . 0 Accessory building For special inlbroiation use checklist. 0 Multi D Master builder 0 Other; Description I Qty. I Ea, Total 4).#400:c: Heatiligie Air conditioning Job site address: 1 47 ( s --- ¶c.. t ora)iook. i0 , (re‘Piires site plait placement) 46.75 City/State/ZIP: Furnace 100,000 BTU' (duets/vents) I 46.75 F umac 100,0004 BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 liydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel not electric), in-wall, in suspended, etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: Other; 23.32 Tax map/parcel no.: Other fuel appliances .::: !..:,'4.77 'i , . (7 177 75777 Water heater I 23.32 J Gas fireplace 33.39 1 .) Q_#7.3 -- 0 ano-O_C . 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 ,, . ,....,„ Chimney/liner/flue/vent 23,32 /:: x 16 VIS'Atil l, ' .4 ;: : ' ,:i < ' '±'L f .LI'L : ii'iiiiair li 7.7 1 ■.;:i'll'iiaIl'i,;i4 °dm: 23.32 Name: Environmental exhaust and ventilation Watson, Eric R10582 Range hood/other kitchen Address: 10635 SW Lady Marion Dr. equipment 33.39 City/State/ZIP; Tigard , OR 97224 Clotho:5 dryer exhaust 33.39 R. Single-duct exhaust (bathrooms, Phone: ( ) 503-860-3855 toilet compartments, utility rooms) 23.32 , -iZzi 1 trie/ctawlspace fan 23 32 s . *57IOTi'...:.U3E-17:27a';4,V A .PF Other: 23,32 Business name: Fuel piping — Contact name: $14.15 for first four; $4.03 for each additional Runace, etc, Address: _ ,,........_____, Gas heat pump City/State/ZIP; Wall/suspended/unit heater Phone: ( ) _LFax: : ( ) Water heater ------- — — Fireplace E-mail: , Range ''':''''''''' ''' '''''' ::•:.:''; :.''' ';':',''. ' ''.'•:. ;'",(.: :;:l ..:::. , ' , .:::::'',''':..J , ;',.;.:',.\l'' :::'.:: , :.:':'.,,I.! Barbecue Clothes dryer (gas) Business name: Specialty Heating and Cooling Other: Address; 7500 SW Tech Center Dr #130 City/State/ZIP: Tigard, Or. 97223 Subtotal Minimum permit (cc ($90.00) 10, 0(...3 Phone: (503) 620 Fax: (503) 681 Plan review (25% of permit fee) CCB lic.: 66578 State surcharge (12% of permit fee) to) , SI) ,i .---- 411. - . 411101" TOTAL PERMIT PEE This permit application expires if a permit is not obtained within l80 Authorized signatur: — mar.._ . days after it has been accepted as complete. —..,—______,„...,_ _„.„,—.—.. Print name: Andre I I rip,. — 1 Date: / E cr . Fee methodology tel by Tri-County Building Industry Service Board 1:NauildeksTennitsWaEC 10/01/00 440-4617T (11/02/COWWEB)