Permit CITY OF TIGARD MECHANICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00684
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/27/2010
Parcel: 2S110BB05400
Jurisdiction: Tigard
Site address: 14158 SW 121ST AVE
Project: SCHOBLASKE Subdivision: ARLINGTON RIDGE Lot: 31
Project Description: NC installation.
Contractor: SPECIALTY HEATING & COOLING INC Owner: SCHOBLASKE, JON &
7500 SW TECH CENTER DR #130 ELTING - SCHOBLASKE, ANN T
TIGARD, OR 97223 14158 SW 121ST AVE
TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 12/27/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/27/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/27/2010 $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 50329 1987 or 1.800.332.2344.
Issued By: Permittee Signature: ,
�Git - tom i�
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.
DEC /23 /2010 /THU 11:06 AM FAX No. P. 002
Mechanical Permit Application FOR OFFICE. 11Sf ()Nl,v
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 9 ' V ED
Date/By: � ' :// L ! • '`
Plan Review
NI Phone: 503.639.4171 Fax: 503.598.1960 2 3 2010 flag
Inspection Li 503639x175 Otber Permit
kJ) nspecon ne: , DE C Date Ready /By; la See P 2 for
Internet www.tigard- or.gov Notified/Method: VA Supplemental information
TiGARD
Mechanical permit fees are based on the value of the work
❑ New construction i� Addition /alteration/replacernent
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. _
m
, . . Value: $
log 1- and 2- family dwelling 11 ComtnerciaUindustrial ❑ Accessory building "' "' ` I '' "
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other;
Description Qty. Ea. Total
'tip. ,,; r:f :�'k e:ih' ". ,e.�,� { ..�d:7 .lµa, ,. �.. .; .., ��., r. y ,. � �,:... ¢: ,� ,. r • r' ,. '.m: .:a' ,. 1'' : .. :, . r v. YJ�' • �' i l , i',� Q'•: 9 4 �; ) r :, „ 'i iCt� ` '. fp „ j' Hearin ll
(...O.: (...O.: r...,Gl; :. .
;:).,`i'.•a•.i,,..,∎. _...fair xe 7` `FT h,, ,. 2.-....,, ''li":r, . ' -"I:r, is x,44''. F�COO n�
Air conditioning
Job site address: 111 ... /A. i . , (requires site plan showing placement) t 46.75 t .-75—
City /State/ZIP: Furnace 100,000 BTU (ducta/vents) 46.75 r
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgiapt. no.: I Project name: 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
Flue/vent for any of above 23.32
Subdivision: I Lot no.: 23.32
Tax map/parcel no.: Other fuel appliances
- -' � ;� • i /� ° '1"-;"`I. ' � N�p tl M 1 a p�6 y, qu � ' , ' ' ( r Iw d %y ' 23.32
id r� } ,� .:
. �f � .' .k.:. 1 �'X' i [LM �uti d � `�”. M1L 1 ; 4. ' ' ;, �^ nw�.. ,�? l,f.. ...t��;1r,':
Water heater
X ` 9 Gas fireplace 33.39
. i 4 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
F ' mY i w a s? r,�, 4 �; r i , Chimney/liner /flue/vent 23.32
> i, o a r r A i7.- .. . f . ', . ize r re 'i j/ i r Other: 23,32
Name: 5t hoblaske, John 810591 Environmental exhaust and ventlladon
Range hood /other kitchen
Address: 14158 SW 121 st Ave equipment 33.39
City /State /ZIP: Tigard , OR. 97224 Clothes dryer exhaust 33.39
503-598-9545 Single -duct exhaust (bathrooms,
(
Phone: ) toilet compartments, utility rooms) 23.32
7 : 1 :r?. 'x ; 'y .. (
. i j T .sss�"i t '. ..:4; . i, o cn� ; ' i'1tr,:'ri: % :.. ; i, Attic /erawlspace fans 23.32
i :, �A••i l r i' il,:.r,a, .:r)1:,.. t'SP. c. r 4 `r 1:;..V:, r s,;, :..,,,. :: � , J -' $ .utlf.j2...6
Other. 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat •
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heester
Fireplace
E -mail: Range
(� ,ii -J.,.
•w.'1-' t y "l r'a' = . : r •, . ;:ii ', ii - ..:;k1. „ vi;::-,;-'.. 'Y,r .•rLr.?- a,5V7,'�47✓2, Ir ''.. r . .1. . Jr', ,, - 4,: V •,0 .
Clothes dryer
Business name: Specialty Heating and Cooling
Other
Address: 7500 SW Tech Center Dr #130 i a ; 'a ,
City / State/ZIP: Tigard, Or. 97223 Subtotal Ilip , 7C
Minimum permit fee ($90.00)
Phone: (503) 620 -5643 I Fax: (503) 681 -0793
Plan review (25% of permit
CCB lie.: 66578 J. State surcharge (12% of permit fee) f(f t
TOTAL PERMIT FEE [(/v_P
• Authorized signature This permit application expires N a permit It not obtained wrtLin 180
_ .> '" days after It has been accepted as complete.
I Print name: Andrea t vs L Date: / X^- '� /� "' Fee methodology set by Tri -County Building industry Service Board
\
1:Builds,g \Petmiu try GPermitApp.doc 10/01/09 / 440.41 171 (11/02/COMIw6B)
DEC /23 /2010 /THU 11:07 AM FAX No, P.003
•
SITE PLAN
'PL
•
•
PL
r
PL
Ve„ 17ra,9 IQ 6 7y r
STREET
NOTE — Please show the following on the site plan:
:• Location of Indoor Unit and Outdoor Unit
:• Indicate how the flue will be run (thru the roof — out the sidewall — etc)
Indicate with dotted line how the lineset will be run and approx. distance
Indicate how the condensate will be run
7500 SW Tech Center Drive
Sp ecialty Suite #4130 Tigard, OR. 97223
HEATING & COOLING INC. (503) 620 -5643 Fax: (503) 681-0793
www.specialityheatina.com
4V re nut comfortable u you ■arid