Permit CITY OF TIGARD MECHANICAL PERMIT
' 2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00690
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2010
Parcel: 2S112CB07400
Jurisdiction: Tigard
Site address: 15323 SW 81ST AVE
Project: WALKER Subdivision: ASHFORD OAKS NO. 2 Lot: 88
Project Description: Furnace installation.
Contractor: SPECIALTY HEATING & COOLING INC Owner: WALKER, MICHAEL D & JANEE STEARN
7500 SW TECH CENTER DR #130 15323 SW 81ST AVE
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/29/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/29/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/29/2010 $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 It NC by calling 503.232.1987 or 1.8r =344.
Issued By: j / / Permittee Signature: • J„ 4
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/27/2010/MON 05:11 PM FAX No. P.002
Mechanical Permit Application poi; OFFICE USE ONLY
74 City of Tigard EiffilMiN Permit No.: 1g
, .- ' 13125 SW Hall Blvd., Tigard, OR 97223
II , Phone: 503.639.4171 Fax: 503.598.1960 R EC El v i tEsiiimim other p.n.:
.. .
., .
TIGARD .. Inspection Line: 503.639.4175 Date Ready/By: M See Page 2 for
Internet; www.tigard-or.gov DEC 2 8 2011 Notified/Method: Supplemental Information
. :.,,f :':....''..'.::::: Y i' li*:#0g .' „ig4W
El New construction Uil Addition/alterationY Ul vINON Mechanical permit fees* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
o Demolition El Other: mechanical materials, equipment, labor, overhead, and profit._
. ....!■::: : ,3?: , ..,';',.:'; , ' , : . : F ,:..': ••••• :.':::, :. ,.. ,•:••••• :'•.:.• "i _, _ Value: $
„., •.- .. ,o,.;........... -- • ••• - o• • . - ••••• - • • . • . . , , •••••••• ••• • ' ':' • ...• ' :'•- '-'"•• 'l• ''' '' :',, ',,!;.;' J* '.• ;
111- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist_
EjMulti-family I=1 Master builder 0 Other:
Description I Qty. Ea. _ Total
1,1 • , 00400001-00.40 1: 04 i .j.: - i:i::a:::a1::■K•:)1 Beating/cooling
Job site address: /5'3 23 5, s/t 14 __,.. Air conditioning
(requires site plan showing placement) 46,75
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) _ I . 46.75 H0, 7c;-
Furnace 100,000+ 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
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) -
Unit heaters (fuel-type, not elecni),
in-wall, in-cluet, 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
'' i,•.•,:j4,:; •':,::"; • .P.Ira11 : • V.;.2•:!• t:..!, '-:•,;) ';';','g,•''., Water heater 23.32
..„.4,-. .,,:,..• ..,,:•... ••, '*.K1:■•' A''' ''''',"•: Nissit:itttlof ' , ..”4.:':: '‘ ,';' ., .
Gas fireplace 33.39
..- OQ *)o-Q-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
Ar m,• i ng . t . 3 , -Ly...:47 .,.., ,u ft.-i 1 ___ 1p:•,,,,!,,T.7,, Chimney/liner/flue/vent 23.32
4, 4;.)•2 oth 23.32
Name: Walker Michael R10598 Environmental exhaust and ventilation
,
"" Range hood/other kitchen
Address: 15323 SW 81 Ave equipment 33.39
City/State/ZIP: Tigard , OR. 97224 Clothes dryer exhaust 33.39
503-502-3715 Single-duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) 23,32
f,...."‘14 • 0 , :r.•r!',:-' • " ' el ,,, ..1 1 ,r$ , ',.., , ' ,, ,r1 ,,,, 7.< ,, r , i17.io:Va.. , :',.r . ,,:`,..V.4 , 1 1, 44 ,,,,,, i-t;? .. ...,tw ......bt .. .., .,.....,,,,‘,.■ t. ,, ,_, 23.32 4 ittilwctawisnace fans -
Other; 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
,. Gas heat pump ..,
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax; ; ( ) Water heater
Fireplace
E-mail: Range
1: i‘•: ; '■I' Y ':';' - 'Z: :•4;::' • ) ii'....:: ...,;,'',,::.7..• '‘,t Barbecue ::.•••:',..,i;: :•`•;.:..!■'•,•!'.i. , :::;',, • 4:: , !•.■::- , :•:„;!2• , :;•!",',..:•,:), .• • ,, .. ... ,...,....,-.:.'•i:•••• V - •;:lk.:!:';' ,t! 3
Business name: Specialty Heating and Cooling Clothes dryer (gas)
Other.
Address ; 7500 SW Tech Center Dr #130 1 :?:,:lyiAtiii#60%glikiAWbialk!'; •
City/State/ZIP: Tigard, Or. 97223 Subtotal ‘46.
Minimum permit fee ($90.00) ( rack)
Phone; (503) 620-5643 Fax: (503) 681-0793
Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee) /d, ,h,
_ ------ TOTAL PERMIT FEE /ad, id
:
Authorized signature: . . d . This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Andrea t • ip v Date; j D''' 6 • Fee methodology net by Tri-County Building Industry Service Board
Ktuildineermirs \ MIC-PermitApp.doe 10f01/09 440-4411T (1 VW/COM/WEB)
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