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Permit CITY OF TIGARD MECHANICAL PERMIT 2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00677 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: Parcel: 2S102BC01804 Jurisdiction: Tigard Site address: 12575 SW WATKINS AVE Project: FORD Subdivision: Lot: 0 Project Description: Furnace installation. Contractor: SPECIALTY HEATING & COOLING INC Owner: FORD, JOSEPH E JULIE B 7500 SW TECH CENTER DR #130 PO BOX 230801 TIGARD, OR 97223 TIGARD, OR 97281 PHONE: 503 - 620 -5643 PHONE: FAX: 503 - 681 -0793 FEES Specifics: Description Date Amount Furnaces < 100K BTU 12/23/2010 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 12/23/2010 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/23/2010 $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: 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 /22 /2010 /WED 11:36 AM FAX No, P. 002 Mechanical Permit Application -. . FOR OFFICE USE (MIN City of Tigard R a " " ` d Permit No.: . C‘,01:,,, : l �?a,. By, 1�- o .ter * lo der III ° 13125 SW Ball Blvd., T igard, OR 97223 Plan Review II . ' Phone: 503.639.4171 Fax: 503.598.1960 Data/By: Other Permit T' l U A R. D Inspection Line, 503.639.4175 DEC 2 2 201" Date Ready /By. lill See Page 2 for • Internet: www.tigard - or.gov Notified/Method: UM Supplemental Information CITY OF TIGAR I T.'Y3* :ate. Iwo � : >auE 00 ;0>i>r� © New Construction ] Addition/alteration/replacement , . . p permit fees* are based on the value of the placement Mechanical ermit f * work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition 0 Other. mechanical materials, equipment, labor, overhead, and profit. : ,.. • :�; �;,, ...: , : .. • " CA' CO�IS'�tiTCi1QN: ' _ ... ,. - , Value: 1- and 2-family dwelling C om me rcial /industrial , > ,�slt�0rl•T L F ll4gn§1 s` s7r> lui� '. y g ❑ ❑ Accessory building For special information use checklist Multi family ❑ Master builder ❑ Other: Description I ‘ Qty. Ea. Total 1 0 . ,; w ' ` ,' : '. ;d' i.i :`.' Hearin cooll n Air conditioning Job (( site address: S" '75 5, J W r�S Au g_ ' (requires Bite plan ahowing placement) 46.75 City /State /ZIP: W Furnace 100,000 BTU (ducn/vents) ( 46.75 '•/Li r 75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt no.: [Project name: :r---...6. 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 for any of above 23.32 Other. 23.32 Tax map /parcel no.: Other fuel applianees , .r i r, = Mi d , a Water heater 23.32 t . i', t ,:::':11' r. - ( tii-_L. !J-'. 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 : ",' °' ,,.r Chimney/liner /flue/vent 23,32 r�P.�, Y' . : { ": . a ^r ,. .,.i xr 4 r ^ :a., .��:T �. n; .'" , 1 q � i � :iZ..,.� ir_�..�,:J 1..�Fy; •; 3�- • - FI,b ,�,_ , , � 0 "' •` Outer. 23.32 Name: Environmental exhaust and ventilation Address: Ford , Jeff R10586 Range hood/other ldtchen 12575 SW Watkins Ave equipment 33,39 City /State/ZIP: Tigard , OR. 97223 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) 503 - 639 -3838 toilet compartments, utility rooms) 23.32 ;;i !.;:. !' (! '''':' ,- - ------ 7 - 1 i'" ," " K Attic /crawlspace fans 23.32 Other 23.32 Business name: Fuel piping Contact name: $14.15 for Brat four; $4,03 for each additional Address; Furnace, etc. Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone: ( ) I Fax:: ( ) Water heater • Fireplace E -mail: Range C y , A • 4jk Barbecue Business name; Specialty Heating and Cooling Clothes dryer (gas) Other. Address: 7500 SW Tech Center Dr #130 x ' City /State/ZIP: Tigard, Or. 97223 Subtotal 14. _ Phone: (503) 620 -5643 flax: (503) 681 -0793 - Minimum permit fee ($90,00) qd JQ Plan review (25% of permit fee) CC13 lic.: 66578 State surcharge (12% of permit fee) /0, 80 e All � -_ TOTAL PERMIT FEE /00 ) Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Andrea Drip . Illii Date: p _.- ` Fee methodology tat by Tri -County Building Industry Service Board IABuiIdmt \Pertens\MSC- PtrmitApp•doe 10101/09 44146I7T(I1 /02 /COM/WEB)