Permit CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00676
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/23/2010
Parcel: 25111 CAl2700
Jurisdiction: Tigard
Site address: 9798 SW OAKS LN
Project: CHAMBERLAIN Subdivision: SATTLER PARK Lot: 12
Project Description: Furnace replacement.
Contractor: SPECIALTY HEATING & COOLING INC Owner: CHAMBERLAIN, JEFFREY J &
7500 SW TECH CENTER DR #130 DEBORAH L
TIGARD, OR 97223 9798 SW OAKS LN
TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 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 0 NC by calling 503.232.1987 or 1.800.3 44.
Issued B ` / �/ Permittee Signature:
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 /22/2010 /WED 09:49 AM FAX No. P.002
Mechanical Permit Application FOIL Hirsch ESE ONLY
City of Tigard + Review
Re Received
13125 SW Hall Blvd., Tigard, OR ' "f, ' P 1/ 1•
Phone: 503.639.4171 Fax: 503. T.:. f`
7 a; Plan Other Permit:
q Date
T I G A R D Inspection Line: 503.639.4175 n ®\ Date Ready /By: . El See Page 2 for
I nternet; www.tigatd -0r.gov O C C - fj Notified/Method: Supplemental Information
:':.l c.•, cam,' _:0 : 1r ;. :r.:
�.. :.......:. . ��� . 411 _ ,, .�JEi� ;�T.
❑ New construction III Addition/alt�i aoement Mechanical permit fees" are basal on the value of the or
performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
RP I- and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building "
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description
.
; ....,. %.n.ra',a; .c. i """ •:•rn ::,:.:::., c :u. w a r ,.�.. �.,.. 7:: 1 Qty. I Ea. Total
. t:: 4 . • ;,,';f, .. •;i; l , y1 `, r� , r !k : tl .. .. ," yyy� :, , � (;,' ;�: , : :11 : . ',AO '..• , ∎.;. 13eatinff cooling
Job site address: 9 $" , � ' n-k s LA) : Air conditioning
(requires site plan Showing pLUement) 46.75
City /State/ZIP: Furnace 100,000 BTU (duets/vents) f 46.75 1 -Its. /S
Furnace 100,000+ ETU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Yleatpump 61.06
Cross street/directions to job site: Ductwork 23.32
Hydroaic 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: Lot no.: .
Other: 23.32
Tax map /parcel no.: Other fuel appliances
#•lt.i.'llf't,i ^;n; ;,al d>i. ! ^ ' ]� j ggiiii ,��,{y;iii '111, : , w , 4'1' �'r,,,, 4;, .0.4;:;1ti1ii7r :; �.�� Water heater 23.32
y;Vgr , 1i,'mixia. , ;16i. U'1.al, t; • '4, a?;1' ii . ".'Y n , ,m,7 i. r•fm. - 'F,L :';G' 1 . i 9'.F'e zl;;o- r ? :a ;:a` "
/0 " � ` � ,/ �� p Gas fireplace 33,39
42J4-43 Vg-t1 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
, p �,; M1, t''t - +.»u rc, �,, a Chitnticy/lincr/fluc/vent 23.32
■ 1 Cam` %1 Ether. 23.32
Name: Environmental exhaust and ventilation
Address: r • Range hood/other kitchen
r (a A,. . . equipment 33.39
City /State/ZIP: It' ' �, 0 �_ C L.K Clothes dryer exhaust 33.39
, ! Single -duct exhaust (bathrooms,
Phone: ( ) G / /` Pax: ( ) toilet comparvnenti, utility rooms) 23.32
., ,.� .i.. .', �x.� :: I pe .. ! , : ;van: 74• ia,' ry :. � ,� %. ,r. F . '.
�� "i�j :; � �'� ,1 ..,t :h:..�P.i;i�j.. ,.. n sF�A��y �1 Attic /crewispacefans 23.32
iI li, 4\ . ;., ' r:;.': .4!.i �.. 4; y .t!r ,M1f:: :Z>ni,.wli, lt; ' rnirftW ;' i ti 4 H."(
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
' Barbecue
Business name: Specialty Heating and Cooling Clothes dryer (gas)
Other,
Address: 7500 SW Tech Center Dr 0130 's, %,', t; " ' d
City /State /ZIP: Tigard, Or. 97223 Subtotal t1 7T"
Phone: (503) 620 -5643 Fax: (503) 681 -0793 Minimum permit fcc ($90.00) 4 .013
Plan review (25% of permit fee)
_
CCB lic.: 66578 State surcharge (12% of permit fee) Jp, 511
_ TOTAL PERMIT FEE lad, d)'
r This permit application expires if a permit is not obtained within 180
Authorized signature' - days after it has been accepted as complete.
Print name: Andr ' : ip .: Date: l?„- ! D . Fcc methodology set by Tri County Building Industry Service Board
I9Building \Permit \Iv1EC- PenuaApp.doe 10/01/09 4404617'f (11/01 /CONUWEB)
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