Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00026
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/13/2011
Parcel: 2S 102 D B08600
Jurisdiction: Tigard
Site address: 9088 SW HILL ST
Project: Miller Subdivision: Lot: 0
Project Description: Install gas furnace.
Contractor: SPECIALTY HEATING & COOLING INC Owner: MILLER, MIKE & ALLIE
7500 SW TECH CENTER DR #130 9088 SW HILL ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643
PHONE: 503 - 501 -6009
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/13/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/13/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/13/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 N ' . • 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 di ct questions to • • • C b . 'q. 503.232.1987 or 1.800.332.2344.
Is ued By:
d Permittee Sig —44111 e i n r jr ,
Call 503.639.4175 by 7:00 a.m. for the next available inspecti• • 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.
JAN /13/2011/THU 10 :28 AM FAX No, P, 001
r(r ,,,
elrmit A licatio `� FOR OFFICE USE ONLY
Mechanical 1 A
City of Tigard JAN 13 2011 Received / �e�ao /! - DO 0 _ iThiriliMB Permit No.
1 1114
rt 13125 S W Hall Blvd., Tigard, OR 97223 Plan Review
i a Phone: 503.639.4171 Fax 503.598'196° Other Permit;
CITY OF TIG Date/By:
T T Gr ARD Inspection Lino 503.639.4175 t Dat R ead y v / By: lure, E See Paee 2 for
Internet: www.tigard- or.gov BUILDING DIVI U! Notified /Method: Supplemental Information
I 1 of ti 9 ' . , io C, , .. . r b , , rc��z a x> „
❑ New construction Addition )alteration /teplaCement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials e ui•lnent labor, overhead. and .refit.
µ
,% : Value $
1- and 2- family dwelling El Commercial/ind 0 Accessory :�1 e0�? t ,
, ; a , 1< ]�c . Y' 1v1 1�T' /,gy rir lt F ii
essory building
For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
-.:7 . e t ' 1 , i 6jii§iii *iii ,44 N`' ;R,0 X S'� Ti M'i i i,�, f y t 'r ' I , 'eating/cooling
Job site address: qO ' P % ` 5k Alt conditioning
T rc .uires site 77lanShOwin7..lacement 46.75
City /Statc/ZIP: ....v ‘,.9 a r 8. , 2 , q . w Furnace 100000 BTU (duets/vents) 46.75 EOM
Furnace 100 000+ BTU (duct, /vents) 54.91
SuifcPoldg. /apt. no.: Project name: Heat .um 61,06 ME
Cross street /directions to job site: Duct work 23.32
Hydronie hot waters tern 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wal in -duct, sus •ended, etc. 46, 75
Subdivision: - Lot no_: Flue/vent for anz above 23.32
Other 23.32
Tax map /parcel no.; Other fuel a . fiances
"^rTA�'^ :4 , : t �a� t l "11 n D i i ,: N q�q Water' heater 23.32
.R• r1 x1. d . � A ' ro th , A4. i , . I t 1 l 6 ✓l K , 1
•7 . •• :.. , t,� , „ I' ,
' ,..l. t ,• r 4
4f t 'i, 9,; ''', ' ' i . ,. , r' r1 d. r . 0� 7 71 ' r7.7 '';''' }
Gas fi .lace 33.39
t S - TI t(Qq' cur ( o- Flue vent for water heater or gas
fireplace 23.32
- -
� Lo• li•hter(aas) 23.32
c s _ tam `d I o 'L_ Wood/•cllet stove 33.39
• Wood f • .lace/insert NM 23.32
1 t t tt vr i y , t , , , i, Chiinne /liner /flue/vent 23.32
u .,.I . f 4. 41;'M. i0� ° !. r . •k° 19 . A } O S� Jfi r4, , �t
:.. a u x.. i n a ,.•,i� fnv,<�1�,�t��49 avd � � .w +.�i: ..wL;�u, Other: 23,32
Name: 14 LLJ 1 „ 1 1_I Environmental exhaust and ventilation
Range � ' 1 l 1 Si equipment oodlotherkitehen
Address: 11 oquiprnent 33.39
City /State /ZIP: ' 4 j (tad ell Clothes dryer exhaust 33.39
`� Single duct exhaust (bathrooms,
Phone ( I Fax ( ) toilet coin.artments, unlit rooms 23.32 in
A ' "`,. z �` Attic /cr awls ac fans 23.32
u , t a . {'r 0 �Yr *TA; ,,:;',:.:ii:',: , , 1 ) 1 7 ' , "P' 4 %; ! ::!.,; l h `+A h i ! I 23.32
Other
Business name;
Fuel . i ■ in;
Contact name: $14.15 for first four $4.03 for each additional
Address:
Furnace etc. E _
Gas heat . urn
City /State /ZIP: Wall/sus•ended/unit
M a =
Phone: ( ) Fax: : ( ) Water heater w _
- - Fireplace WM__
E-mail; Rat • e
i 1': ,j ° . i.*40 .... .. .„ , ' I . Barbecue
Business name: Specialty Heating and Cooling Clothes d er :as
- - Other: �_-
Address: 7500 SW Tech Center Dr #130 ; + ( 1;1'a< A p0 4. .:,,u ',4
City /State /ZIP: Tigard, Or. 97223 Subtotal
Phone; (503) 620 - 5643 Fax: (503) 681 -0793 Minimum permit fee ($90.00) 00
Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee) i ' 0
TOTAL PERMIT FEE WWII
This permit application expires If a permit is not obtained wit tin 180
Authorized signature; \ t i [1( ($4"K days after it has been accepted u8 Complete.
Print name: 6 ` �J SOS Date; (, -l3.�t � * Pee methodology set by Tri -County Building lndusny Service Board
Idp.dld:..,.1P.-..,:o\ /art.- an.n:7A nn Ann lfl /5 /n0 ,..1 440 4617T(11 /02 /COM/WEB)