Permit CITY OF TIGARD MECHANICAL PERMIT
1111 2 COMMUNITY DEVELOPMENT Permit #: MEC2011-00083
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/24/2011
Parcel: 1 S133AD09600
Jurisdiction: Tigard
Site address: 12732 SW SPRINGWOOD DR
Project: NELSON Subdivision: Lot: 0
Project Description: Gas furnace installation.
Contractor: SPECIALTY HEATING & COOLING INC Owner: NELSON, JANET L TRUST
7500 SW TECH CENTER DR #130 BY NELSON, JANET L TR
TIGARD, OR 97223 12732 SW SPRINGWOOD DR
TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/24/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/24/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/24/2011 $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 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 OUN by calling 503.232.1987 or 1.800.332.2344.
Issued By: c / Permittee Signature: Y
�
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.
FEB /23 /2011/WED 03:43 PM FAX No, P.001
Mechanical Permit Application FOR OFO1CF. USF. ONLY
2 3
City Tigard Receives y
t d It 131 Hall Blvd., Tigard, OR 97 p, Datus �, /
Phone: 503.639,4171 Pax: 503.598.7966' 2 Q Dam 1e" Other Permit_
1.' t t; A K 17 inspection Line 503.639.4175 C I OF Ti `�,�D Date Ready /By: 1� la Ste ?see 2 for
Internet: www.tigard•or,gov G • • Notified/Method; 7D:6, Supplemental Information
:::ii*:
i - i VISJON
❑ New construction Addition/alteration/replacement
Mechanical permit fees arc based on a value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition Other: mechanical materials, •L.:.ment, labor, overhead, and profit.
.CA tyoRY;'.RF C{91 !1Z' iuc' ...... . Value: $
1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building :;;:".****110.040.,!'
' S� '
Multi- fapnily ❑ Master builder El Other; For special lh ormation use checklist
bCSCription Qty. Ea_ Total
,.. -,..•''. #O'>E<;',. 0.*; 4 ' . f•Y•'.'.'';:° Bea 00111 7r�
^y �v1 Air conditioning
Job site address.
1 a 1 32 Sw S ( �Wd D — likes site •Ian ahowin:.lacement) . 46.7$ -
City/State /ZIP: I 1 Furnace 100,000 BTU (ducts/vents i 46.75 Willa
Furnace 100 000+ BTU ducts/vents 54.91
Suite/bldg./apt. no.: Project name: Ne., ( 3 0 6 / Heat .. 61,06
Cross street/directions to job site: Duct work 23.32 Ma
H drone hot water _ stem 23.32
Residential boiler (radiator or
hydrorlic) . 23.32
Unit heaters (fuel - type, not electric), . -
in -w: in - due - • _ - • etc. 46,75
Subdivision: Lot Flue/vent for an of above 23.32
Other 23.32
Tax map /parcel no.: Other fuel a . . lianccs
f;,r , : ,� T `• " ; "i' ° '•:� .;��'' +' Water heater 23.32
;l:z,s .p.�., 9.' w : K, t!k: ": '} ^ ..:�+•;� D iv ": ?�G�i.';vl,�'�l
(\5h1 \ (1 Q5 f w fldci- Gas f tf _ 33.39 MIN
1 Va flue vent for water heater or ;a� .
fir lace 23.32
Lo li_hter 23.32
Wo.•.elletstove 33.39
Wood - .lace/insert 23.32
•,
y A . .� ; Oo ,x p:.4. ai° a ? Chime /liner /flue/vent 23.32
, . .: �� ati ..,�:,�:�vi n -r. ,iq,°n� Other: 23,32
Name: Pt'ks N Et 50 0 Environmental exhaust and ventilation •
Address: t 2.'73a S C p ` `„t` e d/othcr kitchen 33.39 ment
City/State/ZIP: Ti r J q sue
2- " Clothes ., er exhaust
Single -duct exhaust (bathrooms, 33.39
Phone ;4 ja !/ / „ Fax: ( toilet com.artmcnts, utili rooms) 23.32
�,. ' `;; t; N
:�', "' ± , w f Attic /craw .: e fans 23.32
Business name: Other 23.32 Fuel . I. In
Contact name; $14.15 for first four; $4.03 for each additional
Furnace, etc. = 11=—
Address:
Gas heat .. •
City/State/2/P: Wall/sus. .ed/unit heater _
Phone: ( ) I Fax: Water heater ( ) Fire •lace
8-mail: R e
•1::.I..:•• •. • .. '•' 'P 1" r: r•y.[ • Barbecue
Business name: Specialty Heating and Cooling Clothes • er - `
Other __—
Address: 7500 SW Tech Center Or #130 ,,0:1 `"..: ir';
City /State/ZIP: Tigard, Or. 97223 Subtotal
Phone: (503) 620 -5643 Fax: (503) 681 - 0793 Minimum permit fee ($90.00) 4IIII
�_,_ �__ Plan review (25% of permit fee)
CCB lie.: 66578 State surcharge (12% of permit fee) MOM
TOTAL PERMIT FEE j,a;
Authorized signature. This permit application expires If a permit 19 Pot obtained within 180
a s ti fiD days after If has been accepted as complete.
Print name:. .pa • hate: ... i ,. ( ' Fee methodology set by Tri- County Building Industry Service Board
1:\ Sui lding\ Permits \MEC- PermitApp.doc 10/01/09 440.4617T(11/02/COM/WCB)