Permit CITY OF TIGARD MECHANICAL PERMIT
` ° 7 COMMUNITY DEVELOPMEN Permit #: MEC2011 -00096
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2011
Parcel: 25111 CB01706
Jurisdiction: Tigard
Site address: 10305 SW HOODVIEW DR
Project: CIROTSKI Subdivision: HOOD VIEW Lot: 5
Project Description: Gas furnace and heat pump installation.
Contractor: SPECIALTY HEATING & COOLING INC Owner: CIROTSKI, LAWRENCE L AND LAURA L
7500 SW TECH CENTER DR #130 10305 SW HOODVIEW DR
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 03/09/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 03/09/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/09/2011 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $104.72
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: i . A id.1111P F Permittee Signature:
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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.
MAR/07/2011/MON 05:56 PM FAX No. P.001
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11‘ Received .... _ erm , t ... .
Datc/BY: ) ii F 1 N " PVC I I — CC 1 014.
Plan Review
Date/By: Other Permit:
Inspection Line: 503.639.4175
TIGARD MAR 8 6 'II Due ReadyiBy: Jung: El See Page 2 kr
Internt e www.tigard Notified/Method: ....-42 Supplemental Information
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Mechanical permit fees* are based on the value of the work
n New construction Ili Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition li Other: mechanical materials, equipment, labor, overhead, and profit
Value: $
'.',•i', 00 4: OA ' elj •''''; • r0$1u.e4' - 'rttibi4 %,. , •ri•:.' , ;:„ u ...4:4!'i:;-'aliiz
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'ai ;iJ.,:k • lgiii Y! NI Il• .... 7k — . .:r:457AN..!' :•: .,f("7,1',.,..: 7.„.,: r. :':.' ' — 1
;fr4. ***0:0
1- and 2-family dwelling El Commercial/industrial 0 Accessory building For special informadon use chealiti.
Multi-family 0 Master builder 0 Other: Description I Qty. L Ea. I Total
.14 i,:.410,0*1007611 fleatingic°°11ng: . r
-- • - • Air conditioning
Job site address: 1 0 305 s Ro v Dr.L., (requires site plan showing placement) 1 , 46.75 Lt
Furnace 100,000 BTU (ducts/vents) , _ , I 46.75 - 17
City/State/ZIP: "1 (Ira.. 612 cl 1.2a 3 Furnace 1110,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. nO.: Project nam e: ' • :. Heat pump
(requiret'ine plan showing placement) 61.06 ,
Cross street/directions to job site: Duet work _ 2332
liychnnic hot water system , 23.32
Residential boiler (radiator or
hydronie) 2332
— Unit heaters (fuel-type, not electric),
. in-wall, in-duct, suspended, etc. 4635
Subdivision: I Lot no.: Flue/vent for any of above 23.32 _
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater 2332
ittlA!SIBM
Gas fireplace 33.39
n ! . 1 I
•, 4 ' ' -_,--• / ,. 1 4 - Flue vent for water heater or gas
1 .21 k j r fireplace. 2332
, ,s Log lighter-(gas) 23.32
.i,
— Wood/pellet stove 33.39
Wood fireplace/insert 23.32
„iii 30,1 ;i ,„ • R Chimney/liner/flue/vent 23.32
.' iii,;. it. u ■L .` . i'• 1 amtlm ...■=nn..: : .,..mgvEr4iVtriv'il'fili'vl Other. 23.32
Name: 1.4 0 rry C-4 ro+sit..x.%
Environmental exhaust and ventilation:
-
Address: (03 ci,o'i-iacavic Range hood/other kitchen
equipment 33.39
City/State/Z1P: 1 • . d (2-J cil 2 a.3 Clothes dryer ahaust 33.39
Single exhaust (bathrooms,
Phone: -71 ) ,,, 4 ... dif q Fax: ( ) toilet com rtments, u tility rooms)
'E P.Wg 7..446411114 Attic/crawispace fans 2332
. . Other, 23.32
Business name; - • y .
__:_...„.. . ** Vet ' ■ Jul:
,
Conte& Mane: ; i ." ,;.,.,114.15 for ant four; S4.03 for each additiOna1
— , i; ,, .. • ,.
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fril...-....:, - v. :•:,
Isi:.•':':-.4)., •... Furnace; etc.
,
• - 014;bi:, .11M.. IESIIIME
City/StitorL12: ' i , , , _ : ;;`-g- •,. . 1: , P2c- W , l'fiu', 41...4iirlit heater IIMIIIIIIIMIN
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Phone: ( ) • 7 , • •••• , Water b •
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E-mail: • Tigard, OR 97223 ..
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Business name:
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.2. Address:
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• •:,City/Stnte/ZIPI atZ611:I0 ` ,--- . m Subtotal 0 II \
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Phone: ,, 0; li: - ' • - -
V imurn permit fee ($90.00)
e )
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_a 1 a AO _h ' }r' ' ' 503 O e 1 4! L . . Plan revirw (25% of permftfee) M
CCElic,i, 651 s .ra 4.. • • .g... • ... „, • -. v 7 4 State surcharge (12% of permit feo MI=
_
. ,...:::.- • . ; .. , '2 • '• TOTAL. PERMIT PM irer.ela
Authorized signature: Na permit a pplication expires if a permit is not obtained nlibln:180
„' if i •
1 ...i '1 d as ays after it has been ac speed complete.
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