Permit r
�� CITY OF TIGARD MECHANICAL PERMIT
III #> COMMUNITY DEVELOPMENT Permit #: MEC2009-00370
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2009
Parcel: 1S134AC04100
Jurisdiction: Tigard
Site address: 10863 SW 111TH AVE
Subdivision: HART'S LANDING Lot: 12
Project: Higgins
Project Description: Install furnace and A/C Must maintain a 3' rear and side yard setback
Owner: FEES
HIGGINS, WILLIAM L & SUNKI Description Date Amount
10863 SW 111TH AVE Air Conditioning or Heat Pump 07/22/2009 $14.00
TIGARD, OR 97224 Furnaces < 100K BTU 07/22/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 07/22/2009 $8.70
Minimum Fee Adjustment - Mechanical 07/22/2009 $44.50
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR STE 120
TIGARD, OR 97223
PHONE: 503 - 620 -5643
FAX: 503 - 681 -0793
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: JeLlfaeAl dl./4—t- Permittee Signature: rye
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
JUL /22/2009/WED 10:42 AM FAX No. P. 003
. i
Mechanical Permit App I� FOR OFFICE LSE, ONLY
City of Tigard Received Permit No :gg�avvR•- va 3 10
t '1 13125 SW Hall Blvd., Tigard, OR 9 Plan }zeview
- Phone: 503.639,4171 Fax: 503.59 2 2009 D ate By; Other Permit:
T 1(i.t1 K1_] inspection Line: 503.639 Date Ready/By: Judo. n See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental information
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0 New construction pi' Addition /alteration /replaccrncnt Mechanical pctmit fees* are based on the value of the work
performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit.
�1 7 tr 1 f+ ` }11 f+r 1 .';1 111 1, l'utr r1, ri4 r 1 rnt i )-ra .n 19 it { 311 } 'hr l„ II 1I •yy • Value $ • .i.ili - ,.,,, l l ii l. t : ,�j .. !• . r.11 11 I ; } ; 0 ( 1 I,,LhW:, I,. 1 , i j} ,' } }. • , } 9 i • 1 :wr
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ti;;.',, , if i ` i 411r10 1 91 1 +x: t`1� I,�i jl r df {t�,.Ij
ill 1 - and 2-family dwelling G, a Lil d, 1, t. 1 „ iJ } : t G n u.tu a _aH :1
y g ❑ CommerciaUindustrial ❑Ac cessory building For_spectal tr(formation use checklist,
} Q Multi family El Master builder ❑ Other I Description I Qty, I Ea. I Total
y E }1 +iuj2 t (�iE�l ' ' J ] { ,i r ii r � Q �d l tl a n y 4 E l l fi t l y bfV l oll Cl iti = ri�ffll. lbY l tlr 1:1 , 1 fi I { 72 ,1, It {
: I,G�J } `'t;Jtd �r � it'l (I}ii,ir,} . ;44 11 ; �rF ; . l � - � t ' L12)1. 1:13 . blG . l a{t 1:: eatim /coolln_
t+ u i d huz
ress: Air conditioning or beat pump
lob site add
`Q 1p I (requires site plan showing placement) 14.00
City /State/ZIP: Furnace 100,000 BTU (ducts/vents 1 14.00
Furnace 100,000+ BTU ducts/vents 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pun. 14.00
Cross street/directions to job site:. Duct work 10.00
Hydronic hot water - stern 14.00
Residential boiler (radiator or
h dronic 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc, 14.00
Plue/ventfor any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
i 1 ,flillS t i!j ,n 11 lj 7 ^1, 11r } 11 1 1 w ilf IIt }i I r it ,
I I f I , 11 ° t 1 .: i t t Ir l i n if1l 1 fil I ” E ∎11 4 I ;13'il �u j ` ` i L� t j l i' t I} I} h j Water heater 1 .00
L..Lill a1 i f {,GI .,iAi.dsEw .' 2L,.._.,h,[.,at,2.,t . u,.yltat u.u.J�t:..z lla „yllE }t:,a. {.i..1f.G. Lit,,ti,l
Flu e 1 vent foe 1 1
Flue vent for water heater or gas
. , fire p lace m .0
Log lighter (as) 10,00 III
MIIIMIMMit Wood/.ellet stove 10,00
Wood fireplacc/inscrt 10.00
t r cr f t + r2,91h r te ai{ ,:UCi1il 11,11 {,1 ^: + ,1; 11 d i r { 2 1 V'1.4,4-111' i f[' ,{ r P Chimney/liner /flue/vent 1 11
i }1 `I i } / 11 { Q �2rt f1! ";rl1 t:' �1 t l . 4i €i, 1 /1
( L.rl.f{ jff . , ..,,,,,,, ,, }.},n2, l i d ,+ [j Other;
Name: Higgins, Bill R09191 Environmental exhaust and ventilation
10863 SW 111 A v e Range hood /other kitchen
Address: e. uipment 10.00
City /State/ZIP: Tigard Or . 97223 Clothes dryer exhaust 10.00
(503)684 -7207 Single -duct exhaust (bathrooms,
Phone; ( ) toilet compartments, utility rooms) • 80
Attic /Crawls ace fans 1 11
t ) 7 ut 1 r' lif +1i .16 ; ° 11 7t}1 yq 1 I 1 ' 1} ��' t , t a i r 1 { l , t + 1 , S 1 , ill' a 1 I tt r I t j lixl 1 ' lilI { 1 I il . �i i} i 1, :la;:f � it r ki ( 1 1 1 ? . r i ;: Il.
I a..,,,,1,lntralu« ld uu,; i }`# I. +.i Li[:'N.• +Ij� la. it :i.,,I .a. a a,,.k�,,l -c t. ,.l �i 10.00
Other:
Business name: _ Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace etc.
Address: Gas heat pump -
City /State/ZIP: Wall /sus • ended/unit heater
ill I.
Phone; ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Ran ,..e
:
,i(] t PI t }912 + «+ 1 � j 1 1 l Alli 1t +' lli#i lri i 1 `` uIWI 1y . i f l +11121,6 r f t ` r '1 1 1 t 2 1t i :11 'r t r tr q , i j! Barbecue
fti,l } ,,(!1j,)1,,i i l t1 {1 �;Ir1i i :litI Eir i,ii :: l!,4 1I ,1< � � It .iil iiii,1] I ii a7 1r i d'ilial,1 ;2' ...t.}r:11 { u,,�,ii P t 10 1. +�di �..ilt. ..:. l� a I lid , u,
Business name: Specialty Heating & Cooling, Inc. Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Drive #130 4 ,� ,(I i( i;Iifi if4 11[f I i �':' 912 14' 2 1 �a,`ri `i `h:.i 1111 1 }J- !:4 { ij # I
rCi! ii.iiiii . ;, fI likiLa l.rr l .uM,I L s lr,,tut.i,,,y 1 ,111, I1-,nn t ,:ii:�ea k ul i }ILliaiaL*1 ,41
City /State /ZIP: Tigard, Or. 97223 m Subtotal MOM
Minimum permit fee ($72.5
Phone: (503) 620 -5643 Fax: (503) 681 -0793
Plan review (25% of permit fee)
)
CCB lic.: 66578 II r � / State surcharge (12% of permit fee)
2� TOTAL PERMIT FEE
is permit application expires it a permit is not obtained' within 180
Authorized Signature' '' �� • days after it bas beee accepted as complete.
Print name: Andrea Dripps Date: - - (7 * Fee methodology set by Tri -County Building Industry Service Board
1: 13UIldina1Pe rmitsIMEC- P(rtnitApp.doc 01/19/07 44t (11 /02/COM/WEB)
JJL /22/2009/WED 10:42 AM FAX No P. 002
JUL-21-2009 08:91P FROM: ( Ik1S t wMMUriu, cum- a 5ds rbU (,6 i U; NIJ e ris H. a i
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SITE PLAN
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PL
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STREET
NOTE - Please show the following on the site plan:
) Location of Indoor Unit and Outdoor Unit -411111111
Indicate how the flue will be run (thru the roof - out the sidewall -etc)
Indicate with dotted line how the lineset will be run and approx.
Indicate how the condensate will be run
g33 c A 7500 SW Tech Center Drive
Suite 0130
SPECIALTY Tigard, OR. 97223
HEATING ($03) 620.5643 Fax: (503) 68 t -0793
COOLING ww w.snecialitvheadna.cnm
LAuwn now 'ter% 1 /
horizontal 3a f