Permit ` 1
CI TY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00434
:41111 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/20/2005
PARCEL: 2S 104AA -09100
SITE ADDRESS: 12220 SW 127TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 2 LOT: 094 JURISDICTION: TIG
Project Description: Installation of furnace & A/C unit.
CLASS OF WORK: OTR • FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
KONRAD, NICHOLAS J + PATRICIA L Description Date Amount
12220 SW 127TH
TIGARD, OR 97223 [MECH] Permit Fee 7/20/200: $72.50
[TAX] 8% State Surcha 7/20/200E $5.80
Total $78.30
Phone: 503 - 590 -2593
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #120
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Phone: 503- 640 -3607
•
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: ._l-u —
Call 503 - 639 -4175 by 7:00 a.m. for inspections 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.
Mechanical Permit Application FOR OFFICE USE ONLY -
City of Tigard RECEIVE0 RReecei -+ ._ c..� gElltiMMBEffa
13125 SW Hail Blvd., Tigard, OR 97223 Y'
Plan Review
Phone: 503.639.4171 Fax: 503,598.1960 L 0 /2, ,,: �, „ .,, A , i . 1 . + Other Permit: y
Inspection Line: 503.639.4175 JUL `' , �,L , ; _ I
Da ff
2 � ,,,,LL Data Read f 8y: um S Sao Pogo 2 rot
Internet: www.ci.dgard,or,us Notified/Method: upplementallnformadon
CITY OF TIGARD
_
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..., in : =S - o •' G .:fiH �:'trC II[TI:E L)SE�CFIECKLIST'
❑ New consrrueriott ❑ Addition/alteration/replacemen[ Mechanical permit tees are based on the value of rite work
performed. Indicate the value (rounded to the nearest dollar) of all
,n Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
a`�'`� "'liI - ,. ' '.=•I,V1*.,Ellk;ci0;g 0 :V,I ON 5'1R 1C;'T 47\i dt;'M .,, „'.)-7.- r -. value; s
'1- and 2- family dwelling El Commercial /industrial ❑ Accessory building '' 4i''RFJ j I or M$NT / SYSTEMS.FEES"
❑ Multi - family ❑Master builder ❑Other: For special information use checklist.
;;;` R Description Qry, I Ea, Total
P:. } ,•ly; ; 0JUB x1`7 liltiliA IOPrr.._i_.lYr�_OC:AZION,�, , ., ,- ". .' :,I '
::' e. •i. - �rci• 3a. - -o'X`" y:::r; 1 I3Catlhp.,/0001ina
Job site address: 4,'. -a-1 =1 . „..1. hm
{ Air req site plan condinoning sh owiti pu tr�p laoefi p ent) l 14.00
Ciry/Srnt &ZIP: "a r.r _ Wel 9 . L I Furnace 100,000 BTU (duets/vents) i 14,00 ■ Furnace 100,000+ BTU (ducts/vents) 17,90
Suitelbldg. /apt. no,: I Project name: Oav heat u Ia.00
Cross street/directions ro job site_ Duct work_ 14.00
lydronic hot water system 14,00
Residential boiler (radiator or
hydronic) 14,00
Unit heaters (fuel -type, not electric),
in-wall, in -duct, euepended, etc, 10,00
Subdivision: l Lot no ": Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
er , ':" , ii" fit n n', r'W R U" nn"1' \r elf' ^ T water heater
,l �'i9:����i.:��� �' l '��i >�,':��M� „ 1f� ,�gi'!�, a'l�l �r:��:,'l',r�,.��:,,�� +'�„ pr -
10,00
Gas fireplace 10.00
Flue vent for water heater or gas
____ig%k JA_IR 6"---s-- t! A-�� - fireplace 10,00
1 Log lighter (gas) 10,00
Woodlpellet stove 10.00
Wood fireplace/insert 10.00
" Cd ll.l , ;,w,.,. 2 � r , { _} I „ i
d ,dpm�
,� ". ':' 4+ :. 1 Chimney/liner/flue/vent end )0.00
l ' '1,- G , ,, ' i_tida::, ,: ,, ,- , 't:':,. "+b ,1 4 `, , I i > Other: 10.00
Name: ` fr! -' „ �� � Ga Environmental exhaust and ventilat
Address: �' Range hood /other kitchen
equipment 10.00
Ciry /State /Z/F: Clothes dryer exhaust 10,00
Phone: ( ) G l r �j Fax; Single -duct exhaust (bathrooms,
?
1 O -- o�'.J ( ( ) toilet compartments, utility rooms) 6,80
in, •: ,, },, '': ;, p`t•. .+r i ,� •, 6 , - :z . a , , ' L i' Attic /craw ace fan
;: I ,;'', ; N; i F �Al „ _G << -' CIVd �EBSCTN,;," !' P s 10,00
Business name: C - C_C 7� ( /4 Other: 10.00
5 f' ( - 1.,� ( Fuet piping
Contact name: L�1
1 r1Gf -t^ E• C (�” / .s-,c , ] S5.40 for arse four; 51 - 00 for each addldonal
Address; -} SCI c S' v
- re C i- r 1.+- Furnace, etc,
- v [ (� v Gas heat pump •
Ciry /State/ZTP: 7 i a \. C(... , (� if . )- j 3 Wall/suspended/unit heater
Phone: (S'b ) L.( ca _ 7 iv Fax:: (s v S) ( _ _ _ Water heater
E -mail: Fireplace
A1 7 at� ° : i }r.i� ri_:�;. �� 'ue"l'.1:hp. ,. ,�„-' :,� r Ran
e, -.
� 1 t fd ,'S' P ,i� ir '. ` , Ir .,lei + " r,,
11 n k `v O �. 1� a r, :,n
'"rr � iE�II 'lw' rl ib r {m' s `4 ���fY' � "q � � '��' iU �A ,�v�� 4R •tA ll��s r�
Barbecue
Business name: r.� . .. Clothes dryer (gas) • Other;
Address:
s' • r�f`;'4 i eliANItke
Ciry /Sratdz)p: ; ' J'"
Subtotal
Phone: ( ) — 1 P ax: ( ) Minimum permit fee (572,50)
Plan review (25% of permit fee)
CC$ lie.: L S S/ State surcharge (8% of permit fee)
r, _ TOTAL PERMIT FEE , :70
Authorized signature: ,L.4�k,• -�. ` This permit appiication expires If o permit is riot Obtained within 180
I days a ttar It has been accepted as eompicte,
/�
Print name: P1 1,-0-1,--_,:-.. ( .S ", Date: /, a j 1 • Fee methodology set by Tri County Building Industry Service Board
1 : 1 Buildlna 1 PamuieNEC•PermkAnn dnr 11 inv
COO/Z00121 XVJ 80:80 9002 /OZ/ L0
SITE PLAN
PL
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PL 141 , L 1 .7 PL
If
PL
STREET
_ . `
.. Specialty Heating & Cooling, Inc.
-•9528 -SW Tigard Street
. Tigard,. OR 97223 .
Phone '503.620.5643 Fax 503.598.0718 -
Hillsboro Phone 503.640 -3607 Fax 503.681.0793
€00 /E00IJ XVJ 80:80 9003 /03/L0
CITY OF TIGARD
il l BUILDING DIVISION PERMIT #: MEC2005 Ogfi34
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/20/2005
Phone: (503) 639 -4171 i� �t l �f�l��
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.._-_,10-
INSPECTION WORKSHEET FOR DATE: 7129!2005 TIME: 7 : 07AM PAGE: 116
SITE ADDRESS: 12220 SW 127TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 2 LOT #: 094 TYPE OF USE:
PROJECT NAME: KONRAD
DESCRIPTION: Installation of furnace & A/C unit.
OWNER: KONRAD, NICHOLAS J + PATRICIA L, PHONE #: 503. 590 -2593
CONTRACTOR: SPECIALTY HEATING & COOLING PHONE #: 503.640 -3607
Inspection Request Scheduled For: Date: 7/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012239-01 503.640 -3607 Y
Corrections/Comments/Instruction - s t :
M tjybg- t i4- g6 7 Fu n.tfFGc
MP' . '
P ASS M! PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL FA / L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ■,b._ �a e.` 72 - v Phone #: (503) 718 -