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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00205 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05!11/2011 Parcel: 2S111CD06000 Jurisdiction: Tigard Site address: 9620 SW BRENTWOOD PL Project: Parcel) Subdivision: SUMMERFIELD NO.9 Lot: 519 Project Description: Install gas furnace. Contractor: SPECIALTY HEATING & COOLING INC Owner: PARCELL, JOHN T & JOLENE C 7500 SW TECH CENTER DR #130 9620 SW BRENTWOOD PL TIGARD, OR 97223 TIGARD, OR 97224 PHONE: 503 - 620 -5643 PHONE: 503 - 968 -6033 FAX: 503 - 681 -0793 FEES Specifics: Description Date Amount Furnaces < 100K BTU 05/11/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 05/11/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/11/2011 $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 'cation 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 dire questions to OUNC • c.11i•g 503.232.1987 or 1.800.332.2344. / 9 Issued �� / Permittee Signatur � • �� 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. MAY /10 /2011 /TUE 02:14 PM FAX No, P.001 nit . �,�; • . -- 1 -800- 395 -1223 City of Tigard Received � �j � /G n _ _ L� Date/By: (D // (ZIP) _ " PennitNo.; GeOI()f� ,,Q�� I .t 13125 SW Hall Blvd., Tigard, u p b 3 Plan Review Phone: 503.718,2439 Fax: 5i , ' 0 Date/By: Other Permit: TICARD Inspection Line: 503.639 DatcReady /By: 7 aris: HI See Page 2for Internet: www.tigard- or.gov MAY 10 2011 Notified/Method: Supplemental Information - . 1 ,. d! . :,1� ... . ....... ;; i:` O. CIA *, ..;c, 7:7'.. >. . ;' .l! ';G �� : �;,,1jE�.,, ,,��1E1�.Cf Irf � �,�����... • i :'r,l�;, :! �•'; . i,l:; •'' . ,1 . 1. 11 ,l .. , . CCrnr r New construction iN Ad: la t 8Ed 9MIZIN 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, equipment, labor, overhead, and profit. .ih i r ,,., • �y ('� S� �* ,XQi .. ,. ..,., 'vl!1 :!�i :i :di,�;Ei''f: 6i�'ii,ii: ,F i.,.. ,. .. rr : . i,,. , .,�tf.!• .,, . ,, R,.,.L, A H. !,, .� :.,... � ...:h'�a. : ,"`T,..: ' • ..:•^_a . ..,La, !' i u d�,�; > i. :� r, � ., i at •.,..... .. : Y dwelling ❑ Accessory building For special or .: :,..,.:::. , , . ... . , • ,- :� . �i .,,� ,., , ,; , Ili :.��4'��� ....:....,:::.. :•1,. 1 - and 2- fttrrril dvvellin ❑Commercial /industrial Accessar buildin • � p Information use checklist. Multi- family © Master builder ❑ Other: Description Qty. Ea. j Total � r ll Frei :...,. :: ; r..iO :.11 11�, ; , ' .:.: , 11 ;! . • { .. p � r ��� { ?.r1. , i , ` �{ , ...:: _ t ,,, •• ..• , ,. 1 y , ••• ) - ,• • .• .. . ,,.. -- 1V ,,,, :,,,. �! ii'''''''':''''''''''''7`.' : i , z ';,,' 1 4 "1 <I "r` °i�ld��1'i'}�t I .,C,,.,i,.*4i ".: �f jR` "Cw,'T'(,.' ,i:�=`� ., ,,,..4,,.....,,.. .!1 1�,11,:I,iL&9Et � 1 1 ,� i ;C � :;' �' a" i ,,., ;! itl; : ,; , Heating/cooling , ' .� I re. uiressite lanshowin• .Iacement 46.75 , ; ...,... : � Air conditioning Job site a . ddress: 4 (0420 O) f t l� � City /State/ZIP: e V�(yl Q 4 hu Furnace 100.000 B T U (d u et /vents) 54.9] t 1 46.75 L . aryl l Furnace 100,000-h BTU (duets/vents) Suite/bldg. /apt. no.. Project Heat pump ��..- (requires site plan showing placement) 61.06 _ Cross street/directions to job site: Ductwork 23.32 llydronic hot water system 23.32 . — Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), . in -wall, in -duct, suspended etc. 46.75 — Subdivision: Lot no.: Flue/vent for any of above 23.32 Other: I 23.32 ~^ Tax map /parcel no.: Other fuel appliances: 1: ilf t1} J�llijiP `';yi(mgl :Pi!tIPE1f }h(.! p., t. k1,._.: � � .;r: li :aar! :;, 17.1' , ,..,,;'` ihil ,�t"flFd :v411�rh,il,l +�a17;1)1 t L� .,,,t,- V r d:,{ !:h>„ *,§ P, Y 1•:Q ' ,fir, . illO illr�l^!L{lill:lilIl,- �� }l.',1, �!1 ,l Water heater 23.32 --t�- 300) /+� � ■ ! 5 1 11. 5 1 nt for water hcatar or gas LJ fireplace, 23,32 Log lighter (gas) 23.32 Wood/pellot stove _ 33.39 Wood fireplace/insert 23.32 ,, 11 kl . r „il „!a•a .1 . . ;ii:i :0 1∎ ti:; .1A.i. : :q,;;: ,Yz,— ,,%.4..,...7..;, ,r,7d' Chimney/liner/flue/vent : :III:flgilillii.11ii6�.`I ! .r .r�i . u ";i ?Ilal� €';i1 �'.lr' :'4;'i Otrer /li 2332 Name: Jack Parcell R11128 — _ 9620 SW Brentwood Place Environmental exhaust and ventilatlon: Address: Range hood/other kitchen Tigard, OR 97224 equipment 33.39 City / State/ZIP: 503 -968 -6033 Clothes dryer exhaust 33,39 Single -duct exhaust (bathrooms, Phone: ne: ( z +� i) t »» . ,! ..;,.r,:,7 rr w ^;,: •1:;, „ r ty rooms) 23.32 com,Lartments utli r s 32 'Y ! li ;,;: E;fl i 1 1 ;1,, .:' i. �,: � i::.:: { ,•,,,.. c (Y ,,.., i' Attic /craws t. �II- r, l::, lil' 1, �1{ I.. II., �: �; �i��ri�' t<`', ����ift• r,rn {ll•rl�,,,l�l>{,5.;.}t,;c ?; .) : : :i, :c�a1.Gt��iT,+, . �?I :PEI����in :: :r : :,i:l!i,(Ilt�;'C lace fans , _ 23.32 P Business name: Other: , 23.32 Fall piping: . • , Contact name: 1 ' •.::;,14.15 for first four; 54.03 for each additional Ad ,..,„ _ Furnace; eta `to- i . Gas h a .urri. Mil Ph City / State /ZIP: ;` ' Wa 1 %su'1 t .cd/unit heater one: ( ) Pax: : ( ) Water bale, .;•;.• . fireplace . E-mail! s :i ` 7 Range �I ..h lF- c': P:n.1 ° "r .,.1 Mi i ll' n ; {d d v , .,'` : !(1!� i ! , ', :,am i'if, tc :' .', :'t i: ! "pI� :!g4i' : :!'� iiil.11, 1 � ,: y .o,x:i 7.I! F i 6, .. is ' :':,- t!' ::i!i731 , mil''''ord :',, : ',;il"' " i' .. �al"beCt10.. IIIII 1i( 1 nlSil;ill� 1 ".;F13yMl ,i (r�dPl^�1JitA ? 11(r. L....�. ' �f�..� ...�,. Nir; r1 i..r1i�1. 1'ri'C "11 :li; l rather d e ( 93) . Business name: _ p . Address: at ool , glte. }iii l'.�;�: . 5 'ubto .ar S��t !'�] C � � � : :� .! &li..,... ...,. �itA:�?Y•��tV,.. 4• ' , , �ili ° rl g ii �f�lia Irs� :}ip; City /State /ZIP: 7500 S.W. . 'bob center Dr Subtotal Minimum permit fee ($90.00) - 9O Phorre: ( ) ' Tigard, 1.223 ) 3 —59a -01 Plan revises (25% of permit fee) CC 1 ie. A0_511 � 1W NWSpeC i3aIaltYIleatlf9.c0tti State surcharge (l2% of permit fee) . in 10 X - 8 43 - • TOTAL PERMIT FEE:, i 0 VQ • • 'r This permit application expires if a permit is not obtalued wi bhi 1 0 Anthoi ed signature; 1 • days after it has been ac toted as complete. ' ,. - i n_._ ' F,'.. ,r •mr' u,iv ^ :ei i,. Tii- . injnztrV Scrvicc Bond