Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2011 -00426
Date Issued: 09/23/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel: 2S1106C10400
Jurisdiction: Tigard
Site address: 12031 SW CAFFALL LN
Project: Warzenski Subdivision: BULL MOUNTAIN VIEW ESTATES Lot: 2
Project Description: Install air conditioner. A/C unit must meet minimum 5' side and rear yard setbacks.
Contractor: SPECIALTY HEATING & COOLING INC Owner: JOHNSON, DEBBIE S
7500 SW TECH CENTER DR #130 WARZENSRI, DANIEL T
TIGARD, OR 97223 WARZENSKI, STEVEN
12031 SW CAFFALL LN
TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 719 -3396
FAX 503 -681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 09/23/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 09/23/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/23/2011 $43 25
Occupancy Grp:
Stories:
Fuel
Fuel Types
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
issuanc i suspended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Uti • Notification Center. Thos ' es are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules
direct questions to OUNC b -fling , 1. 2.1987 or 1 800.332.2344
I _
Issued By: 444. Permittee Signat 're:
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.
SEP /23/2011/FRI 03:34 PM FAX No, P.00I
Mechanical Permit Applicati r` e)ultIc r USE ONLY
City of Tigard Received p /
Date/By < M Permit Y l /��TF �j� e/ -
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
M Phone; 503.718,2439 pax, 503,598,1960 DatO/By. Other Permit:
TI CrA RD , Inspection Line: 503.639.4175 Date Ready /By. Juris 0 See Page for
Internet: www,tigard or.gov Notified/Method: Supplemental Information
.. , '! °i `i•..; • ' 1", 4E'; iiii Miitte• ^; ,',',''', •- • r ,: `' , ;4',0" i E4 .,I Olt`;' yP L • ,`�7'�S"E.Cff 040 .:
„ Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
(r. / Value, $
"•Y;' °'; ;„`t,," ;;,'. %1' , \' „CA G'rOl Tt,` Y'. . IDT)I r „' � 1 ' � , ,,, i „ ,
v� ,a'i'r ,, , �•;,, �';t � °SIRI1 $Q] &4'E$$Q *; ' di
' V, 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist,
❑ Multi - family y. ❑ Master builder ��{� ❑ Other: Descnpnon Qty. Ea Total
,., ;'': q: % ``',;' n;JY � i lii`V "±'. ; Yol ,;ii*i?LQfitc Ix1Y f,'•, r,•i 't,'.;;,'� (, i�,l j•' HeatinQ/coounn:
g
”' ° Air conditioning l T5'
Job site address: • a 6 5 _ • 1 4 \ (re.uiros site .1nn showm • •lacement 46 75 t0
11 - City/State/ZIP: 1 1 9 and_ r Furnace 100,000 BTU (ducts /vents) 46 75
Fu nace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: roject name: Heat pump
-��- . w..•- .»M... (requires site plan showing placement) 61.06
Cross street/directions to job site. Duct work 23.32
I4ydronic hot water system 23.32
Residential boiler (radiator or
hydinnic) -. 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: 23.32
Tax map /parcel no.: Other fuel appliances:
, 1, , '•' A'' : »qc 1PZ.,'0 ORF► Water heater 2332
5 �O�C � (� \ Gas fireplace 33.39
��J Flue vent for water heater or gas
fireplace 23.32
Log .lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/rnsert 23.32
' ,„∎, • ( , p opgnt11 ' v swh tonn'L,,' ,I.,L,:`'s -,..•.�_11S1,i At n•; Chimney/liner/flue/vent 23.32
Steve Warzenski R11260
— other 23.32
Name: Environmental exhaust and ventilat
12031 SW Ca ffa l l Lit Range hood/other kitchen
Address: Tigard, OR 97224 equipment 33,39
City/ State/ZIP: 503 - 719 - 3396 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) 23.32
1„ •e - _ T
II 'A4.1!17t,ICiAiNT s. • • , , . •A• „ :,..e. 0 •CONTACT TA:§0N Attic /crawlspace fans 23.32
Business name:
Other; 23.32
- Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
City/State/ZIP- M Gas heat pump
WaIUsuspended_/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRAC'TOl(t , • , t Barbecue
Business name: Specialty Heating & Cooling Inc Clothes dryer (gas)
Other,
Address: 7500 SW Tech Center Dr Suite #130
City /State/ZIP: Tigard, OR 97223 Subtotal
Phone; (503) 620 -5643 Fax; (503) 598 -0718 Minimum permit fee (890 00) cii 6 d
Plan review (25% of permit fee)
CCB tic.. 66578 o , s ,. S '- urcharge (12% of permit foe) i) 1
i `. TOTAL PERMIT FEE ! 1 4
Authorized signature: iii This .ermlt ap. expires If a permit is not obtained within 180
„� *J It has been accepted as complete.
Print name: ,�, - L !1 Date: I 1 ° Fee methodology set by Tn- County Building Industry Service Hoard
I \Bu id,ng \Permits \MEC- PertnitApp doe 09 440-46 7T (11 /021COMWWEB)
SEP /23/2011/FRI 03:34 PM FAX No, P.002
SITE PLAN
j/
fig
I
PL Farv
PL
PE
STREET
NOTE -- Please show the following on the site plan:
• Location of Indoor Unit and Outdoor Unit
• 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. distance
• Indicate how the condensate will be run
7500 SW Tech Center Drive
Sp ecialty Suite #130
Tigard, OR. 97223
HEATING & COOLING INC, (503) 620 -5643 Fax: (503) 681 -0793
www.snec ialitvheatina,com
Ivo,. not corrrfO(tnble until yon nro'