Permit pr ! CITY OF TIGARD MECHANICAL PERMIT
. °= COMMUNITY DEVELOPMENT Permit #: MEC2011 -00542
I G
IAAD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011
Parcel: 2S 112BB09400
Jurisdiction: Tigard
Site address: 14335 SW FANNO CREEK LP
Project: Rossi Subdivision: COLONY CREEK ESTATES NO.3 Lot: 76
Project Description: Replace furnace
Contractor: SPECIALTY HEATING & COOLING INC Owner: ROSSI, CAROL
7500 SW TECH CENTER DR #130 14335 SW FANNO CREEK LOOP
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 684 -1953
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/30/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/30/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/30/2011 $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
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: P Signature:
Crl e9A1 Fri° / eJ C if-770
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.
NOV/28/2011/MON 01:44 PM FAX Ni, P.002
Mechanical Permit Application FOR OFFICE USE ONLY
' City of Tigard Received
PennitNoHb-- 0,, / —0 05 ...
" 13125 SW Hall Blvd., Tigard, OR 9722RECE
i 2 , . Phone; 503.718,2439 Fax: 503,598.1960
11111 Date/By:
Plan Review
Date/By: Other Pennin
Inpection Lint: 503.639.4175
TIGARD s NOV 2 8 2011 Date Read Juria: E See Page 2 for
Internet: www.tigard-or,gov Notified/Method: -176r Supplemental Information
.
`'..' --• '"M*46:14::it0 sektiitie*vgt at ' ' 'll '..
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Mechanical permit fees* arc based On the value of the work
EI New construction KI.drddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
D Demolition ID Other: mechanical materials, equipment, labor, overhead, and profit.
0*004* OSI;;V:';',:.:.',:;:,-::'(:,": Value: $
: - . . .'; • R .--. ..-., -.. -•4 - itIV44.4ie - "---.
' ' .:' ''' :' • - • • • ''' ' " ' • . • • ' ''' ''': '''" . ''' ;" : ;. Q...,,,, ...:/'Y,STP,IM'f.P.
tri and 2-family dwelling I: Commercial/industrial El Accessory building For special information use checklist
El Multi-family D Master builder p Other: Description Qty. I E. Total
''::-:;;A'•.;-;‘i.'=::•4;''P:'#*:■:'i4-0414.001(iitAAill(*UTN:5::'Hi!;•''7.;'*'j fleattngic"ling!
-"' . • ' ' " '''. ' Air conditioning
Job site address: (requires site plan showing placement) 46,75
i Rossi, Carol R11362 Furnace 100,000 BTU (ducts/vents) I 46./5
Cty/State/ZIP:
14335 SW Fanno Creek Loop Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg/apt, no. Heat pump
Tigard, Or. 97224 (requires alto plan showing placement_ _ 61.06
Cross street/directit (503)684 Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23,32
Unit heaters (fuel-type, not electric),
in in suspended, etc. 46.75
_
- Flue/vent for any of above 23.32
Subdivision: Lot no,:
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
. :',,I . : i. ,; : ;;. : L ! :: '' ';; ‘ :''' , ', 'Y•l . . ' ...•"1 . :.:: : . : : :• ‘: : : : . "'. i0..;0C*0.# te:,.•'':::: Water heater n.32
Gas fireplace 33.39
Flue vent for water heater or gas
AL19-6:3"."4-4-- I AN-i -1., fireplace
Log lighter (gas) 23,32
23,32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
23.32
l' , ‘;:,
fl TENT:: ,:!..!,,..,.*,,..„
Other: 23.32
Name: 04..4%.-.A.-- ; Environmental exhaust and ventilation: _
Range hood/other kitchen
Address:
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone:( ) Fax; ( ) toilet compartments, utility rooms) 23,32
—
0 . ;414,iCMT :: .,•."...:,....:...;;;:: 'fl' ''jpi*,,jN. ;'',: :; Attic/crawispace fans 23.32
Other: 23,32
Business name:
Fuel piping:
Contact name: S14.15 for first tour; $4.03 for each additional_ ,...
Address: S Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax; : ( ) Water heater
Fireplace
E-mail:
Range
Business name: Specialty Heating & Cooling Inc Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Dr Suite #130 - - ' • ' • " - •
Et:HANICAL ;PERMIT F .:'..',.::.,:.•.„.., i :
City/State/Z1P: Tigard, OR 97223 5 , Subtotal
Minimum permit fee ($90.00)
Phone: (503) 620-5643 Fax: (503) 598
Plan review (25% of pennit fee)
6k 7 CCB lic.: 66578 SAV State surcharge (12% of permit fee) , • . A r ...1
TOTAL PERMIT FEE
Authorized signature: / t11-.----, This permit application aspires if a permit is not obtained within 180
days after it has been accepted as complete.
Date: '
Print name: /4 D / 1,/- -,.,/ / ( • Fee methodology set by Tri-County Building Industry Service Board
FaUildingTermits 1 MEC-PermitApplcw 09/09/10 440 (11/02/COM/WER)