Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00601
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/23/2011
Parcel: 1S 135CA00303
Jurisdiction: Tigard
Site address: 9605 SW NORTH DAKOTA ST
Project: GILLINGHAM Subdivision: MEADOW VIEW Lot: 8
Project Description: NC and furnace installation.
Contractor: SPECIALTY HEATING & COOLING INC Owner: GILLINGHAM, TERRY L AND
7500 SW TECH CENTER DR #130 SHARON A
TIGARD, OR 97223 9605 SW NORTH DAKOTA
TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 12/23/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 12/23/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/23/2011 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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: / .� � Permittee Signature: i r / ^
Call 503.639.4 5 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.
DEC/22/2011/THU 04:32 PM FAX No, P.002
A s
Mechanical Permit Application cb;\ . mit OFFICE USE ONLY
City of Tigard Il&S ct $ 1
SS Received
id n,. 140
iinlarrAMM41 - ■ ■ &
114 " 13125 SW Hall 13Ivd,, Tigard, OR 972 V O Date/By • Ian Revi //
ew
Phone: 503.718 • ' .2439 Fax: 503.598.1960 C. G, ' Other Permit:
TIGARD 4
Inspection Line: 503.639.4175 (.\().. ,
I nternet: .....,..t- bate Ready/13y: El See Page 2 fel
internet: www.tigard accsk.V. Notified/Method; ° An Supplemental Information
CA:,
#:i!*i'0.;i'VC4Vn ' ,";7 :00.$00.* 04,00.4f ..400#0 0 ' 40 , : '
Mechanical penult fees* am based on the value of the work
D New construction a<adition/alterationireplacement performed. Indicate the value (rounded to the nearest dollar) of all
CI Demolition p Other: over head, and mechanical materials, equipment, labor, profit.
1 4 "A
Value: $
:.' 4, icl, ... ,,.....„.., ..,„,,.... ....,.„...,.... ..,...„ .., . ,..‘„ ., .,,......,..,
- — •''. . - , •-•---- - ,.. , • - J ...... — ',----,'• .', - .ig.Pcm.1.0,AA:40,14.01v,g00,f0,74;*::v7.,,:
Etrl and 2-family dwelling 0 Commercial/industrial Q Accessory building For special liVoinatiou use checklist,
El Multifamily p Master builder El Other: Description I Qty. Ea. 1 Total
;:k4ti:Eig.t1%.4i . )'$ Hea"ngic""ng: Air conditioning — • " , ' , .L.a . .... • ' - :: :: - ' • itioning
Job site address: (requires Site plan showing placement) 1 46.75 %, 7 5 "--
Gillingharn, Sharon R11404 Furnace 100,000 BTU (ducts:Mats) ( 46.75
City/State/ZEP: 9605 North Dakota St Furnace 100,000- BTU (ducts/vents) 54.91
Suite/bldg,/apt, n Tigard, Or. 97223 Heat pump
(requires site plan showing placement) 61.06
Cross street/direc (503)639-7352 Duo work 23.32
Hydronic hot water system 23,32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in-wall, induct, suspended, etc. _ 46.75
- "
Subdivision: :
Flue/vent for any of above 23.32
Lot no.
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
'; .,:•.: .; .,•';.': ,;...:,.,,' .„biEgOkilititols,10.:841okk :1'':,,.' : ' 7:. .'.‘; ..• :"..'," Water heater 23.32
... ... , . . . ,.. -
Gas fireplace 33,39
Flue vent for water heater or gas
/ ' °Y' 01.A fireplace 23,32
1 Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23,32
Chimney/liner/flue/vent 23.32
','• ':::,;;',.. ',,;• k,'. ":: f.. '...!;.'!..'•••:. :;_____________________IPANT. . .i , „,
' • Other: 23 32
Name: .(..‘,..s..,,, Environmental exhaust and ventilation:
Range hood/other tdtchen
Address:
equipment 33,39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) Pax: ( )
toilet compartments, utility rooms) 23.32
. — - . . .. . . ..
:::•..,•:.: •,;::, ...,..: ,:. ,': 0 APPLICANV: ',"'.:' :: : '..' : '::..:,.; i ;.:.: ::1:j :c0,10. ,',.'.:.:.:::.. AtIjoicrawisPa9F. fans 23.32
„ .., ..., • , . . .. , . ... ..., ..,.
Other: 23.32
Business name: -
Fuel piping:
Contact name; $14.15 for first four; 54,03 for each additional
Furnace, etc.
Address:
Gas heat pump _
City/State/ZP. Wall/suspended/unit heater
-
Phone: ( ) Fax; : ( ) Water heater
Fireplace
_ -
B.-mail: . ... . , . . . . ,...,„ . Range
':...; '.'.....,'::. :.!;; ;.:. '..•1 • :. • .'.."..:,.• ''' . ;:.... '.....:... .{'!::‘..,.:; :!..! .;!:.'.':.'.,:,, Barbecue
Clt
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 /Ls' ..so
._ Minimum permit fcc ($90.00) --
Phone: (503) 620 Fax: (503) 598-0718 Plan review (25% of permit fee)
CCB lie.: 66578 State surcharge (12% of permit fee) f/. AL .....-----"
. 1 TOTAL PERMIT FEE
• / This is permit application expires If a permit is not ob n d within 1. fl
Authorized signature:
days after It has been accepted as complete,
Print name: Date: D * Fee methodology act by Tr-County Building,Ind .stry Board
1:k2aildina 1 Permitn■M2C-ParnitApp.doc 04/09/10 440-4617T (11/Ca/COM/WEB) 10 IC 9 (-1)-,
DEC /22 /2011 /THU 04:32 PM FAX No, P.003
C A (Ito' .V1
SITE PLAN
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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 {give
Suite #130 S pecialty
Tigard, OR. 97223
HEATING & COOLING INC. (503) 620 -5643 Fax: (503) 681 -0793
www,nec ialitvheatinE.corn
w4'C'ry not c mr/ort 7 / I trOtrl y )u WV!