Permit 11 - ✓; CITY OF TIGARD MECHANICAL PERMIT
; - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00494
lic w 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 09/18/2009
Parcel: 2S 111 AB06900
Jurisdiction: Tigard
Site address: 9220 SW INEZ ST
Subdivision: Lot: 0
Project: Brown
Project Description: Install furnace.
Owner: FEES
BROWN, RONALD R & KATHRYN L Description Date Amount
9220 SW INEZ ST Furnaces < 100K BTU 09/18/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 09/18/2009 $8.70
PHONE: 503 - 598 -2339 Minimum Fee Adjustment - Mechanical 09/18/2009 $58.50
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR STE 120 •
TIGARD, OR 97223
PHONE: 503 - 620 -5643
FAX: 503 - 681 -0793
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N 'cation Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You ay obtain a copy of the rules
or dir ct questions to O. NC by call 503.246.6699 or 1.800.332.2344.
Iss •d By: • i t o 4 Permittee Sig ature: 7_ , Q`iri
all 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
-J, 72009 /FRI 02:11 PM FAX No, P, 002
Mechanical Permit Application C.% FOR OFFICE 115E ()NLY
nroIs,n rQ , 3Le ceived
City of Tigard , eV 1)ate/By: y l �o / - '. lei - co l
/ 'a 13125 SW hall Blvd., Tigard, OR 9 F , . IZ dO Plan Relics)
1 : Phone: 503.639.4171 Fax: 503. f c Daro/ily: Other Permit;
Q 9
TiGAAD inspection Line: 503.639 4175 j'�, /� � Date Ready /By: H See?age 2 for
Internet: www.tigard- or.gov f . Notified/Method: 7( Supplemental Information
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❑ New construction kddition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
tit {. rl x t r = J} �S > :r {{ :-:tu { { ar • z � s +1l ���,$ t. nt+!' J",'r !r� l.i:xl rlx l +a '. F l i'+= +I Value: $
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x "! 1 1ilill r, t r it ,iu r1 { +l zF{+' in ill`k ' . . 4 ;�f -fill nfl 1 ` ?ds i e r , f
w' 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special Information use checklist.
Multi- f0 ❑ Master builder h
er ❑ Other: ❑ Y Description Qty. I Ea. Total
! 1 , 1 -t Fart It r r 1 u , fJ y'!,l'sr +y } i3 Uy c..lW. { tl }1 = }t[ 1 1 s t f 1} jtii
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Job site address: qq Silva_ Air conditioning or heat pump
�i (� S.� ✓ (requires site plan showing placement) 14,00
City /State /ZIP: Furnace 100,000 BTUSdects/vcnts) t 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg, /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site; Duct work - 10.00 ,_
" Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
- Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended. etc, 14.00
Subdivision: Flue/vent for any of above 6.80
Lot no.:
Other: 10.00
Tax map /parcel no.: 1 t Other fuel appliances
t ,F i t} t , ) , l t t L t �.l i Ufa ! r., ltd 1 y °}H r } { Hsi }, S� Jlf t' i r 1, ; f i #1 t I I i ll l Water heater 10,00
ii i' �ll� r ►� I 4,
. 1 #j,1,1 ii�lr�f1 rrli , U i 1 I t }1 I# I I ,1 + err# !l ! ?T�,. R
,1 # ifl? dtfr wuty iar!t .1 .Lf. d.Ylo s R..,.: a.,,, }.t{ Oltu .utuul i .111.1.,•••1" Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Lo: lighter as 10.00
Wood/pellet stove 10.00
Wood firepl /insert 10.00
1+ } a I ,r1! Iii; ' i .at i f ii S >, rtu (y# ;fire {e: i1Kt'' t l t; J ll E ' E 1 t i d F ' , l 1 , vft ., + i+ f 11 v I li ply 1f1( Ghiinne /liner /flue/vent 10.00
1 ti ti iii f �:J y & it 4i ' : , , . { i I' f l 'A 1 . . , 'i, � k i' p I ii ; ,AM .1�1 I I1 ?1:I,' ' 1 00
Other: 0.
Name: Brown, Kathryn R09280 _ , Environmental exhaust and ventilation
Address: 9220 SW Inez St. Range hood /other kitchen
equipment 10.00
City /State /ZIP: Tigard, Or. 97223 Clothes dryer exhaust • 10.00
(503)598 -2339 Single exhaust (bathrooms,
Phone; ( ) toilet compartments, utility rooms) 6,80
1br.J,�11 1 1s1 }' ED t` "r!� i 1. i, ,/iii }a + f {j4{II (i„:1U1,1 . ,1 � alg "� }.ifigif %.tu� il:�Fl:6 #:� �{Ii Attic /orawlspa fans 10.00
(111 J!!1 ....� {nl l:: #K {rAMJ.: f I.t d. „„
Other: 10.00
Business name: R uel
,,. piping
Contact name: $5.40 for first four- $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/Statc/ZIP: Wall /suspended /unit heater
Phone: ( ) Pax:: ( ) Water heater
. Fireplace
E -mail: Range
J ' 1 Iii 1. I !I ¢ l xl 1 lig ' i i� 1 � °L it 1 ! 4 1 1 ) 1 i 4,#,,.:( i 7 1'I' i 't i 1t # L r l i Barbecue
Busin name: Specialty heating & Cooling, Inc. Clothes d er
Other.
Address: 7500 SW Tech Center Drive 11130 � { {11F1 r i 6 +R k #4 > iia ' r ie f t )�p P ;I }, i ts / 'n # # ) i t {i11 €I 1 11
l , 4 27., ,, 11G 411 � `' . . i f r l Islis :U.:tflf{11.11I{sk.�ussi d i a b.s.m44 4.11lIi a sip > 1 '1 , 91
City /State /ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee (872.50) /91 • S
Phone: (503) 620-5643 Fax: (503) 681 -0793
Plan review (25% of permit fee) t9
CCB lie.: 66578 State surcharge (12% of permit fee) ; . 7D
TOTAL PERMIT FEE ' 1
Authorized signature; ( Q This permit application expires if n permit is not obtained within 180
C^ l_A� � III days after it has been accepted as complete.
Print name: Andrea Dripps Date: W 2 A f!'—'11 ! . Fee methodology set by Tti- County Building industry Service Board
I :\Boiidls5\Perrnita\M5C PermitApp.doe 01/15/07 440-4617T (11 /000MAVEr