Permit CITY OF TIGARD MECHANICAL PERMIT
• '' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00497
Date Issued: 09/22/2009
- 'TIGARD - 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 09/22/2009
D06000
Jurisdiction: Tigard
Site address: 9710 SW LONDON CT
Subdivision: Lot: 0
Project: Arnold
Project Description: Installation of furnace, heat pump and gas fireplace. Exterior unit must meet 3' minimum rear and
side yard setbacks.
Owner: FEES
ARNOLD, MARGARET E Description Date Amount
PO BOX 231178 Air Conditioning or Heat Pump 09/22/2009 $14.00
TIGARD, OR 97223 Furnaces < 100K BTU 09/22/2009 $14.00
PHONE: 503 - 620 -5278 Gas Fireplace 09/22/2009 $10.00
Fuel Piping 09/22/2009 $5.40
Contractor: 12% State Surcharge - Mechanical 09/22/2009 $8.70
SPECIALTY HEATING & COOLING INC Minimum Fee Adjustment - Mechanical 09/22/2009 $29.10
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: Natural Gas
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: 0/1 /Pf'L
Call 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.
S- LP/21/2009/ ON 12:51 PM � .--s FAX No, P, 002
Mechanical Permit Applicatio ' .-= ' u , €)� FOR OFFICE USE ONLY
City of Tigard �) i Received ��� ��
SEP = „away; vZtiZ D tS &"G ,2041 5'9 ,
13125 SW ball Blvd., Ti gard, OR 97223 Plan Review
—S .. q ,_, Phone: 503.639.4171 Fax; 503.598.1960 r r T Dau/B Other Permit:
TIGARD
Inspection Line: 503.634.4175 C 1T\ i ,,. ,,.- r :1Date,ReadyBy: PJ See Pape2for
Internet: www.tigard- or.gov F.1 ,1),5' z ^ 11 i ' ° - Ndtitied/Pvlethod: Supplemental Information
,
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Mechanical permit fees` arc based on the value of the work
0 NCW conStrUction oddition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor overhead, and profit.
:,: Wily , g p v t , .l af= >, }t l ilt % uu tycl (i 4-11 t I r';= ,' ? i p Value $
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rail 1- and 2- family dwelling 0 Commercial /industrial Q Accessory building
t� .li,�i1t tfi •) rwf;, , R�� /rY =ti. �t�i,.�eY7
For spectal irlformatiwrz use checklist,
0 Multi- family 0 Master builder 0 Other: Description Qty. I Ea. Total
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Is;.tt r . € Ileatin /coolie
•-" l0 , Air conditioning or heat pump
Job site address; 1
�^) �, �l (requires site plan showing placement) 14,00
City /State/ZIP: Furnace 100.000 DTI) (ducts/vents) 1 14.00
Suite/bldg. /apt. no,; 1 Project name: Gas heat 100,000+ BTU (ducts/vents) 17.90
Gas heat pump I 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 —
Flue/vent for any of above 6,80
Subdivision: I Lot no.;
Other: 10.00
Tax map /parcel no.: Other fuel appliances
, Ili i ' y r i �t 1 }, z } ) l i .� 1 u11'1 : ee q rl' yf ✓;2! q 1 .4 f t 1{l r i #! z 1111 it i) Water heater 10.00
11,t r''f ' s '� cif, , +L.:ri !: Js . 4 1 A ::: I + ii i i F � )4 5 ',t.�. �I1-11,�H l ){tI!, ;I: ' ; I Gas fireplace 1 10.00
Fine vent for water heater or gas
fireplace 10.00
• lighter as 10.00
C C " �n>�`4 Wood/pelletstove. 10.00
�t Wood fireplace/insert 10.00
f p I ` lamot a 1Ftani;,t m z , i! I s i c•;;^ --n s4:l+.klr< } it t, #tl ,)Il}ta {� Chitnnc /li_ner /flue/vent 10,00
Yti1l %1� f;1,, 4"a l i ,1 4 fi i;t 1I ^J1 ,t i iz l,- l t tt0f)�ill ## i1 �,. Other: y 10.00
fFi
Name: Arnold, Marge R09282 Environmental exhaust and ventilation
Address: 9710 SW' Landoll Ct: Range hood /other kitchen
Tigard, Or. 97223 equipment 10.00
city/State/ZIP: 620 -5278 or X03 703 -0629 Clothes dryer exhaust 10.00
(503)620-5278 Single -duct exhaust (bathrooms.
Phone: ( ) 7 toilet co partmcnts, utility rooms) 6,80
�p1 t I? fll :t ii I)dy�utr ,ih j t') ,,���1i1�11t {
" � t r { al ai }e ° {f 1 f ir l( N 4Ff _ Attic /erawlspacefans 10.00
h, 1. 'i . ;ihtglI .i.., t t�E.Atu.R?.ilii1€ `�J w l ' �.it ti lHllf'III" .A..,.3if �a LILillt"4 a;il 4a'.11 11.1 l � 11 Other; I0.00 •
Business name:
„,. Fuel piping - _
Contact name: $5.40 for first four; $1.00 for each additional
Address; Furnace, etc.
Gas heat pump -
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
--M. Fireplace I
E-mail: }n Range
j `; [ fF S} 1 j� p y y
� flilf # 1 €( HI.l!1 ItllUfil l ltrl {ft illi {} " n1�l t u y } {ttt^Ftilsi }G1Pi I I III ilz.t , PI a ?�� �� { J €� I Barbecue
E t3,i1.;A l i!s € Ik �. 1{ h 1 7 ( } 1 � `E all)ll )))ii lt:ti ,
Business name: Specialty Heating & Cooling, Inc. Clothes dryer (gas)
Other:
�i jlE' " , a 0,; t5 , { }{ 1
Address: 7500 SW Tech Center Drive #130 r,r tli�, {t Jt ) 1t F 1 l .
�
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City /State /ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee ($72.50) 72. . 5'0
Phone: (503) 620 -5643 Fax; (503) 681 - 0793 '
1
V ° Plan review (25% of permit ft:e)
CCB lic.: 6667$ V' J State surcharge (12% of permit fee) a F le
v ° TOTAY. PEY21iIT FEE / -- :- 24/
g (�
Authorized signature: \._1, 0-4-(1^/1 This permit application expires if a permit is not obtained within 180
(� t ' days after it has bean accepted es complete.
Print name: Andrea Dripps Date: 1 * Fee methodology set by Tri- County Building Industry Service Board
l:\ Bui ]dinelPormiis\xtsc-NrmitApp.doc 01 /19/07 440-46171(11 /o1/COMiwee)
SiP /21/2009/MON 12:52 PM FAX No, P. 003
SITE PLAN
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Z I- 7 A1 4) 1V 1
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
SHC 7500 SW Tech Center Drive
SPECIALTY Suite #130
PECIALTY
HEATING
Tigard, OR. 97223
COALING (503) 620 -5643 Fax: (503) 681 -0793
N www.specialitvheatinEcorn