Permit „ CITY OF TIGARD MECHANICAL PERMIT
1111 2 :. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00127
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2012
Parcel: 1 S 133DCO2100
Jurisdiction: Tigard
Site address: 11950 SW MORNING HILL DR
Project: Grodem Subdivision: MORNING HILL NO.1 Lot: 49
Project Description: Replace fumace
Contractor: SPECIALTY HEATING & COOLING INC Owner. ROSENLOF, ERIN
7500 SW TECH CENTER DR #130 GRODEM, WADE
TIGARD, OR 97223 11950 SW MORNING HILL DR
TIGARD, OR 97223
PHONE: 503 -620 -5643 PHONE: 503 - 521 -9203
FAX: 503 -681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/09/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/09/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/09/2012 $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: Permittee Signature: yA1 2
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.
MAR /08 /2012 /THU 04:23 PM FAX No. P.002
Mechanical Permit hOR OFFICE LSE ONLY
City of Tigard Received Permit
° 131 W H Bl Ti OR O \1. Daffy "" A / H " eva _z/O2 • Plan Review
Phone 503.718.2439 Fax: 5 Tt.‘cii‘'
Date/By: Other Permit:
II C; A K T7 Inspection Line: 503.639.4175
P
Ins R`Q Date Ready /BY: ions: iii See Page 2 for .
Internet: www.tigard-or.gov `P ��� ``\c � 0 Notified/Method; Supplemental Information
TYPE. 0)F VDO 1� � ♦ �� 1 \"C? . :: COMMERCIAL PEE! SCHEDULE USE CHECKLIST • v Mechanical permit fees* are based on the value of the work
❑ New construction "Addition/alteratiot facement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, e. ui. men, labor, overhead. and profit.
Value: S
. CATEGORY 'Or CONSTRUCTION :. _ RESIDENTIAL EQUYPMENT [SYSTEMS FEES* .. . •
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
Multi family 0 Master builder ❑Other: Description 1 Qty. I Ea, I Total •
' . YOB 'BI'['E.'INFORMATION ..AND tOCA'T]<ON : :: Heatin
Air conditioning
Job site address: (requires Site plan showing placement) , 46.75
Grodem, Wade R12076 Furnace 100,000 BTU (ductsvente) 1 46.75
City/State/ZIP: 11950 SW Morning Hill Dr Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. r Tigard, Or. 97223 Heat pump
(requires site plan showing placement) 61.06
Cross streeddirer (503)521 -9203 Duet work 23.32
Hydmnic hot water system 23.32
Residential boiler (radiator or
hydronic) 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:
. ' . ` DESCRIPTION OF WORK Water heater 23.32
' Gas fireplace 33.39
Flue vent for water heater or gas
11.11/111-,C_—> 6t't/trb94'CL fireplace 23.32
Log lighter (gas) 23.32 '
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
PROPERTY OWNER I • • • . ❑ TENANT Chimney/liner /flue/vent 23.32
• .
f Other. 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39 -
City/ State/ZIP: Clothes dryer exhaust 33.39 ,
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) _ toilet compartments, utility rooms) 23.32
. El APPLICANT . ❑ CONTACT PERSON . Attic /crawispece fans _ 23.32
Business name: Other: 23.32
Fuel piping:
Contact name: $14.16 for first four; $4.03 for each additional_
Furnace, etc.
Address: -
Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace _ ,
Range
CONI RAC71 OR . . Barbecue
•
Business name: Specialty Heating & Cooling Inc Clothes dryer (gas)
Other.
Address: 7500 SW Tech Center Dr Suite #130 MECHANICAL PERMIT FEES* _
City/State/ZIP: Tigard, OR 97223 Subtotal
Minimum permit fee (590.00) 9 • a�
Phone: (503) 620-5643 I Fax: (503) 598 -0718 Plan review (25% of permit fee) - e
CCB lie.: 66578 State surcharge (12% of permit fee) /' -go
/ � TOTAL PERMIT FEE /00 , gQ p
Authorized signature: /�/� Thu permit application expires If a permit it not obtained within 180 �� k,
Alt �_� 4r �� � days after It has been accepted as complete.
Print name: ,,;410, 1 � Date: A-� • Fee methodology set by Tn - County Building Industry Service Board
L B,dld:ng Permits MC- 'ermitApp.doc 09 05 440 -161 (II X03 C01.1• WEB)