Permit •
•
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00362
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 2S 111 AD13000
Jurisdiction: Tigard
Site address: 15025 SW 89TH PL
Project: Furukawa Subdivision: SCHECKLA PARK ESTATES Lot: 29
Project Description: (1) Heat Pump Must be within 5' side yard setback and approved rear yard setback
Contractor: SPECIALTY HEATING & COOLING INC Owner: FURUKAWA, TOM
. 7500 SW TECH CENTER DR SUITE 130 15025 SW 89TH PL
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 639 -2283
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Heat Pump 07/16/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 07/16/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/16/2012 $28.94
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 503.2332..198877 AGet or 1.800.332.2344. �n/ /1 �) tl I
Issued By: opt./ Permittee Signature: Ok � 1 r 1 ✓/ (i►'1 /� 1 I c
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.
JUL /12 /2012 /THU 11:08 AM FAX No, P,002
Mechanical Permit ApplicatiotRECEI VE
City of Tigard V t o a` -71(4 �( Sr Permit t d,p Id -
IlIl
n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
II Phone: 503.718 2439 Fax: 503.598.1960 JUL 1 2 2012 Date By: Other Permit:
Inspection Line: 503.639.4175
TIGARD Date Ready Curb: See Page z for
�/� R yBy:
Internet; www,tigardirr.gov CITYOFTIGAR Notified'Metbad: 11( Supplemental Information
BUILD!NG DIVISION
TYPE OP WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
—
Mechanical permit fees* are based on the value of the work
❑ New construction ( :14ddition /alteration/replaeement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; mechanical materials, equipment, labor, overhead, and profit.
Value; S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2- family dwelling ❑ CommereiaUindustria! ❑ Accessory building For special lnform:Ion use checklist. -
ID Multi - family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION H eatiarecoolina: ,
Air conditioning
Job Site address: (requires site plan showing placement) 46.75
City/State/ZIP: Furukawa, Tom R12240 Furnace 100,000 BTU (ducts vents) 46.75
r^- Furnace a u n00.000+ BTU (ducts gents) , 54.91
15025 SW 89 Place
Suite/bldg. /apt. no.: P P
Tigard, Or. 97224 -- (requires site plan sltowin g placement) I 61.06
Cross street/directions 503)639 -2283 — Duct 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; 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
fireplace 23.32
A _ ..4 e 1( , _ J .i. Log lighter (Ras) 2332
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 `
(►PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent
_ 23.32
Name: 1 ." Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State /ZIP; Clothes dryer exhaust 33.39
) Fax: Single -duct exhaust (bathrooms,
Phone:
( ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT C] CONTACT PERSON Attic/crawlspace fans 23.32
. Business name: Other, 23.32
Fuel piping:
Contact name: $14.15 for first four $4.03 for each additional
Address: • Furnace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax; ; ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR 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
Phone: (503) 620 -5643 Fax: (503) 598-0718 Minimum permit fee ($90.00)
Plan review (25% of permit fee) _
7CCB lie.: 66578 State surcharge (12% of pennit fee)
TOTAL PERMIT FEE tO• $0 sr ---
Authorized signature: v
/5'� This permit application expires If a permit is nor obtained within I80
days after It has been accented as complete.
Print name; 4 0 Date: ( L, r • Fee methodology set by Tri-County Building Industry Service Board
I: n.;Idrt J Pam ;rt ME C•PermiiApp.dor 09 rr) 10 J40 - 161 Tr (II 02 COM wEa)
JUL /12 /2012 /THU 11:09 AM FAX No. P. 003
SITE PLAN
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NOTE -- Please show the following on the site plan:
-4111
:• 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 Drive
Specialty Tigard, Oft 97223
HEATING & COOLING INC. (503) 620 -5643 Fax: (503) 681 -0793
www. spec ialitvheatine.corn
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