Permit CITY OF TIGARD MECHANICAL PERMIT
1111 • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00422
T t GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/13/2012
Parcel: 1 S134CB16100
Jurisdiction: Tigard
Site address: 12393 SW ANTON DR
Project: McCormack Subdivision: ANTON PARK NO.2 Lot: 88
Project Description: (1) NC Installation Must be placed within 5' side yard setback and approved rear yard setback
Contractor: SPECIALTY HEATING & COOLING INC Owner: MCCORMACK, DANA SUE
7500 SW TECH CENTER DR SUITE 130 12393 SW ANTON DR
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE: 503 - 816 -5010
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 08/13/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/13/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 08/13/2012 $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: O Permittee Signature: t�jJ I' /� f P T 1 L b
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.
AUG /10 /2012 /FRI 01:19 PM FAX No. P. 002
Mechanical Permit Ap plic � FOR OFFICE USE ONIX
�iE.ig r
City of Ti Rece
Tigard Permit
III Date ,� i> Sr 9u6 L� /a1 004-0- -
1 31 2 5 SW Hall Blvd., Tigard, OR 97 � (' Plan Phone: 503.718.2439 Fax: 503.598. 1 `� 2 2 an Review
Other Permit:
Data By
Inspection Line: 503.639.4175
'1' 1 c; A It D Rate Ready By: turfs: El See Page Z for
Internet: www.tigard- or.gov CITYOFTIGARD Notified 'M ethod: -VI A Supplemental lnformndnn
BUILDING DIVISION l
TYPE OF WORK • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees" are based on the value of the work
❑ New construction ddition /alteration /replacement 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*
I -and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
-
❑ Multi- family ❑ Master builder ❑ Other Description 1 Qty.J. T Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: (requires site plan showing placement) 1 46,75
McCormack, Dana R12296 Furnace 100,000 BTU (ducts. vents) _ 46.75
City/State /ZIP: 12393 SW Anton Dr Furnace 100,000+ BTU (duclo vents) 54.91
Suite/bldg. /apt. no.: Tigard, Or. 97223 Heat pump •
(requires site plan showing placement) 61.06
Cross street/directions to (503)816-5010 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, in-duct, suspended, etc. 46.75
Subdivision Lot no.: Flue/vent for any of above 23.32
_ Ocher . 23.32 1
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
i-d9f—'41A(■04-"A 1 // ∎ fireplace 23.32
Log lighter (gas) 23.32
_ Wood/pellet stove 33.39
Wood fireplace/insert _ 23.32
i ROpERTY OWNER I ❑ TENANT Chimney /liner/flue/vent 23.32
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
0 APPLICANT ❑ CONTACT PERSON Anic/crawlspace fans 23.32
Business name: Other. 23.32
Fuel piping:
Contact name: 514.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump _ ..
City /State /ZIP: Wall/suspendediunit heater
Phone: ( ) , Fax: : ( ) Water heater
E -mail; Fireplace
Range
CONTRACTOR _Barbecue
Business name; Specialty Heating & Cooling Inc Clothes dryer (sas)
Other:
Address: 7500 SW Tech Center Dr Suite #130 MECHANICAL PERMIT FEES*
City /State /ZIP: Tigard, OR 97223 Subtotal
•
Minimum pennit fee (S90.00)
Phone: (503) 620 -5643 Fax: (503) 598 -0718 _ Plan review (25% of permit fee)
CCB lie.: 66578 State surcharge (12% of permit fee)
J/._ TOTAL PERMIT FEE / -9r' lc
If T his p application expires if a permit Is not obtained within 186
Authorized signature: k days after it has been accepted as complete.
Print name: Date: v Y Jlt , ' Pee methodology sit by Tri- County Building tudusrry Service Board
1: Buildini Nimbi MEC- PcnniiApp.doe 00 04 10 +1 o I7 (11 02 COM WEB)
AUG /10 /2012 /FRI 01:20 PM FAX No. P.003
SITE PLAN
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STREET
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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 Drive
S pecialty Suite #130
Tigard, OR. 97223
•
HEATING & COOLING INC. (503) 620 -5643 Fax: (503) 681.0793
www.soeciatitvheatins.corn
We'ry not conqurtfb!e worn you are!