Permit CITY OF TIGARD MECHANICAL PERMIT
• 3 COMMUNITY DEVELOPMENT Permit 0: MEC2009 -00472
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/09/2009
Parcel: 2S103BCO5700
Jurisdiction: Tigard
Site address: 12255 SW TIPPITT PL
Subdivision: Lot: 0
Project: Micallef
Project Description: Install furnace.
Owner: FEES
MICALLEF, RICO F Description Date Amount
12255 SW TIPPITT PL Furnaces < 100K BTU 09/09/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 09/09/2009 $8.70
PHONE: 503 - 810 -7882 Minimum Fee Adjustment - Mechanical 09/09/2009 $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 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: � J PermitteeSignature: el t7 e/9---770,1 •
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 ;r/04 /2009 /FRI 01:10 PM FAX No, P. 002
n c ,C�l'f
Mechanical Permit Applica �n i _ ' FOR OFFICE USE UNLY
II City of Tigard { Received - p� !�� ' tN�' EC�2009-40 7
'e 13125 SW Hall Blvd., Tigard OR 97223 S E P ®4 2009
I • Ph one: 503.639.4171 Fax: 503.598.1960 Plan Ravi: Other Permit:
, Date/fly:
T I GARD Inspection Line: 503.639 CIT OF TIGA D Date Ready/By: /uric 57 see Page 2 for
Internet: www.tigard -or.gov 1/� ( z ! , Notified/Method 77 - Supplemental Information
BUILGI�!'.) UIVIS.OP�
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Mechanical permit fees' are based on the value of the work
❑ New construction [, Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit
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-�1 and 2- family dwelling El Commereial/industrial El Accessory building
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For special information use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I En. Total
7 : tti M0 1Ti:rtnli „ - s V; i1A : { I is �::!ei!rtcr "1: 1 = ' :`i;li i { i i }ICI ;: �Ilh ;l: ?i i iyg.i:e
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Job site address: -7 -7 e, a Air conditioning or heat pump
r� [.. lit) � l QL ri�CL (requires site plan show placement) 14.00
City/ State/ZIP: ! I Furnace 100,000 BTU ( ducts/vents) j 14.00
Furnace 100.000+ BTU (ducts/vents 17.90
Suite/bldgJapt. 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 (Tel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
l tr; }!: 7' ::iii ii i1
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..`,' ! 1'ri= _` ; : " : r Gas fireplace 10.00
Flue vent for water heater or gas
LR.A. eb,„„,,-•-4.4._. Log fireplace
gh 10.00
Log lighter (gas) 10.00
Wood/pellet stove , 10.00
Wood fireplace/insert 10.00
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1 1.7,' UK; ;F~ '1 :'Mi!I li',:Mi1`„'"i'F' ^1 ;a;�∎11/ i Ti 'Ii:filig Chinmey/liner /fluc/vent 10.00
isti , ,1 { II U ..i. .i.i ' I,G;t l lul l 1' KI i� ..i,si'a
Etc` 10.00
Name: Micallef, Rico R09270
Environmental exhaust and ventilation
12255 SW Tippitt Place Range hood/other kitchen
Address. Tigard, Or. 97223 equipment 10.00
City/State/ZIP: k503)810-7882 Clothes dryer exhaust _ 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) 6.80
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. i Attic/crawlspace fans 10.00
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Other. 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
^
-
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
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Business name: Specialty Heating & Cooling, Inc. Clothes dryer (gas)
Other.
{ , • t ii ':. i- a: :::%'.. i, ly PP llIF u� Ic I ;l ' t , ..
1 ! ; E i-i 'f
Address: 7500 SW Tech Center Drive #130 { . ; L. 1: il:ih 1il r, :Ij' ik :::: i. aa : il,l.<<4 -,: i = iil �{. ! r�:L ii i' tciL,
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City / State/ZIP: Tigard, Or. 97223 Subtotal
Phone: (503) 620 -5643 I Fax: (503) 681 -0793 Minimum permit fee ($72.50) °f p, ,5 a
Plan review (25% of permit fee)
k''f CCB lic.: 66578 State surcharge (12% of permit fee) J 70
r
TOTAL PERMIT Tt a D
Authorized Signature: This p ermit application expires if o mtIsTFEE permit Is not obtained within' 180
r days after it boa been accepted as complete.
Print name: Andrea Dripps Date: -,CI S' • Fee methodology set by To- County Building Industry Service Board
1:1Buiding\Po niuV C-PermiIApp.doe 01/19/07 440 -46171 (I idnicoM/WP2)