Permit %1 (■ • OF C I TY TIGARD MECHANICAL PERMIT
"LIVOI 'DEVELOPMENT SERVICES PERMIT #: MEC2004 -00530
` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/6/2004
PARCEL: 1S125DD-09200
SITE ADDRESS: 09670 SW VENTURA CT
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 ZONING: R -4.5
BLOCK: LOT: 100 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of furnace and A/C.
Owner: FEES
JEFF STONE Description Date Amount
9670 SW VENTURA CT [MECH] Permit Fee 8/6/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 8/6/2004 $5.80
Phone: 541 579 - 3737 Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 66578 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: ` %C�fl J' /� Permittee Signature: Ct,-P , Ps sp
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bus day
Mecj in :�, it Permit Applica�tiO Op� FOR OFFICE USE ONLY
G �� Received' C `
City of Tigard rd V` Date/By: V— a
g v , 1 A Permit No. i
13125 SW Hall B1 d , Tigard, OR 972
Plait Review
Phone 503.639.1 71 Fax: 503.5 ^ o ![ >. , r ;n ti t Date/By Other Pertrut
Inspection Line: 5)3 639 4175 { t y 4j i '
� _ _ ` --,� Date ReadylBy: 1 ‘..‘s' 0 See Paget !or
Internet: vrAnv.ci.' igard.or •
us � y(° �A= Nonficd/Method. � Cr Supplemental Informatio
i. :..) u ' i l k @INP 4• ' ,. , i *i :,;;e - ; •;b f i CO ' 'SCHEDULE — USE CHECKLIST
• ' ` � .'..''. , ' - " . rYP a ,- • ''I
❑ New constru :tion ❑ Addi$ i ration/replacement ^` Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all i
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
:-.''':''=- 'CATEGORY OF CONSTRUCTION " ;t' Value. $
,' RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
4 1.- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi - :amit ❑ Master builder ❑ Othet For special information use checklist
Description Firty Ea I Total
_. - ;" 0B ANEY LOCATIOtf.• ," Heating//cooling
Job site address l c SL ) /.2 u - Air conditioning or heat pump / 1 v (requires site plan showing placement) 14 00
Ciry/State/ZIP: �",t ,i -,, an G) � Furnace 100,000 BTU (ducts/vents) / 14 00
`� _� Furnace 100,000+ BTU (ducts /vents) 17 90
Suite/bldg. /apt. n ).. f Protect name: Gas heat pump 14 00
Cross stree t/direc eons to job site: Duct work , 14 00 I
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel - type, not electric), 1
in -wall, in -duct, suspended, etc 10 00
Subdtvisio i. Lot no.. Flue /vent for an of above 1 10 00 I
Other. 10 00
Tax map /parcel ro. • Other fuel appliances
' 7 'DESCRIPTION OF \YORK , r ,`i r Water heater 10 00
Gas fireplace 10.00
:q,,,s-,c,<AAL Flue vent for water heater or gas
dl replace 10.00 �� L ` s°T C . fireplace
lighter (gas) 1000
Wood /pellet stove 10 00
Wood fireplace /insert 10.00
.BR )PERTY'„ OWNERS - : ;'L _ • ,
. Chimne�ihner: flueivent 10 00
- . : :� 'kr�N ,.[� ' �`' I'Er t 'aNT;•., � . � , �;= I
Other: 1 10 -00
Name: l y f 61 Environmental exhaust and ventilation
Address: IVY Range hood /other kitchen
equipment 10 00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ($"'i/ ) ;j } 9- 3 . 3 > Fax: ( ) toilet compartments, utility rooms) 6 80
°: _C APPLI '•!•, -". Pik' Ir d'NTA.GI.PE Attic /crawlspace fans 10.00
_ Other. 10 00
Business name: ' ., c L .. ..- l i t' !
f (4,- 1 - 1 6 ' Fuel piping
Contact name:
(
Contact i C C - 1 � .. t r i2...1 r .. 55.40 for first four; SI.00 for each additional
Address: 14 r` i L r-- !- t._' 1..f C. t. Gas heat etc
Gas heat pump 1
City /State/ZIP: I.1't 1 ,' j) `••r —O 0•11- t/ 7. / 1 3 Wall/suspended/unit heater •
Phone: (St' S ) G C ti U - 7 L C Fax:: ( .0 i) f l _ C ) .( -1 Water heater
E -mail: Fireplace
Range
L• ;;'•f.. ;., a iCOITRACTOIU t': ;/'a' ` : -' , :.a •:-i. Barbecue
• __ it ' '
Business name: Clothes dryer (gas)
---- Other: I I
Address:
• Mien - :U FICA :TERN& PEES*
City/State/ZIP: Subtotal
Phone ( ) F ax ( ) Minimum permit fee (572 50) ).
Plan review (25% of permit fee)
I CCB lie.: 6.. t. r • &' State surcharge (8% of permit fee) S . frO
TOTAL PEPJ"UT FEE C"• j ri
.Authorized sight ture: ( '---r • C • c- t- -s------- " This permit application expires it a permit is not obtained within 180
days after it has been accepted as complete.
Print name: , rZCI 6 -f e,_ { I S 1 t ? ! Date: s 7 cq
' Fee methodology set by Tn County Building Industry Service Board
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SITE PLAN
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Specialty Heating & Cooling, Inc.
9528 SW Tigard Street W
Tigard. OR 97223
Phone 503.620.643 Fax 50 3.598.0715
Hil::sboro Phone 503.640 -3607 Fax 503.651.0793
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