Permit ._� n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00565
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Date Issued: 10/29/2012
Parcel: 2S103AC07400
Jurisdiction: Tigard
Site address: 12972 SW 113TH PL
Project: Oehler Subdivision: FONNER WOODS Lot: 10
Project Description: Install furnace.
Contractor: SPECIALTY HEATING & COOLING INC Owner: OEHLER, RUSSELL E &
7500 SW TECH CENTER DR SUITE 130 CATHERINE A
TIGARD, OR 97223 12972 SW 113TH PL
TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE: 503 - 598 -1047
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
• Furnaces < 100K BTU 10/29/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 10/29/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/29/2012 $43.25
Occupancy Grp:
•
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
+.Y
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 Notif nter. 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 estions to OUNC by c ing 503.232.1987 or 1.800.332.2344.
Issue By:
....44 Permittee Signatur • o
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.
From: 10/29/2012 10:38 #053 P.002/002
•
Mechanical Permit ApplicalRECEIVED FOR OFFICE USE ONLY
t 31 Of Tigard Receive �24 ,401 /� „ �f Permit No.: NCrA42�d� ...4,45-42 ...4,45-42 a 131 SW Hall Blvd., Tigard, OR 97223 OCT 2 9 2012 Da n R : w l�,At
Phone: 503.718.2439 Fax: 503.598.1960 D an Review
DateB)•: Other Permit:
TIGARD Inspection Line: 503.639 CITY OF TIGARD Date Ready.'By: Juris: ® See Page 2 for
Internet: www.tigard or.gov WOB W DNG � Notified'Method: Supplemental Information
_ OF WORK - COMMERCIAL FEE* SCHEDULE — USE CHECKLIST ,
Mechanical permit fees* are based on the value of the work
❑ New construction p Addition/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 : ,
R ESI D EN T I A L : EQUIPMENT /SYSTEMS"FEES• _
[i'1- and 2- family dwelling ❑ Commercial, /industrial ❑ Accessory building For special information use checkl st.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION' Heating/cooling:
- - — - --- Air conditioning
Job site address: (requires site plan showing placement) 46.75
City/State/ "LIP: Oehler, Tina R12389 Furnace 100,000 BTU (ducts'vents) I 46.75
12972 SW 113 Place Furnace 100,000+ BTU (ducts;vents) 54.91
pump
no.: Heat P mp
Tigard, Or. 97223 (requires site plan showing placement) 61.06
Cross street/directions (503)598 -1047 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.: Flueivent 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/insen 33.39
,(
�� Flue vent for water heater or gas
` , e /i ' � x ryx L _ 4_,t. f--'e t. fireplace 23.32
Log lighter (gas) 2332
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chim
ney'liner. % flue/vent 23 32
❑ PROPERTY. OWNER" : 1 " ❑`
. . ' TENANT -. _ ,
- Other.
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. , , " 0 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 / StateiZIP: WalL'suspended/unit heater
Phone: ( ) 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 #130 . I
,":. . " . . - _•MECHANIGAI:PERMIT FEES! _, =:','...: f:- = - :,
City /State/ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee ($90.00) 90.0°
Phone: (503) 620 -5643 Fax: (503)598 -0718 Plan review (25% of permit fee)
CCB lie.: 66578 State surcharge (12% of permit fee) /0 .go
(44_,,i_c I TOTA L PERMIT FEE /4061 ' re) azure: Thi permit applicatiion expires if a permit is not obtained within 180
Authorized si Sn 1 days after it has been accepted as complete.
1 0/24/(t Print name: Andrea Dripps Date: * Fee methodology sct by Tri -County Building Industry Service Board
I:: Building 'PermiisMEC- PermitApp.doc 01 440.461 — r (IVU2 /COM/WEB)