Permit •
•
u CITY OF TIGARD MECHANICAL PERMIT
114 ` CMMUNITY DEVELOPMENT Permit #: MEC2012 -00623
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2012
Parcel: 2S110BA02400 •
Jurisdiction: Tigard
Site address: 14570 SW MCFARLAND BLVD
• Project: Hale Subdivision: SHADOW HILLS Lot: 40
Project Description: (1) furnace installation
Contractor: SPECIALTY HEATING & COOLING INC Owner: HALE, ROBERT RUSSELL
7500 SW TECH CENTER DR SUITE 130 14570 SW MCFARLAND BLVD
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 620 -0454
FAX: 503 -681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/03/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/03/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/03/2012 $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 503.232.1987 or 1.800.332.2344. /
Issued By: "r Permittee Signature: D 1�4 APei ATV ad
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: 11/30/2012 16:37 #161 P.002/002
Mechanical Permit Applicatio ' C EIVE , FOR OFFICE USE ONLY
la q City of Tigard Received 1 . � p N
. DateBy: 1 /3 94.167 d lo
D — co
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DEC 0 3 [ i 2 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639 Date Ready. By: Juris: 0 See Page 2 for
Internet: www.tigard- or.gov cr ^a - TIG ApD Notified/Method: - 1 / Y Supplemental Information
t. TXp,EalILDIAIG"DIVISIO.N ' `OF= W OMMERG'lAl: FEE' SCAEDI3I:>:`- pSE:CHECIQ:I_ST :' =', •
Mechanical permit fees* are based on the value of the work
❑ New constructionddition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Di Other: mechanical materials, equipment, labor, overhead, and profit.
- �TEGORX.`OF :CONSTRUCTIO ; ..`
Value:
_ . _ � CA .., .RESIb_ENlAI :,EQUIPMENT %.SY,SfEMS'FEE : e -r ":
1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special Information use checklist.
❑ Multi - family ❑ Master builder ❑ Other. Description I Qty. I Ea. I Total
JOBS[TE 414ORMATI014'.A1 . LOCATIOINC1 - -: ".,,.'`' -. - -`' . Heating/cooling:
_ -" ircon i omng
Job site address: IL{ c ---- 1 o 3-) 1/1 .. i - c -( ]2 t . /t _ (requires site plan showing placement) 46.75
City /State /ZIP: 6 V , } ` / V i Furnace 100,000 BTU (ducts vents) l 46.75
Furnace 100,000+ BTU (ducts vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 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
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
_ DESCRIPTION RIPTION OF:: WORK _ _ _.. Water heater 23.32
- Gas fireplace /insert 33.39
Flue vent for water heater or gas
y 14 � e .4 fireplace 23.32
l.• Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
- Chimney/liner/flue/vent 23.32
:. " :; PROPERTY O*SEAt.. • ;_ : .FTENAIVT.; :. Ot 23.32
Name: 1772 O 0 f ink Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Clothes dryer exhaust 33.39
Phone: ( ) IC .2 - . 0 ` S Li Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
: E . APPLICANT, ::', '. - CONT,AC')t :pgRSON , 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: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
= CONTRACTOR : - Barbecue
Business name: Specialty Heating & Cooling, Inc Clothes dryer (gas)
Other.
Address: 7500 SW Tech Center Dr #130
. ";' : MECAANICALF�Rh1IT"FEES!�• :< :,: '.,.:' =.,'.,
City/State /ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 620 -5643 Fax: (503) 598-0718 Plan review (25% of permit fee)
CCB lie.: 66578 State surcharge (12°% of pennit fee)
�� TOTAL PERMIT FEE /00. PD
Authorized signature:
/ t This permit application expires If a permit Is not obtained within 180
/ J( / days after It has been accepted as complete.
Print name: Andrea Dripps Date: I /) 0 t / L " Fee methodology set by Tri County Building Industry Service Board
I :`. Buildings ..Pamits\MEC- PermitApp.doc 0307'12 440-461 TT (II /02,COttWEB)