Permit CITY OF TIGARD MECHANICAL PERMIT
1111 v
� � • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00645
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2012
Parcel: 25111 DD12700
Jurisdiction: Tigard
Site address: 8604 SW HAMLET ST
Project: Getgen Subdivision: MILLMONT PARK Lot: 4
Project Description: (1) furnace installation
Contractor: SPECIALTY HEATING & COOLING INC Owner: GETGEN, RICHARD A & CAROL J
7500 SW TECH CENTER DR SUITE 130 8604 SW HAMLET ST
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 598 -8788
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/10/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/10/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/10/2012 $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. �1
Issued By: ✓ , l / ` I � ff I/n. Permittee Signature: O0X1 4 PALS e4 ' fo Al
f
/ 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: 12/07/2012 16:14 #190 P.002/002
Mechanical Permit A licati cEIVE FOR OFFICE: USE ONLY
. City of Tigard R eceived sr IN Permit No.:
q 13125 SW Hall Blvd., Tigard, OR 97223 DEC 10 2012 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 D Other Permit:
T I GA R D Inspection Line: 503.639 V CITY l IG A R D Date Read3:'By: Juris: FA See Page 2 for
Internet: www.tigard - or.gov CITY Notified/Method: 'C Supplemental Information
BUILDING DIVISION
TYPE OF W ORK COMMERCIAL FEE" IQ SCHEDULE; — USE CHECKLIST -
Mechanical permit fees* are based on the value of the work
❑ New construction tddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATE OF CONSTRUCTION-1 RESIDENTIAL EQUIPMENT! SYSTEM &FEES" " -
C1( - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist '
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
. JOB` S1TE INFORMATION AND LOCATION
Heating/cooling:
Air conditioning
Job site address: O G' 0 L( .5 ) 1.4 -`..t t e ,'j - S� (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts vents) / 46.75
City/State/ZIP: Furnace 100,000-1- 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. 4-6.75
Subdivision: Lot no.:
Flue/vent 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/insert 33.39
Flue vent for water heater or gas
e . f , ,r fireplace 23.32
��� 4,..4,..c.-4.--• Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
WPROPERTY OWN_EB . ,. .❑ TENANT Other: 23.32
Name: fro, r ` e - (�,-F j p� Environmental exhaust and ventilation:
Address:
Range hood%other kitchen
equipment 33.39
City /State /ZIP: cr -- Clothes dryer exhaust 33.39
Phone: ( ) (' "'el j � Yg Fax: ( ) toilet )) toilet corn rtments, utility rooms ) 23.32
❑ APPLICANT : - " , . Ej 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 /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 MECHANICAL I
ANI[`sii•PERMITFEES' - -
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 lic.: 66578 State surcharge (12% of permit fee)
TOTAL PERMIT FEE tQt . 2-1) Authorized signature: i ( ^ l This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Andrea Dripps Date: / 1 1 1 // ' Fee methodology set by Tri- County Building Industry Service Board
: Building `.Pennaa.MEC.PenchApp.doc 03 440- 4617T(1 102'COM/WEB)