Permit CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2013 -00007
Date Issued: 01/03/2013
TIGARD 13125 SW Hall Blvd.. Tigard OR 97223 503.718.2439
Parcel: 2S114BB16100
Jurisdiction: Tigard
Site address: 10252 SW PICKS CT
Project: Grim Subdivision: RIVERVIEW ESTATES Lot: 7
Project Description: Install furnace.
Contractor: SPECIALTY HEATING & COOLING INC Owner: GRIM, SCOTT R & JENNY K
7500 SW TECH CENTER DR SUITE 130 10252 SW PICKS CT
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 806 -4777
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/03/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/03/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/03/2013 $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.
Issued By: Permittee Signature: /1,(,/ 770,(./
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: 01/03/2013 16:38 #246 P.002/002
Mechanical Permit ApplicatiR>t ,< ENED
City Tigard
Receiv �DO 7
Date By , 3 +{ / Permit N Ee1� / j"
13125 SW W Plan Review
Hall Blvd., Tigard, OR 97223 JAN O 3 ?013 ��
to Phone: 503.718.2439 Fax: 503.598.1960 Date By: Other Permit:
TI GARD Inspection Line: 503.639.4175 CITY OFTIGARD Date Ready /By Jur » See Page 2 for
Internet: www.tigardor.gov Notificd,hletbod: 11 � / Supplemental Information
BUILDING DIVISION
—
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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.
Value: 5
CATEGORY OF CONSTRUCTION} „ RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
t4] I- 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 SITE INFORMATION AND LOCATION Air conditioning
Job site address: I O Z rot `S el ( 3 ' (requires site plan showing placement) 46.75
I Furnace 100,000 BTU (duces'vents) ( 46.75
City /State /ZIP: 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 OF WORK 0: .
Water heater 23.32
- -- — � — — Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
�' Log fighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplaceinsert 23.32
PROPERTY OWNER ' 0 TENANT Chimney /liner /flue/vent 23.32
I Other: 23.32
Name: 1-.[7 -/-- -/ ! Tyr Environmental exhaust and ventilation:
Address: 11 Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Clothes dryer exhaust 33.39
�/ Single -duct exhaust (bathrooms,
/°
Phone: ( ) d Co y 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: S14.IS for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wallisuspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater
Fireplace
E -mail
Range
CONTRACTOR Barbecue
Business name: Specialty Heating & Cooling, Inc Clothes dryer (gas)
Other l
Address: 7500 SW Tech Center Dr 4130 MECHANICAL PERMIT FEES*
City / State/ZIP: Tigard, Or. 97223 Subtotal
hone: (503) 620 -5643 Fax: (503) 598 -0718 Minimum permit fee ($90.00) 9
Plan review (25% of permit fee) '1
CCB lie.: 66578 State surcharge (12% of permit fee) /0 ,6'U
^ TOTAL PERMIT FEE ! l (9O , h ! -
1.� This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: Andrea Drippa I Date:
Fee methodology set by Tn Building Industry Service Board
1 ,� /�j
f. Building `Pamits.MEC- Pn,eeApp.doc 03 07,12 440 -461'r (11'02'COM'WEB)