Permit CITY OF TIGARD MECHANICAL PERMIT
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. 2 , ,, COMMUNITY DEVELOPMENT Permit #: MEC2013 00170
T WARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/27/2013
Parcel: 2S110AB03600
Jurisdiction: Tigard
Site address: 14245 SW 114TH AVE
Project: Anderson Subdivision: COLE'S ACRES Lot: 16
Project Description: (1) furnace installation
Contractor: SPECIALTY HEATING & COOLING INC Owner: ANDERSON, TIMOTHY
7500 SW TECH CENTER DR SUITE 130 14245 SW 114TH AVE
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 670 -0650
•
FAX: 503 -681 -0793 •
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/27/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/27/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/27/2013 $43.25
Occupancy Grp:
Stories:
•
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ( /� np �1
Issued By: /24(A C� Permittee Signature: 0 0/(1 H f f C T7o 1U
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
From: 03/27/2013 15:35 #502 P.002/002
Mechanical Permit ApplicatioID EWER . . FOR OFFICE USE ONLY
Cl of Ti and Received c...,,,-- `� g Date By: � - 7 '/ 3 �r Permit No.:ig 0
n 13125 SW Hall Blvd., Tigard, OR 97223 MAR 2 '7 2013 Plan Review ( _00 ( 7
Phone: 503.7182439 Fax: 503.598.1960 D Other Permit:
1'IGARD Inspection Line: 503.639 Date Read .B fu rs:
Internet: www.tigard- or.gov / sIT\/ F T
O i!' A D D Y Y See Page 2 for
CI CITY O IGA. � Notified /Method: 1 Cv Supplemental Information
BUILntN(DIUISIO ,
. , T - SC, D1JLE * `i$SE'CRE `'1ST' -'
: ,. E: OF;WQRK ' , -. OMIMF�Rt:Ir�L � .... •.
:.. ,., ,_ .-:v , __ __ ,._.�� YP -- - • _ .,_ • . , . _ _ _ - :. -- Mechanical permit fees* are based on the value of the work
❑ New construction F' Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
�. , .. Value: $
,._ , , ,.. , Y rEGORY OF CONSTRUCTION ' . -- - - - _ ,..,.� ;. ,
SIDEN77Ati EQlii1!!VI17 /SYb'L -
e '(i] 1- 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
w J4$ S1 • E•' A ND- LO . = e -* • , ':. Heatin
u -- '''• f ' ' .. A cond
Job site address: ( 4 2 t( S'~ Jc. L) / / '1 �/�{ - (requires site plan showing placement) 46.75
/ , Furnace 100,000 BTU (ducts/vents) i 46.75
City/State/ZIP: i t a•-- 02 , CO t! Z Z 3
Furnace 100,000+ BTU (duets /vents) 54.91
Suite/bldg. /apt. no.: I 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 •WOR Wat heat
.. ... ,_.._.._... _.._.. -,- - ._ _ . - ._._ 23.32
Gas fireplace/insert 33.39
r Flue vent for water heater or gas
�fi eplace 23.32
r j �>2.0 t Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney /liner /flue/vent 23.32
-- Other
,_�;_.- ........, T,._._,. ......._..,- 1 23.32
Name: /• 4'1 Environmental exhaust and ventilation:
Address:
Range hoodrother kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (i ■3 ) 4/ )4 •- 6tr5 ZJ Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT _';,, , ; :, _ 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: Walls
uspended;unit heater
Phone: ( ) I 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
_ . .. ,_. .... , . ;11gCA„i1N1CA1<:sPE,�MITFEF _::; W;.isi"_ • 2 • Lt:
City /State /ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 620 -5643 Fax: (503) 598 -0,18 Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee)
TOTAL PERMIT FEE /07) -cij
Authorized signature: , ��� 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: 3/? -7 �/) Fee methodology set by Tri- County Building Industry Service Board
t:. Building ■Permits\MEC- PemitApp.doe 03/0712 440.4617T(I1,