Permit CITY OF TIGARD MECHANICAL PERMIT
.,
: a ' COMMUNITY DEVELOPMENT Permit #: MEC2013 -00226
Tigard OR 97223 503.718.2439
1 3125 SW Hall Blvd., Ti Date Issued: 04/29/2013
Tlt_;AKI_) 9
Parcel: 2S 112 BD05700
Jurisdiction: Tigard
Site address: 15091 SW 79TH AVE
Project: Gross Subdivision: 2006 -004 PARTITION PLAT Lot: 2
Project Description: Install furnace and a/c. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: SPECIALTY HEATING & COOLING INC Owner: GROSS, ANDREW C & ANGELA M
7500 SW TECH CENTER DR SUITE 130 15091 SW 79TH AVE
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 -419 -7850
FAX: 503 -681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 04/29/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 04/29/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04 /29/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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 direUNC by calling 503.232.1987 or 1.800.332.2344.
Issue k „ Permittee Signature: , .r
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.
Frorn : 04/25/2013 10:01 #554 P.002/002
Mechanical Permit Applicatl101LL.CEJVED FOR OFFICE USE ONLY
City of Ti and D ate y , / 3 � j ilteato/S -0O39--
- h' g 2 5
Date By: `� a?5 Per ini, No.:
13125 SW Hall Blvd., Tigard, OR 97223A PR 2 5 2013 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 D Other Permit:
T I G A R D Inspection Line: 503.639 CITY OF TIGARD Date Ready /By: Jura: la See Page 2 for
Internet: www.tigard or.gov BUILDING DIVISION Notified /Method: Supplemental Information
TY PE OF V.ORK C OM M ERCIAL FEE* SCHEDULE •- USE Cl �,
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: $
CATEGORY OF CONSTRUCTION
RESIDF.NTIAL EQI7PMENTI SYSTEMS FEf
❑ 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
30B SITE INFORMATION AND LOCATION u . Heating/cooling:
Air conditioning 1 46.75
Job site address:
Furnace 100,000 BTU(ducts'vents) i 46.75
City/State/ZIP: Gross, Andrew R13114 Furnace 100,000+ BTU (ductevents) 54.91
Suite/bldg. /apt. nc 15091 SW 79 Ave Heat pump 61.06
Tigard, Or. 97224 -_ -_ -.. Ductwork 23.32
Cross street/direct {503)419 7850 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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
. Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
•
- -' ��y �` " Log lighter (gas) 23.32
- ' �' L Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney liner/flue/vent 23.32
Other: 23.32
PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: S �� t r/C Range hood/other kitchen
equipment 33.39
Address: _ Clothes dryer exhaust 33.39
City / State/ZIP: Single -duct exhaust (bathrooms,
- toilet compartments, utility rooms) 23.32
Phone: ( ) Fax. ( ) Attic /crawlspace fans 23.32
❑ APPLICANT `r Offier: 23.32
❑ CONT. PER SON ey rjr
Business name: Fuel piping:
514.15 for first four; 54.03 for each additional_
Contact name: Furnace, etc.
Address: Gas heat pump
Wall: suspended /unit heater
City/State/ZIP: Water heater
Phone: ( ) Fax :: ( ) Fireplace
-- - Range
E - mail
Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: Specialty Heating & Cooling, Inc Other
- MECHANICAL PERMiTTEI $ a i.r =
Address: 7500 SW Tech Center Dr #130 Subtotal . 1
City/ StateZIP: Tigard, Or. 97223 Minimum permit fee ($90.00)
Plan review (25% of pennit fee) --
Phone: (503) 620-5643 Fax: (503) 598-0718 State surcharge (12% of permit fee) /1. 2 9*
CCB lie.: 66578 TOTAL PERMIT FEE A*, 1 A
This permit application expires if a permit is not obtained within 1110
A �
1/2, days after it has been accepted as compkte.
Authorized signature: ' W • Fee methodology set by Tri -County Building Industry Service Board
Print name: Andrea Dripps Date: /2.-i . ,r j
I: PennitApp 040113.doc 440.4617T(I i 02.COM'WEB)