Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00281
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/29/2013
Parcel: 1 S125DD04700
Jurisdiction: Tigard
Site address: 9775 SW VENTURA CT
Project: Ball Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 55
Project Description: Installation of A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: SPECIALTY HEATING & COOLING INC Owner: BALL, MIKE
7500 SW TECH CENTER DR SUITE 130 9775 SW VENTURA CT
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Air Conditioning 05/29/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/29/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/29/2013 $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. n /
Issued By: '// Permittee Signature: v /V /1-7 — �0N
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.
F rom: 05/24/2013 12:55 #643 P.002/003
Mechanical Permit Application FOR OFFICE USE ONLY
}y g Received
City of Tigard EIVED Dat : W. i3 '.I ei r Permit No 6-42 e /� elo ZP/
13125 S50 Hall Blvd., Tigard, OR 9 7223 Plan Review �� ��((JJ ��``[CJI
= Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Inspection Line: 5036394175
2 8 201 D a1t ' R e a
T I G A RD . . D ate R e d y ' By: 3uris: �/ ® See Page 2 for
Internet: www.tigard- or,gov Notified Method: '/ Supplemental Information
CITY t OFTIGARD y�r -
TYPE °BI AING DIVISION COMMERCIAL FE SCHEDWLE - USE CHECKLIST
Mechanical permit fees" are based on the value of the work
❑ New construction Et Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
Value: S
CATEGORY OF CONSI'RUC "PION RESIDENTIAL I:QUIP,ME>\'r / :SYSTEMS FEES*
Dom"' and 2- family dwelling ❑ Commercialindustrial ❑ Accessory building For special information use checklist
El multi-family ❑ Master builder ❑ Other: Description 1 Qty. r Ea. l Total
JOB SITE INFORM.A'[ION AND LOCATION Heating/cooling:
Job ( / - Air conditioning ) 46.75
ob site address:
7 7 . �1_ �� ?i- i 7: " ` C- - Furnace 100,000 BTU (ducts/vents) 46.75
City / State/ZIP: 4 'D 4'C • Of 7 L 2. 3 Furnace 100,000+ BTU (ducts, vents) 54.91
r Heat pump 61.06
Suite/bldg. /apt. no.: Project name: Duct work 23.32
Cross street'directions to job site: 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 Vol$RI;6' ` a . � a y... Gas fireplace'insert 33.39
- -- , , ., . r ..,.
Flue vent for water heater or gas
fireplace 23.32
- Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace insert 23.32
Chimney /liner, lue'vent 23.32
r- - Other: 23.32
ler PROPERTY OWNER ❑ TENANT
/ / Environmental exhaust and ventilation:
Name: j2/14, C�-� 'f G.t.C. _ Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
CityiState/ZIP: Single -duct exhaust (bathrooms,
f toilet compartments, utility rooms) 23.32
Phone: ((b) ) LI L' - (a 9 fr 1 Fax: ( ) Attic.'crawlspace fans 23.32
0 ,APPLICANT ❑ CONTACT PERSON Other: , 23.32
Business name: Fuel piping:
514.15 for first four; $4.03 for each additional
Contact name: Furnace, etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/ State/ZIP: Water heater
Phone: ( ) Fax: : ( ) Fireplace
Range
li -mail:
Barbecue
CONTRACTOR y, Clothes dryer (gas)
Business name: Specialty Heating & Cooling, Inc Other:
MECIIAN1C,]L PE1E\HT FEES'
Address: 7500 SW Tech Center Dr #130 Subtotal
City/State/ZIP: Tigard, Or. 97223 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
hone: (503) 620 -5643 ` Fax: (503) 598 -0718 State surcharge (12% of permit fee)
l�0
CCB lie.: 66578 jig 1/ TOTAL PERMIT FEE , efd
.1 This permit application expires if a permit Is not obtained within 180
r days after it has been accepted as complete.
Authorized signature: / ./ i • Fee methodology set by Tri- County Building Industry Scrvke Board
Print name: Andrea Dripps Date: 2-• I/O
1.13uildiagPermns MEC PennnApp_0401 13.doc 440 -4617T (I1:02,COM -WEB)