Permit CITY OF TIGARD MECHANICAL PERMIT
r� CO MMUNITY DEVELOPMENT Pe rmit #: MEC2013 00319
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/11/2013
Parcel: 2S 103AD06200
Jurisdiction: Tigard
Site address: 12655 SW 111TH PL
Project: BARNETT Subdivision: WILDERNESS Lot: 8
Project Description: Furnace and heat pump installation. Placement of NC unit must comply with the manufacturer's clearance
requirements.
Contractor: SPECIALTY HEATING & COOLING INC Owner: BARNETT, CAROL A & CHARLES E JR
7500 SW TECH CENTER DR SUITE 130 12655 SW 111TH PL
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/11/2013 $46.75
Type of Use: SF Heat Pump 06/11/2013 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/11/2013 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types: •
Gas Pressure:
Total $120.75
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: I
Call 503. .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: 06/11/2013 10:30 #705 P.002/002
Mechanical Permit Applicat' FO FO OFFICE 1J51? ON LI',
City of Tigard t�p�� Re / P No.:
{, Date /By: .ii 1 GI
• 13125 5W Hall Blvd., Tigard, 3 ) I P 3 Plan Review '�� ��
• g Phone: 503.718.2439 Fax: 50' ' 8.l96Q 1 r��O*. Date/By: Other Permit:
T I A IL D Ins Line: 503.639 \ , 6 NN c° Date Rcody.'By: 65 See Page 2 for
• Internet: uww.tigard or.gov Notiried'Method: Supplemental Information
,. , . TS'PE OF W . M>~ COM terAt. FEE +..SCHEDCLE. USE CABCKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction 'JAddition/alterat on/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
C3i
Value: $
TEGOJR •O C.OIVSTRUCTION :
: Q _ .1FJ!iT / SYSTEiNS FEE§ ..
`� I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special inforntasion use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I la. I Total
„JOB SI'FE.,IINFO_RMATION AND :LOCATION Heating/cooling: • Air conditioning 46.75
Job site address:
Furnace 100,000 BTU (ducts/vents) 1 46.75 '/(p, - 1 V
City/State/ZIP: Barnett, Carol R13176 Furnace 100,000+ BTU (ducts, vents) 54.91
Suite/bldg. /apt. nt 12655 SW 111 Place Heat pump 61.06 (p / -dam
Tigard, Or, 97223 Duct work 23.32
Cross streetidiree Hydronic hot water system 23.32
(503)620 -9534 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- N OF WORK. , Gas fireplaca'inser 33.39
•
Flue vent for water heater or gas
�,0� C fireplace 23.32
1`. /` J _ _ t � � Log d / pellet sto 23.32
y �Lf[ �/ , Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue'vent 23.32
❑ PROPERTY OWNER • :0 TENANT Other' 23.32
Environmental exhaust and ventilation:
Name: 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 •
' . - o' ARPL'ICANT ., - . -- 0 CONTACT "-PERSON Other: 23.32
Business name: Fuel piping:
$14.15 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
E -mail:
Barbecue
.: r • U Clothes dryer (gas) ,.._.: ... . Cloth d er )
s
Business name: Specialty Heating & Cooling, Inc Other: _ `
Address: 7500 SW Tech Center Dr #130 : - _ -- 4.i0HANI4(iP R MIT Fit. .-'
Subtotal 1 o7. (I
City /State /ZIP: Tigard, Or. 97223 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: (503) 620 -5643 Fax: (503) 598 -0718 State surcharge (12% of permit fee) / A , 19 /
CCB lic.: 66578 r
-'1_1'tTOTAL PERMIT FEE 1aO,') S s/
This permit application expires If a permit is not obtained within 180
;'� �:' d ays after it has been accepted as complete.
Authorized signature: ' L�� ' Fee methodology set by Tri- County Building Industry Service Board
Print name: Andrea Dripps Date: /i f b,
1:.Building\Permiu NEC PemmApp_040113.doe 440.4617T (I 1!021COM. WEB)