Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2013 00434
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/31/2013
Parcel: 1S135AA00804
Jurisdiction: Tigard
Site address: 10161 SW JEFFERSON ST
Project: Lai Subdivision: METZGER, TOWN OF Lot: 5
Project Description: Install heat pump
Contractor: SPECIALTY HEATING & COOLING INC Owner: LAI, DANH DUC
7500 SW TECH CENTER DR SUITE 130 10161 SW JEFFERSON ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Heat Pump 07/31/2013 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 07/31/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/31/2013 $28.94
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 • - ions to • • C by calling 503.232.1987 or 1.800.332.2344.
Issu = • By: I OOP I 0 1 Permittee Signature 0, WI"
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: 07/30/2013 13:04 #894 P.001/002
r ,
,,, ....,, - . • ..:.,:. .- ..- .•_ . • „... . , ,
Mechanical Permit Auplicatio i • EIVC:::':::', , :.::::. 'IF OFFICE :U SE •ON I .•'.':. '''' '::: :•':
. .:
- -
'1 H:': City of Tigard Received ...., „
• 13125 SW Hall Blvd., Tigard. OR 97223 JUL 3 0 2013 Date/By; / ..)/ ADM Pennit No.: /Yee , 4.4 6 , .. v ...3 I
Plan Review
; 2 . :, Phone: 503.718.2439 Fax: 503.598.1960 te:By: Other Permit:
Da
503.639.4175 . Inspection Lin . CITY OF TIGARD Date Ready:By: Juris: rg See Page 2 for
- • Internet: www.tigard-or.gov BUILDING DIVIS!O ' INotified/Method: Supplemental Information
"'-v; '''''' " ' ' o'4ciikutTui:=t
, :'Otiiktia4§ .
A"..: :,,--:,,,,:-,:,,,--, :,,,::: : ,--='..A,,,.,..1:::-,,;i ' 0: ----'-- - — '-' -''• ' ' --.- - ''
Mechanical permit fees* are based on the value of the work
0 New construction 1S-Additionialteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other mechanical materials, equipment, labor, overhead, and profit.
,
oN Value: $
cATEp ii
ipertv.:csik0101 -,.,,,-, ,. ,:, • ,,,,, ;,..:.-., -----,-„-., .,,,- ,, -, =.,-, ----.,,--,..--...--,.....,- .:,..- . --. ..
- - -- - --,, .---,---- - ---,------ --- -------- - --,-- ---- :!.•, .a
1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist
Multi-family 0 Master builder 0 Other: Description
I Qty. Ea. I Total
&JOB .,."-gitt Heating/cooling:
Air conditioning 46.75
Job site address: tb 1 t I ,.. LA D ‘,.... f.p cp ., 4 4..
Furnace 100,000 BTU (ductshents) 46.75 _
City/State/ZIP: T 9,4_,..,0 ci - 7 2- 2-? Furnace 100,000+ BTU (ducts,Vents) 54.91
Heat pump 1 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
Other: 23.32 i
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
;.:P.Ki:,; Gas firePlac&insert 33.39
— Flue vent for water heater or gas
fireplace 23.32
1ft/L-- pt...,,,,, Log lighter (gas)
Wood/pellet stove 23.32
33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
.,.
.t**0:rt:1:'•iV 0
d:ZA:,,VC'•;:::,qirti•?* 23.32
,, ,;ii:;:t:.::::::x4 : , , . Mel.:
•"• • . — - ...". `'-'' " ''' Environmental exhaust and ventilation:
Name: 0 62 ....4 , 1_ L ....,_ 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: (SO) ) 7 .- Li.._ D 1 t) Fax: ( ) Attickrawlspace fans 23.32
ti'400W•Ia a. Other 23.32
Fuel piping:
Business name:
$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
,,,:::.;',:5n:,:a4g'F-,2•:::.-.:"--2r:-...,;'.".,;•Zi.i];.;:iiir,,n-40.tilg*OOt=-1 54•-i-,-,;--g.g;rr.;'t=501kR Clothes dryer (gas)
Other:
Business name: Specialty Heating & Cooling, Inc
=4'...
Address: 7500 SW Tech Center Dr #130
Subtotal
City/State/ZIP: 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) /0 ro
CCB lie.: 66578 TOTAL PERMIT FEE
This permit application expires if a permit Is not obtairied within 180
Authorized signature: tl ik Fee methodology after it has been accepted as complete.
t ology set by Tri-County Building Industry Service Board
Print name: Andrea Dripps Date: -- 2/
o / / 3
1. \ Permits MEC Permit App_040113.doc 440-4617T (II 02/COMVES3