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Permit Support Document
CITY OF TIGARD *=" ., MECHANICAL PERMIT . s �� COMMUNITY DEVELOPMENT Permit#: MEC2019-00048 Date Issued: 01/25/2019 T-I[;,k R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 111 ACO2600 Jurisdiction: Tigard Site address: 9080 SW PINEBROOK ST Project: Hampton Residence Subdivision: PINEBROOK TERRACE Lot: 67 Project Description: Install replacement furnace. 1/29/19: REPRINT to add(1)gas line. Contractor: SPECIALTY HEATING&COOLING INC Owner: ROBERTS, BARBARA TRUST 7500 SW TECH CENTER DR STE 130 9080 SW PINEBROOK ST TIGARD, OR 97223 TIGARD,OR 97224 PHONE: 503-620-5643 PHONE: FAX: 503-681-0793 FEES Specifics: Description Date Amount Fumaces<100K BTU 01/25/2019 $46.75 Type of Use: SF Fuel Piping 01/25/2019 $14.15 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 01/25/2019 $10.80 Occupancy Grp: (manual) Stories: Minimum Fee Adjustment-Mechanical 01/25/2019 $29.10 Fuel Fuel Types: Natural Gas Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �1 rLiz(, // ;� Permittee Signature: <u b /� .- � Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applicatio;l¶:::('"7:,: ',,, City of Tigard cc;; {{ Received Permit N 13125 SW Hall Blvd.,Tigard,OR 97223 J A 1 i 2 �t L°f Plan Review Other Permit: plate/By. ( �� �5 e20/,.. 6' Phone: 503.718.2439 Fax: 503.59$.1960 Inspection Line: 503.639.4175 DatelBy: Re I I i:; It f) Internet: www.tierd or. ov , " p Date Ready/By: loris: Supplemental See Page 2 for g g ) jet Notified/Method: Supplemental Information + ''''''i.;.:"' " �* , "` .:c- c e'� 1,Y. - ti N '"' r,,- rr - f - .� ±�;. i.f Irl 7c .'',I: . i. C ]i�t.C.P: o i E 'sj r 'i" " � �u4C1lt c./C4 :es*ariase �t � ._i-_-.,(< � ..,.e„ _... 'w ��._...y '�_s#� .t_.... 51.1._a_ �s�-�_+i..d. , _t �.. Mechanical pemtit fees*are based on the value of the work ❑New construction la Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other:,i,,,,4,,..,,, ,...;$... , ..,-- ;..'",'-`:i,1 !£ , mechanical materials,equipment,labor,overhead,and profit. ..,,,g. # 't pfgi-+c y-i f Yi x r+ a ei, 'S 1.; '. ,`t ( _ 4 '" P .. t 1�t11 J�,C �t��0�l,_ sl^'i It/� t SSI (,�, �,.�'' r, g I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special Information use checklist ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total i � Heating/cooling: "g. :4:li;!4cv).L,6 i bi .:--r.-7-2_.:::-':'-'"',/,`',7,,,,,-,1/4, ' ,Air conditioning 46.75 lob site address: so sL✓ f)an.ebtock Drive Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: T', a r R t�"t � Ftunace 100,000+BTU(ducts/vents) 54.91 S Heat pump 61.06 Suite/bldg./apt.no.: Project name:14&#.v j„y •�t 1 e ence Duct work 23.32 Cross street/directions to job site: �" Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: 1 Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 l} PTfO1V0 WORK *F Gas fireplace/insert 33.39 .<f .. Ash .. kj }_ . ... s rr . #6 t .a , ' Flue vent for water heater or gas pleikSe old SRS jJ,E 1.6. T jersr 'I.- - fireplace 23.32 M E e 2,0 t q-000ri$ Log lighter(gas) 23.32 Wood/pellel stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 ,s '° o ,. ., Other: 23.32 �� ` ©.. -4 -'' R m_ � '4 1: "0 r.„ :- °• ( Environmental exhaust and ventilation: Name: M&j,y. 141,. i-Pel Range hood/other kitchen equipment 33.39 Address: f SW p,nel ywk br,r ve Clothes dryer exhaust 33.39 City/State/ZIP: T.' a,,t( c'R ¶7 2�`I Single duct exhaust(bathrooms. S toilet compartments,utility rooms) 23.32 Phone:(St.3) _ 5 - Fax:( ) Attic/crawlspace fans 23.32 �. 3r'.rt Jif-7.,-,7T._..,._^,1i ,.".. gor1 .,!frit .J ,-.,, ,1 T,ti Other 23.32 Business name: ` l bill, Fuel piping: �6C'`t,I,7 1 k 4.1.' '1� f 514.15 for first four;$4.03 for each additional Contact name: ,j,, Mg,rL,1-.e 2 Furnace,etc. ` 176 Address:75 Sw ' J 64.., Dr. 4-130 Gas heat pump WaWsuspended/unit heater City/State/ZIP: 11:5,,,..,1 OA. /71.23 Water heater Phone:($4.3 3 ) b 2.0- SVyi Fax::( ) Fireplace � � Range E-mail: wke . 4 e ,1-4-1 ie'�L.(i .co Barbecue '* . „ r nt i,ti (-r r e 3.7-',I . Clothes dryer(gas) Other' Business name:Specialty Heating&Cooling,Inc �, ?r:Yt T(e'. 7 .::..",.,‘11,-, -.1-1:::0, YY i Address:7500 SK Tech Center Dr#130 Subtotal 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) CCB lic.:66578 TOTAL PERMIT FEE This permit application expires if a permit Is not obtained within 180 days after it has been accepted as complete. Authorized signature: G * Fee methodology set by Tri-County Building Industry Service Board Print name: ��el(' Date: 1-47.5-/'/ City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9080 SW PINEBROOK ST, TIGARD, OR, 97224 March 19, 2019 at 8:47:01 AM Record Type: Record ID: Residential - Mechanical MEC2019-00048 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS - NoCofO Comments: Minor label ELS 696114,699177 Violation Summary: Inspector Contractor