Permit CITY OF TIGARD
MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2009-00672
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/23/2009
[G A R L?; Parcel: 2S104AB05600
Jurisdiction: Tigard
Site address: 12279 SW 131ST AVE
Subdivision: MORNING HILL NO. 4 Lot: 85
Project: Nicholas
Project Description: Install furnace.
Owner: FEES
NICHOLAS, CYNTHIA JOAN Description Date Amount
12279 SW 131ST ST
TIGARD, OR 97223 Furnaces < 100K BTU 12/23/2009 $46.75
12% State Surcharge - Mechanical 12/23/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 12/23/2009 $43.25
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR STE 120
TIGARD, OR 97223
PHONE: 503 - 620 -5643
FAX: 503- 681 -0793
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N ' ion Center. rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or di ct questions to OUNC b allin . 503.246.6699 or 1.800.332.2344.
I sued By: i Permitte Si gnature: • Call 503.639.4175 by 7:00 a.m. for an inspection that busin • : - day.
This permit card shall be kept in a conspicuous place on the job site un 11 completion of the project.
Approved plans are required on the job site at the time of each inspection.
'DEC /17/2009/THU 10:56 AM FAX No, P, 001
Mechanical Permit ApplicatioRECEWED , ' "_, • ;FOR c� - il � t - y$� 14� . '
' City of Tigard Received gj Permit No v 13125 SW Hall Blvd„ Tigard, OR 9722? D 1 7 2009 ?=�' �� ( °2
Plan Review
7 1 n '' • Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
' 1110 '4' 011-
T11 G A Inspection Line: 8 503.639..4175 CITY OF TIGARD Dace Ready/Hv' JUri : 121
See Page 2 for
tnaiw� Internet: www.figard-Or.gov ov NoafiedMethod: TIC Supplemental Information
. BUILDING DIVISION 1
f ^- � L !), 7 i „ �,,'.ic -' ,�'' At—'419, � ,i i rJ' �. w [ j- , 1 � li wd' .,�y Lam . tY y tc� ,� tt l ^ . tl ,,, ,, 1 -4 -� ,+ - - 1
t� l��it v,S 'i F t t•l l l { �,' i t 1 1 - ` ?" y N E ,F,� g ^ F ��; '.' ' .�,.ts..l» l ':1 �w"f t -7 + .. tt t 't ttlf f=A _! y ,'T70 f ieP ] vtktflJ:L" i ' ;:' . #1 - 1 ' . . il � '' w i : I r , }
❑ New construction ,Addition/alteration /replacement Mechanical permit fees* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, end profit.
oZ.� �H ;�,}, � �� ^�a }r . g ;a: �i�n^cWx nst;� - "3'�" Value: $
• 1, ; a a r1.:'. i t l d. edt tl .B ti inL.' t�dd r .c �. 1 '- _
i 10 - t � t. - a 4 t , g a' .� • �. a' 1-� �kk 4 r 1 t + 7 } Y -•:14,1W-1.A4
r- P': iA d7 ` r d9ti i 119 9 i: 1 ' { ; ' 1. 7
Ell - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building • rs "` = ° ' r n * znx :.;t
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
r �} i e sri J.! �{b ti{{:���y3. -vx a, .4 r4,--.11't
` C0r M r .1 I 1I ,.„di %ufLr't#3Wi2: rt • � . 4 : " ]ETeat,ng/coolinl;
`T t' �t giii k m y r S 3 .a..$1.,
WI Air conditioning
Job site address: L 1_, i / t (re tares site nlan showing placement) 46.75
City /State/ZIP: ( t c2 _ "7 2,2- . Furnace 100,000 BTU (ducts/vents) I 46.75
Suite/bldg./apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 54.91
!Teat pump — 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) _ 23.32
�Q w -. Unit heaters (fuel -type, not electric),
I in -Wall, in - duct, suspended etc. 46775
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no Other fuel appliances
�_ X81 5tt 'itist c skit : ..., r Water heater 23.32
°` ' 4' '-' " "' Nicholas, Cindy R09397 ama, _ Gas fireplace 33.39 r
12279 SV/ 131 Ave Flue vent for water heater or gas
fireplace 23.32
Tigard, Or. 97223 Log lighter (gas) , 23.32
(503)590 -5141 Wood /pellet stove 33.39
Wood fireplace /insert 23.32
+ �{ ro}. a Q:1 t +s+ps: -.). Chitnne /liner /flue /vent 23.32
s 4' ilk Z�tZ !^ qtr"` - ' ` e ¢ ny fi� 't .. �_) ' sa n.p .. Y ri r I ,.. , a . —�
"r : •—xi a itLar;) t ' :
a- - w z r : ca Other: 23.32
Name: Environmental exhaust and ventilation ___
Address: w Range hood /other kitchen
equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single - duct exhaust (bathrooms,
Phone: ( ) I Fax: ( ) toilet compartments, utility rooms) 23.32
,e ; ;j �� Attic /crawls ace fans
m 23.32
rill i y y , ill ;a . .. :� ,'3: JEN, :. irl'. "S', 1 11 . -. .43 :> ° t . 1 i :. - i. n . „, :. p
Business name: Other: 23.32
N __ Fuel ,piping
Contact name: 514.15 for first four; $4.03 for each additional
Address: Furnace, etc,
Gas heat pump
City /Statc/ZIP: Wail /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E- mail; ( p } g�ry { t ,J� {} ��ry g Range
,`,, !Ar i ll1 W i We, `M , t ,..� �Kfl.. t w p . ! , t , , lii L "i l0 f •' ', o il - e 'v,� ' , e $ larbev.ue — •
Business name: specialty heating & Cooling, Inc. Clothes dryer (es)
—.— Other: ^�
Address: 7500 SW Tech Center Drive #130 2 4r, 'ti et h 7 i)li,r ' • tar ` .. , (1`.: . 'g
City/State/ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee ($90,00)
Phone :(503)620 -5643 _ ` Fax: (503) 681-0793
Plan review (25 of permit fee)
R
CCB lie.: 66578 State surcharge (12% of permit fee)
TOTAL PERMIT FEE /03 • MO V
Authorized 3i AtUre: J 'this permit application expires if a permit Is not obtained within 180
�/ T "� f days after it has been accepted as complete.
Print name: Andrea Dripps V --a
Date: ( 65
° Pee methodology set by Ili County Building Industry Service Board
t teuilding \PermitSWIEC- PermitApD.doC 10/01 /09 440 /02 /COM/WEB)
Ste{ V-\3