Permit , MECHANICAL PERMIT
;a . , CITY OF TIGARD
j f COMMUNITY DEVELOPMENT Permit #: MEC2009 -00685
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/24/2009
Parcel: 2S103DB04700
Jurisdiction: Tigard
Site address: 11145 SW NOVARE PL
Subdivision: GENESIS NO. 2 Lot: 45
Project: Sacks
Project Description: Install furnace.
Owner: FEES
SACKS, WAYNE Description Date Amount
11145 SW NOVARE PL Furnaces < 100K BTU 12/24/2009 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 12/24/2009 $10.80
PHONE: 503 - 639 -1151 Minimum Fee Adjustment - Mechanical 12/24/2009 $43.25
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR STE 130
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct qu- • . • OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued : y: / 0 Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
DEC /24 /2009 /T;HU 11:32 AID FAX No, P. 002
L%
Mechanical Permit Application a °1 °x ...4' �4 . FOR c O v , - ,. � #
City of Tigard CONED
Received : 42 O N ‘0" Perttdt rro �/�se 1 -
f q 131SW Hall vd, Tigard, OR 97; • `1 �- i Phone: 503.639.4171 Fax: 503.598 s • Date/By: Other Permit:
xlr-i ,,. Inspection U A Insection Line: 503.639.4175
4 20 1 6 Date Ready/By: luris: ® See Page 2 for
ki t; t Internet: www,tigard- or,gov �tC h Notified/Method: Supplemental Information
i o
.. 1 9 f s + 't a F t , *� q r a } ¢ 3 1 t" § =' d . , , . d tF 1 = ate x. ,�u ruv.� t k '
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jd�' 1 v..,,. . �:r�4ntiFfiiref i J',tr a ,t 4.i°rl� r _ I3 } {A. ai LYE a 4. 1�,�i- $3 6_'' `t' =cl l • +1 ',:1. t J,' a-(. fnl i •1g • K wsG
u• .,. ii:�t._L'_3.Itr.FF RL'.tlxL�:Y�.- c •
❑ New construction F Addition /altatia • '. . a Mechanical permit fees" are 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, and profit.
«"' l y " �' tr }. �. i S . + i . 5 E Ya i ` ii c ' ` n83� jar
II Value $ • q 4 E 1 k i1 19 t{ 6 p IV G z tl 33
t t r��M ss�Sa i kl .., ' , • •, . ;, a r - } '� 4 , S a `ta = ? s . r-" . t, t -1 ti tf �, r :t k
g'I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist,
❑ Multi family ❑ y, Master builder ❑ Other: Description Qty. 1 Ea. Total
14.• e 1 t+ tt 1 � : �,y2 n 1�1' �' ril 8'!'i li 1 tt1.' .i r ' •''. „' - h,. i. d�F i ;ER
�. ��„><,�.LI�I�.�:� , �.r>rh,�rrak�a�td l �l� .r,��� au- _ L� - -'• ` �t� Igeatlng/cooling
Yob site address: r .4 S: L. N vt/`ct.�l_P ,' . , R. c
_ "� (regires site plan Showing placement) 46.75
City /State /ZIP: Furnace 100 000 BTU (doom/vents) I 46.75
Furnace 100,000+ BTU (ductslvents) 54.91
Suite/bldg. /apt. no.: Project name: yy ' C (4.5
Heat .um. 61.06
Cross street/directions to job site; Duct work 23.32
H dronic hot waters stem 23.32
Residential boiler (radiator or
hydronic) 23.32
- Unit heaters (fuel -type, not electric),
in -wall. in -duct, suspended, etc. 46.75
-
Subdivision: ~ Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
� is K ., 11 i TA - Y „ x '''''' ( (1 5 p + •1.11; 1.4.0 d' r.c Water heater 23.32
m '� { �' I . , t i3 : 1 _., i 4r ` I G -- _ l ��` e £ t � 1 § f ' t° i ∎• 1, h' �1 -1-'
(s.:,: ._ z Gas fireplace 33.39
. 1L, Flue vent for water heater or gas
J
. fireplace 23.32
Log lighter (gas) 23,32
Wood/pellet stove 33.39
Wood fireplace/insert Iffil
'IV 'TAW is % " ` "p rx ti', Ewan r! tea.. a. 71 g� o Chimne /liner /flue /vent
a - I . . l uj l tfty 1
, Oth er: _ ®IIIME
N ame: Sacks, Wayne 809409 Environmental exhaust and ventilation
Address: 11145 SW Novare Place Range hood /other kitchen
Tigard, Or. 97223 equipment 33.39
City /State /ZII (503)639-1 151/(503)701-8936 Clothes d er exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ,� ` y toilet compartments, utility rooms) 23.32
;1L1 il mo i tta r� y r ` p e1. 2 1 1 3 , Attic /crawlspace f ans 2332 • Other: 23.32
Business name: Fuel 1 m
P g -
Contact name: $14.15 for first four; $4.03 for each additional
Address: _ Furnace. etc.
Gas heat pump
City /State/ZIP: Wall /suspended /unit heater
Phone: ( ) -1 Fax: : ( ) Water heater
Fireplace
E -mail: Rance
'
..' '�'• e'1 � a q sir w s n 1 e 4 4 =' r
r. K ,' 4} 1 F 1 + a' ` 13 fi,. �- �l 1 :t: • { , , ,, Barbecue
tiu: . i.li t:s _ . _ t k - ^ > • � • 1' lE � , r1< >,l i t:
Business name: specialty heating & Cooling, Inc.
Clothes dryer (gas)
Other
Address: 7500 SW Tech Center Drive #130 4 MAO' K "n l �. d ' � " 1 i + •
_.. 1 ra 1 � .rr� - tst7�k1 � : , ; tti t rz5: ti
City /StatelZlP: Tigard, Or. 97223
Subtotal ape OO
Minimum permit foe ($90.00)
Phone; (503) 620 -5643 Fax: (503) 681 -0793
Plan review (25% of permit fee) i
CCB lie.: 66378 State surcharge (12% of permit fee) /Q .$r
TOTAL, PERMIT FEE /DO
This permit application expires if a permit is not obtained within 180
Authorized signature: ~ J P_ ; q 7 days after it has beep. accepted as complete.
Print name: Andrea Dripps Date: f �-"� " Fee methodology set by Tee- County Building Industry Service Board
1: 1Building1Permits \MEC- PermitAyp.IOC 10/01/09 440-4617T (11!02 /C0MfWED)