Permit Ipti
" : f`; CITY OF TIGARD MECHANICAL PERMIT
liC
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00535
h � 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/09/2009
TI g Parcel: 2S103CD07700
Jurisdiction: Tigard
Site address: 11715 SW TERRACE TRAILS DR
Subdivision: Lot: 0
Project: Rone
Project Description: Install furnace and water heater
Owner: FEES
RONE, CLIFFORD G Description Date Amount
11715 SW TERRACE TRAILS DR Furnaces < 100K BTU 10/09/2009 $46.75
TIGARD, OR 97223 Water Heater 10/09/2009 $23.32
PHONE: 503- 639 -7104 12% State Surcharge - Mechanical 10/09/2009 $10.80
Minimum Fee Adjustment - Mechanical 10/09/2009 $19.93
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 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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Ate` uktiff Permittee Signature: .
(n p . C4VI
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.
,, _ _ _ _
.0C1/n/20H/FRI U8:47 AM RECET V E FAX No, P, 001/002
D
Mechanical Permit Application ,-- .'n 1 ."..t• .• .'' -'74+;•,.. ''` '',.'• - U ; .'• . '..." ONI ..''' ,.",:;:. , ,'•`;,,t' .. ,*'..,,.
,ICif F,1(2SA .......%..i:',?-•/. 71. :.,
'n' i City of Tigard
: '. ,il 13125 SWHiifl Hail Blvd. Tigard OR 97223
, ,
i i
... 1p,... :. Phone ! 503.639.4171 Fax; 503.598.1 eirry OF
OCT 0 9 2009
Ki) Received
Date/By:
TiGA ....... Plan Review
Date/fly: Permit Noldie 0
Other Permit:
;..i Inspection Line: 503.639.4175
ING DIVISION Date Ready/By:
ta*:lizawcuid Internet: www.rigard-orgov BUILD
Notified/Method: Jwis: El See Page 2 tor
Supplemental information
W471111/titatiriligr klA ernk
Mechanical permit fees* are based on the value of the work
0 New construction Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition Other mechanical materials, equipment, labor, overhead, and profit.
Figa Ril,M-i;.):Wirrefe Value: $
1...„Jr".:kivi.aoleid...s.:ir.s5=.1sei?.... .., .. mth,g a.,...wo ea ; ill ..5 .ii' , =,:: Tit ••'t.t. ' - .t. , • ; - ,. ,:iwrig ;9 --,- . :
1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
y
Multi-family 0 Master builder O Other: 411- !Er" • ' ,',....1T.""ce.. .,', tailift;P'
For special information tcse cliecIdur
Description Qty. 1 Ea. 1 Total
!Wizilifigiciiii ;
Affiff.45,1.4404.,=--saai-4.'--4....:-MR,..I.L.WW-YlisiiRtigliiillsgalthg eating/cooling
Air conditioning
Job site address: 1 k ) 1 .c- -,..) ` TY. i r 0 4, 4 i„Ac
(requires site plat% showing placement) 46.7
- ..
City/State/ZIP: Furnace 100,000 BTU (duets/vents) l 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suitc/bIdg./apt. no.: 1 Project name:
1-1eM pump 61.06
-
Cross street/directions to job sitc: Duct work 23.32
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
Subdivision: Lot no.:
-. - Other 23.32
Tax map/parcel no.; Other fuel appliances
IMENITAPVEMAP:::44ggpiggirim . ! . .1 .-- -Ao N sookiiireaiR*1:41112"Ivarireingim Water heater i I 21.32 1
1.1151-disogtialgAllgliglImmt.ltv.e.....Zi . : .. ..r . ..,Artimi.i,AmatomA..11:6....akwo.4.6.A..t..
Gas fireplace 33.39
Flue vent for water heater or gas i
I. P ' 111111
,• , 0 ' fireplace
I Log lighter (gas) 23.32
1 23.32
1 . r ' Wood/pellet stove 33.39
. _
Wood fireplace/insert 23.32
'M:' '..,:ItFTMO4 :i..:rg.,1.ikatili., - - . :A., 4,:r.i ChimneYainctifiuevent 23.32 I
:4....,te.1....,:kav,..0„... • .., 1A, 414aliti..;4.rc.418: Other 23.32 1
Name: Rope, Clifford R09310 Environmental exhaust and ventilation
Address: 11715 SW Terrace Trails Drive _ Range hood/other kitchen
equipment 33,39
City/State/ZIP: Tigard, Or. 97223 Clothes dryer exhaust 33.39
, (503)639-7104 Single-duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) 23.32 I
ittalligt.10e. f TAERUENt 1.41t.a* Other: 23.32
Bus Oldrae Ogg AtlicicrawisPacc fans 23.32 I
iness name:
Iruel piping,. ._
Contact name: $14.15 for first four; 54.03 for each additional --
.__
Furnace, etc.
Address:
Gas heat pump J
City/State/Z1P: Wall/suspended/unit heater
_..
Phone: ( ) Fax: : ( ) Water heater
_ - Fireplace
E-mail: .1251ge
etrfitirt:isailiVillviai,*-;‘.1416:0*-1rilhia64112:"414;f614111B1P Barbecue
,................s.e 7: .'abl..1 ....- '. .. is
Cl es d ryer kgas)
Business name: specialty heating & Cooling, Inc. —
-- Other:
Address: 7500 SW Tech Center Drive #130
'i•:• 41 ": ! iltr.b...,,,', ...,..... "...: TIg. i .r.;•% s Vagiliall15
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) 1
CCB lic.: 66578 / State surcharge (12% of permit fec)
- v
• TOTAL PERMIT FEE 1/151)•Se S
Authorized Signature:
This perMit application eXpireS if a permit is not obtained within 180 4
A,./1"</ k rk•- -- \__. days after it has been accepted as complete.
Date: (-' ° 19 / 0 * Fee methodology set by Tri Building Industry Service Board
Frint name: Andrea Dripps
TABuildingTermiuNEC-PormitApp.doc 10/01/09 44o-4617T (11/02/COMAWEB)