Permit . ,1 1
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00304
41111°,,t6,4, 4 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/11/2006
PARCEL: 1S136DB-02400
SITE ADDRESS: 11642 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Furnace and AC Value: $7870.20
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: IT
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
CHAMPION, RONALD V AND Description Date Amount
ROBERTA E
11642 SW PACIFIC HIGHWAY [TAX] 8% State Surcha 7/11/200€ $15.50
TIGARD, OR 97223 [MECH] Permit Fee 7/11/200€ $193.20
Total $208.70
Phone: 503- 684 -0454
Contractor:
SPECIALTY HEATING & COOLING
7500 SW TECH CENTER DR #130
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503 -598 -0718
PRI 503- 620 -5643
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By:
44.."-e.44_,A. �� Permittee Signature: g7"7 ci � ��
Call 503-639-4175 by 7:00 a.m. for inspections 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.
07/06/2006 10:03 FAX 1002/003
JUL Mechanical pe rmit Ai illication ' r N: ` { i OR O „lt I( I, I” I O \1 l i ++
, Per mit No � �
City of Tigard �s.
13125 SW Hall Blvd,, Tigard, O R; ; _ 2J Day: �/ O� i : C .-0,./ -' •
Phone: 503.639.4171 Fax: 503,598.1 960 Plan Rervl -
Inspection Line: 503.639,4175 r o t l i 17ece/By Other Permit
Internet; www.ci.tigard.otus JUL 0 6 2006 .s _. Dal Na e d 0�M0�Od 4 Reedy/ay; lip' 8 Sea Pogo 2 for
J L Supplemental Information
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❑ New construction RUE: y " `QiiitTon/alibnition Mc henicar penult feet/• aro based on the value of the work
.. performed. indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ Other: mechanical materials, equipment, labor overhead and profit,
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❑ 1- and 2- thmily dwelling 1 � CotntnerCial /industrial ❑ Accessory building
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0 Multi family El Master builder ID Other:
For special information use chaeklttr.
c ',;;,c('',1,.;,, r Inl t1 I 1 Description 1 Qty. i Ea. I Total
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J Air conditioning or heat pump
t!'.i! (requires site plan shewina placement) t 14.00
F urnace 100,000 BTU (duets/vents) 1 14.00
Suite/b1d /apt. no.: • l I l I JIId II�� F umaco 100,000+ BTU (ducts/vents) 17.90
g. p i /. . Gas heat pump 14.00
Cross street/directions to job site; Duct work 14.00
Hydronie hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wail, in -duct, suspended, etc. 10.00
Flue/vent fbr any of above 10.00
Subdivision: Lot no.: Other. 10.00
Tax map/parcel no.: Other fuel appliances
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[� � 1 I f I . I ^ 1 11 _ P � Lt 1 J I 1r`UI J L�II ,I n 1 1 1 IY i I LI pl ['�tll[I a � tlw[ I °i,l }1'r 4tit Water heater IU,00
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s, `. c;.; ,..+,,, c Gas Fireplace 10.00
! L ! " Fl ue vent for water healer or gpS
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
JS f i5F.i,r-- [ ^1� 6 F" f i :n I r ,n,' G -r Chimney/liner/flue/vent
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'Yi ��1 � rrr , P 1111 tit ( , 1 .11 ; � rl. � '. ,; 11111`'r r.1�� 1 j! III 1 , , I' 1 11 1 ,I 10.00
1i.�,11,4.N__.lL 1. 1 .11.,,1.f,1)�'Y,IS,,.il., lL l,.iSA 1Ti� .l�l! IIr. .. IJ�, I�IO� ,v1.L1l:I,..fl „�I�I.L1.11.M1. � F:1_.J� Other , 10.00 0
_
Name: Environmental exhaust and vendlatfon .111 Range hood/other kitchen
Address: dfairrjrliftWillili equipment 10.00
i Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (5503 — b Fax: ( ) toilet comportments, utility rooms) , 6.80
, r i1�1 F [LJ ,r. , ,rJ ,�1 , - , I , ,, I 11 I1 :
, ,r, t i , l } I :,, i' T) iii: I A ttic/crawl 0.00
, • II ,xr J 1 , .. t`6.Y 1 l r r 1 tl'� , , � 1 , j., f , 4 1 tl ; -.) I ,, 1 >; ,I sip ace fans 1
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Business name: , - Other: , 10,00
v - _ • _ _ 0 d e • I r r Fuel piping
55140 for first four; 51.00 for each addltlonal
Fttrnacc, ctc.
` Gas heat pump
♦; _,_ Wall /suspended/unit heater
Phone: ( ) 5 , tIM Water heater
Fireplace
E-mail: aa 1 Range
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., r 1 I ? , :, .. L I Barbecue
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Other. dryer (gas) -
Business name: ,.. = • �__" • � -� i , ! /fry Other. II I i I
Address: l . : ' ,, 111 t''-I I I r1;1 I,o i , . 1 ii17 1 . '�v 1J 1 #77 , l 9 ._ J J I . I tr�,1 I { -. vl IIK1 bi'IlIl
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City /Stine/ZIP: ®, , a pit 9 7 Subtotal
Phone: 6 s ) Fax: 6 • • • 1 Minimum permit fee (572.50) ' .'9
Pl an review (25% of permit fee)
State surcharge (8% of permit fee) / f.aCf
- D � TOTAL PERMIT FEE teri)
�� L, r Y/`[ _ .(/ i not This permit application expires it a permit la t obtained within 180
Authorized signature: "de/ JAL 1 ■ / v /� J days otter It het been accepted et complete.
Print name: Date:
7f L �✓ • Fee methodology set by Tri-County Building industry Service Board
I: 1BU1IdIna lPermI1sM2C- PeAhApp.doc I2/05 44446i 7T(IlN7/COM 0E9)