Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00565
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/05/2010
Parcel: 2S109AA02500
Jurisdiction: Tigard
Site address: 12990 SW STARVIEW DR
Subdivision: WOODFORD ESTATES Lot: 33
Project: Cook
Project Description: Furnace installation.
Owner: FEES
COOK, LUCIAN W & ELAINE B Description Date Amount
12990 SW STARVIEW DR Furnaces < 100K BTU 11/05/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 11/05/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 11/05/2010 $43.25
Contractor:
SPECIALTY HEATING & COOLING INC
7500 SW TECH CENTER DR #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 $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/ /
Issued By:::- Permittee Signature:
Call .639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
NOV /05 /2010 /FRI 06:47 AM FAX No, P. 002
Mechanical Permit Application FOR (MACE USE ONLY
City of Tigard 1gC ' E'IV E 12eceived
,� PermitNO.: -
. u 13 125 SW Hall Blvd., Tigard, O 3 r Plan Review ..."4..."41. id ' utL r ` � r -
Phone: 503.639.4171 Fax: 503.599.1969 5 201) Date/By: Other Penult
I I Ci A R. L) Inspection Line: 503.639.4175 NO V Date Ready/By: 0 See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
ii OF � ,
�.� r w ,
1:1 New construction I Addition/alteration/replacement
Mechanical Permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
( ;v.. .1 c,., ',.,•,",:):::. •, � ,: o: ; . . :*:.,�; , . , v ;F ,.,.r. -: x:.�. N} .,x ,$ „ - "_..� Value $
y J -. . '..�L •: _-.:. :V ya, . 'u. � ''''�1! ., •, , - I v : • ,.,te' . , !, d , pg ,J t � 17 *
;
� •till, Ilyf•V�' "N I+ 7�>�9�d7FA ��. -T �,. .:�, L, i ' uL .'l' -
1- and 2- family dwelling ❑ Commercial/industrial 11:1 Accessory building YYro
For special information use checklLst.
❑ Multi- family ❑ Master builder ❑ Other Description 1 Qty. Ea. Total
pki 4, '7 7, ''f: je "''b`I 1 .p... G 1 I r , y ay 3 1 7c5 , �F : : : :g ;.;4:04.1iT" ...., . Heating/cooling
� .. �' A 4E1 }..' .. D'1`^'uW[7 �::"ie,lr.'r,.�" : u. ',
Job site address: c� A ir conditioning
1C( q0 JI eine- LA L L.) l (requites site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46. ' l .'1 s-
City/State/ZIP; ( (D
Furnace 100,000+ BTU (dtuct&/vents) 54.91
Suite/bldg./apt.no.: I Project name: Heat putts) 6L06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23,32
Unit heaters (fltel -type, not electric),
in -wall, in -duct, suspended, cm. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other. 23.32
Tax map /parcel no.: Other fuel appliances
r 'r.. a a eNhr�:Y +�Isq-, ec ¢: c, r' <m• t 1 .^t r:; a
� r � `� :�`',. ;+;i:r 1 " „'? ; ;t'�1 t. „� n d Water heater 23.32
. .” ,Ignl tmxraadir ,� n:i 3?`ias:,t:4:'atNa6. s % - ". Gas fireplace 33.39
Flue vent for water heater or gas
S 2}4f4"°J2)1 6E1/%6- fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
;�� ��rr .
. J i +"d • .. `a4e `? e. l �� , �r c jefy r —t y 1 Chimney/liner/flue/vent 23.32
v 3 m ^ir •s n !4t :•{ �. �:. Other 23.32
Name: Environmental exhaust and ventilation
Address: Cook, Lou R10449 Range hood/other kitchen
12990 SW Starview Drive equipment 33.39
City/State /ZIP: T Igaru, Or. 97224 Single -duct exhaust (bathrooms, 33.39 Clothes
Phone: ( ) (503)460 -7688 toilet compartments, utility rooms) 23.32
� a_'
I, ;;: ' ':, * > :' > i : , In r s � „. Attic /crawlspace fans 23.32
r `:�:�dt,il�; : �t ; '�:;}.��r �ti:;�:- x:..'r : a
..,.�:t1�JVet,- ra:a. tcc,::r�lt
Other- 23,32
Business name:
Fuel piping
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: Range
c,
:et' '' t r '.iC':1,. 'V ' e . i@;L a'r-Vm y ., : ip',.',o e. ° ,i4. Barbecue
� ' : 0S A ., • '•' ; i.? . d;l;ffi . ,,, .W • , / . 1 0'J `: ' fir'- r 1 -p .: ''"' iL:�% '/.,,,.. r �
i;N'.'. ,1 . : .1,^ ..t � •. _. .. �i�t,, •2xlh'+ J.y,yu w. AY .�,�. i ..yV a. ,. a. �...I� .:..1 \ .,4.• ,�y;o ::.1; i '. 1: W':.:
Business name: Specialty Heating and Cooling Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Dr #130 liar (r ' ” •.rah ;t'ry
, ;''+'`°:�= �?w=`
. w . 71G dit.A f... .
City/State/ZIP: Tigard, Or. 97223 Subtotal
Phone: (503) 620 -5643 Fax: (503) 681-0793 Minimum permit fee ($90.00) � , Q
Plan review (25% of permit fee)
CCB Iic.: 66578 State surcharge (12% of permit fee) /0 .
TOTAL PERMIT FEE t00, VO
/t� This permit application expires if a permit El not obtained within 180
Authorized signature: �+ days after it has been accepted as complete.
` ) '1'6-County name: Andrea Dripps Date: � Q e Fee methodology set by -County Building Industry Service Board
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