Permit o " CITY OF TIGARD
MECHANICAL PERMIT
14
' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00384
T1GAAD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/29/2009
Parcel: 1 S 134CA05000
Jurisdiction: Tigard
Site address: 11715 SW BURLCREST DR
Subdivision: BURLWOOD NO.2 Lot: 23
Project: Montgomery
Project Description: Install furnace and a /c.
Owner: FEES
MONTGOMERY, TERI J Description Date Amount
11715 SW BURLCREST DR
TIGARD, OR 97223 Air Conditioning or Heat Pump 07/29/2009 $14.00
Furnaces < 100K BTU 07/29/2009 $14.00
PHONE. 12% State Surcharge - Mechanical 07/29/2009 $8.70
Minimum Fee Adjustment - Mechanical 07/29/2009 $44.50
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 $81.20
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 No • ation Cen e Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
or dir questions to OU , - . -Din. 03.246.6699 or 1.800.332.2344.
Iss ed By: - Permitt Signature: i. • . ,� 4
Call 503.639.4175 by 7:00 a.m. for an inspection that b , ess day.
This permit card shall be kept in a conspicuous place on the job si e until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.J /27/2009/MON 10:31 AM FAX No, P. 002
Mechanical Permit Applicati ECEOVED FOR OFFICE USE ONLY
City of Tigard Received Perm;crle.
4 13125 SW Hall Blvd., Tigard, 5 JUL 2 7 2009 D y: N 1 tl Q Q62009 • �"�"`
1 Plat) Review Other Permit:
Phone: 503 .639.417 1 Pax; 503.598.1960 OR 9723 Date/Sy:
•1' I C A RD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/15y: El See Pape 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method; Al' Supplemental Information
� ... • ,.,,. 2 . ° i t' i .: -- '1"r "1 tt; � . � +, e,l1+, ...: � l .. , ; , � ,1 � K r . # ;� r ; . ,�' '„�r f � :_ ,;�1� x - ; n;1cr: r ,, ;1rp i;r faz . a+ :> „ �� ..
1' i �, .;. al' ��"i`. L.. � I , 1 7 t h tlT t� - aYr . IN 1 .I11 r N y:1 # ' , i tl 1. l�r.? ' 1, r. sr r „ , t;3 : f f t# . NF '{ .j �"'b r
?, 3 # ! , IZ • iii `t r� r4li l it r..o:. c . �lr}: ir.9'i •tt:r IL;:IJ, I . It. {: {;.a.:t t 1 i #: r a J : d -r,_ ei'�daN.: r z: ..'" m ,.t.l,+.t.W -4 ' 62t fah .zTic.
❑ New construction ¢ Addition /alteration /replacement Mechanical permit fees' arc based on the value of the work
1L' performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials er Ili I merit, labor, overhead, and ,profit.
I1Ii'ir��F11;:j��,c .0 k ii'., :I1 �`El, to #,l l,{ fie, ,,t. ll 9�S�N t4.i. . t 2,�j� �tti�z t: yl i } `;j ;.{'' `# 'ji ,�rlttr�l'�ki t r { �Ei.:� �'1. �;, Value $
P.R.1 /4? i F � a` t l �l. f" . - atilt f�-S'; a . 1 31 £M. J ' HI. ,3ti li7t"i�FG ee"��CCgix,liTsai tiglt ° l ALL,'r - i•P ;; 6y.Y C " F filif re,.t : k ,.0 S l,tl i (� '
- „tdl[1 Y 1 vt s^•z y r. ., H ='3* :: - r<ira7 d #o- 1 -. ,� - Iw f4 i o U d rf ni! 19 E"tb l tl 7e 'ht 1 '� l� f t99 e, 4'1 1`q S 5y + ' 5
2 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 1 `' lj” 1 rs '` a.r. 3a l�da io. ..r ! '" 13t "1{ t tI�
For special information use checklist.
❑ Multi - family 0 Master builder ❑ Other: _Description I Qty. I )tea. I Total
Ur 1 i H 111 ,sa I t f 1 , W7 ra 3L: 7ri'Y I sz
it }}�� 1 8 `'' tr)! 1 9 l't p - uu °i �tig' i;° e e r ki tuo Ij
Illl��� f s . �! z}1�����fi "- � Cl • rtrat. to .r�r:z.r , .tf r t " . all Heating/cooling
Sob site address: 1 I I- t■ Air conditioning or heat pump
moires 3115 .lam showin• 'keement 14,00
City/State /ZTP: Furnace 100,000 BTU (ducts/verin) 14.00
— Pomace 100,000+ BTU (duets /vents 17.90
Suite/bldg. /apt. no.: Project name: _ • Gas heat pump I 14.00
Cross street/directions to job site. Duct work 10.00
Flydronic hot water system 14.00
Residential boiler (radiator or
hydroni) 14.00
Unit heaters (Thel.type not electric),
in -wall, induct. suspended, etc. 14.00
— �ot no.: Flue/vent for any of above 6.80
Subdivision:
Other: 10.00
Tax map /parcel no.: Other fuel a rliances
f t :., r>H a.+ 1II tk' t 1 g t lruyt s N1rlr'r s 1 1y ,: r Ills! al P T,1 rt ; l Water heater 10.00
I,r, : #r 1 >1 ,fl i1 a , 'l ' l � �,. ,. . 114► " .. 1 1 ! l t 1 i l f!
r i Il f � 1 .. �It.L f t l l�s; ,:t,- :rs #ilc u u t : s m l .t,lt k!•� 1 1.r .11�.1,I l i It 'w Gas fire i lace 10,00
Flue vent for water heater or gas
Kat -�/' firer lace 10.00
�' r / ` s ` Lo lighter gas 10.00
Wood /pellet stove 10.00
Wood fire ilacelinsen 10.00
z
PLi�'�1 a.,. a ,. . o. i1,1,:,,,,, r,,m- i '. r , ti It , :f 1� IPl4.o'F 'asat! , r`1' l y 1 1
z1 jl�S l j'° Chinme /l i ner /flue/vcat 10.00
i a 1 1! it ?, i' rl,ft{ f. Other 10,00
Name: Montgomery, Tell R09200 Environmental exhaust and ventilation
Address: 11715 SW Burleres't Drive Range hood /other kitchen
Tigard, Or. 97223 e uirmcnt 10.00
City /St.ate/ZLP: Clothes d er exhaust 10.00 li
(503)312-3880 Single -duct exhaust (bathrooms,
Phone: ( ) toilet corn .artmcnts, utility rooms . 6.80
r I 1 t ty u. !ta 1 r1 1 # nt't( p « 1 turf,,! qG { t r}yu -zl; �! 7c 10.00
r •f lr 1 .. .' t `t, G ilik 1 1 3 1/111 lilt 1 y ' 6 9 T 3,1 il•�` ' I a r 11 'h11i r . ;i,�ili.rld1�
Attic/crawls "' ' Other: 10.00
Business name: Fuel i in
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace. etc. µ _
Gas heat pump
City /State/ZIP: Wall/suspended /unit heater
Phone: ( ) — 1 Fax:: ( ) Water heater
Fire lace
E -mail: Ran • e
• Ni 1 , 1 5 r1 i , q. t a 1 ?. i -Lrt rt .b t .Li., I l , I . ` I r . : . t r . G a :�E B
Business name: Specialty Heating & Cooling, Inc. Clothes dryer as
Other: �y ?�J'
Address: 7500 SW Tech Center Drive #130 l r; a, y�j�. (sr�b >f►f�1f1?
1' Air ca.. sri} Ainr 4;6. luH
City /State /ZIP: Tigard, Or. 97223 Subtotal MOM O
Minimum permit fee ($72.50)
Phone: (503) 620 -5643 Fax; (503) 681 -0793 Plan review (25% o of permit fee) i
CCB lie.: 66578 State surcharge (12% of permit fee) ' I •
Ck-■j- TOTAL P Tills FIJI 1�Q This permit Application expire* if a permit is not obta;ae within 1,
Authorized signature: n y �t days after it has beer, accepted as c
[Print name: Andrea ))ripps Date: . / ,r- 1 / O� • F ee m set by Tri.Ccunty Building Industry Service Board
1:1 Building \PtrmlccMPC- PermitApp.doe 01 /19/07 440 -4617T (I r /OLCOM/WEB)
JU /27/2009/MON 10:32 AM FAX No, P.003
ITE
LAN"
Lr, S
0
PL
AL
/ G &•r s P1}NCL P
(r (31l 6,6,
Pt
teNJ
STREET
•
NOTE — Please show the following on the site plan: } •
Location of Indoor Unit and Outdoor Unit
• Indicate how the flue will be run (thru the roof — out the sidewall — etc)
• Indicate with dotted line how'the lineset will be run and approx. distance
• Indicate .how the condansete Will be run
SHC 7300 SW Tech Center Drive
SPECIALTY Suite #130
HEATING Tigard, OR. 97223
C Q O L hN G (343) 620 -5643 Fax: 7503) 681.0793
, - www.svecialirvheatinz,com