Permit n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00565
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/09/2011
Parcel: 1 S133DD02200
Jurisdiction: Tigard
Site address: 12878 SW VILLAGE PARK LN
Project: O'LOUGHLIN Subdivision:'ILLAGE AT SUMMER LAKE PARK NO. Lot: 61
Project Description: Furnace replacement.
Contractor: SPECIALTY HEATING & COOLING INC Owner: O'LOUGHLIN, MICHAEL
7500 SW TECH CENTER DR #130 12878 SW VILLAGE PARK LN
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/09/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/09/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/09/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / ermittee Signature: l f��
f
Call 503. • •. by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
DEC/07/2011/WED 01:07 PM FAX Na, P. 002
Mechanical Permit ApplicREC' IVED . FOR OFFICE USE ONLY
City of Tigard Received
Date/By i gym= Permit No.; C ,. I `.--
I ...- .4. 1312$ SW Hall Blvd., Tigard, OR 97 U t f- '7
f 2011 Plan Review
' I . Phone: 503.7182439 Fax: 503.5981960 Date/By: Other Permit:
Inspection Line: 503.639.4175
T I GARD igard Date Ready/By! Z See Page 2 for
Internet: www.t
CITY OF TIGARD Notified/Method:
jiM Supplemental Information
BUILDING DIVISION
.:2 .!•,:,.,,4 ,::,,:.;':.: !..:•:1;ii ,, ..,.,,..•••:.,, - ;,;T:';;:..! ,:::
. Mechanical permit fees* are based on the value of the work
0 New construction ErAddition/alteration/replacement performed, Indicate the value (rounded to the nearest dollar) of all
0 Demolition 1:1 Other; mechanical materials - .lii.ment labor, overhead, and .rofit.
g Value: $
.:! • Y i:;';;; :'.",': '7"' : ...-.....
''''' ''''' ' ''. ' : ) : 1,5
1- and 2-family dwelling 0 Commercial/industrial CI Accessory building For special information use checklist
0 Multi-family I=1 Master builder 0 Other; Description Qty, I Ea. Total
';‘'..:4•4:'h:'.+, Is1,.!. , :.i. ‘.':
Job site address: (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vent4 I 46.75 'it Is
City/State/ZIP; O'Loughlin, Michael R11374
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: 12878 SW Village Park Lane Heat pump
Tigard, Or. 97223 ' (requires site pia Show lag placement) I.
Cross street/directions ti , 503)880 Duct work 23.32
(
Bydronic hot water s 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
1
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
. : .!;!:; ';'..'." .'f ‘.;.:. Water heater 23.32
Gas fireplace 33.39
Flue vent for water heater or gas
A jt1a„.1-&-4•Ct-,E.,LAmi--,a.--, fireplace 23.32
Log lighter (gas) ______ stove M 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23,32
:: ,:':.,,,,;:'.
. Other: 23.32
Name: 42_,IAA-.. :' Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33,39
City/State/ZIP: Clothes dryer exhaust 33.39
- Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
1::1"IkP.PLICANT, ;•,,:. • '•',.•'; '...,', ,:.:...., .;.: CONTACT . 9N.,- ,,,,,, ,•.:: .: Attic/crawlspace fans 23.32
, . . . ,.., ,
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: ( ) I Fax: : ( ) Water heater
Fireplace
E-mail: Range
• , , , .... , ... ,.„ .,.. • : .. ..... • ..,... ": , ..
...,:•• ;.1 coNTR .:.:, :" .‘• ::..,•:,:•,.,••:,•,;!:•:,.,•., : Barbecue
Business name: Specialty Heating & Cooling Inc Clothes dryer (gas)
Other'
Address: 7500 SW Tech Center Dr Suite #130 l', . .:,::':,. ..;:. : ''''::,.:;'::..'...'. •:'"
,..,
City/State/ZIP: Tigard, OR 97223 Subtotal h 6 , 7 S'
Minimum perrnit fee (590.00) TV
Phone! (503) 620-5643 Fax: (503) 598-0718
Plan review (25% of permit fee)
CCB lie.: 66$78 rd•L State surcharge (12% of permit fee) ii), ck.)
TOTAL PERMIT FEE 'aid, 6
Authorized signature: ------N.,_,...- This permit application expires If a per knit is not obtained within 180
days after It has been accepted as complete.
Prh / d ' 7 i / . Fee methodology set by Tri-County Building industry Service Board
Haullaing1Perraiva4RC 09/09/10 440-46 17T ( I 1/02/COM/W613)