Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00153
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/23/2012
Parcel: 2S111AA06700
Jurisdiction: Tigard
Site address: 14340 SW 90TH AVE
Project: BELDING Subdivision: GREENSWARD PARK NO.2 Lot: 53
Project Description: Replacing furnace and installing a tankless water heater.
Contractor: SPECIALTY HEATING & COOLING INC Owner: BELDING, STEPHAN P & JENNIFER M
7500 SW TECH CENTER DR #130 14340 SW 90TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 • PHONE:
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/23/2012 $46.75
Type of Use: SF Water Heater 03/23/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/23/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 03/23/2012 $19.93
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: L Permittee Signature: • / ` `
•
Call 503.639.4175 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.
•
MAR /23/2012/FRI 10:31 AM FAX No. P.002
Mechanical Permit Application FOR ohFlce USE ONLY
City Tigard Ti a nd Re0Q1V0d _
3
1 Dnte(By: . »> _ S
a 13125 SW Hall 131vd., Tigard, OR 972 r....0 ^� 1 ti Plan Review
e Phone: 503.718.2439 Fax: 503.5 ��' ro Dare/By: Other Permit:
T I t . A r, n Inspection Line: 503.639.41 T5 V � , : 1,71 See Page for
Internet: www.tigard- or.gov `�Q C � \C?� SSupptemental Information
O
. TYPE OF WORK ON ",c). \•` CommERC AL FEE* .SCE1D10LE — USE CHECKLIST .
\\.. Mechanical permit fees' are based on the value of the work
El Now construction t[.f+pCddition/ alteration /re ement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other, mechanical materials, equipment, labor, overhead, and profit.
Value: $
. • CATEGOtty o::. CONSTRUCTION • .
RE5IDENYIAI:tUIPMENT / SYSTEMS FEE$`
( and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family 0 Master builder ❑ Other: Description I Qty. 1 a. I Total
::
`30$ SITE ii∎r 'ORMeI'I'ION Am& iocAJ< > ` , . Heatinp/coolitg:
Air conditioning
Job site address: (requires site plan showing placement) 46.75
City/State/ZIP: Belding, Jennifer R12091 , Furnace 100,000 BTU (ducts/vents) [ 46.75 4 6 i ) 7"
14340 SW 90 Ave Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt. no.; Tig Heat pump
ard, or. 97224 (requiree sire plan showing placement) 61.06
Cross street/directic (503)620 -5007 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
Subdivision: Lot no.: Fluelvent for any of above 23,32
Other. 23.32
Tax map /parcel no.: _ Other fuel appliances:
•
• . DESCR1TTION OF WORK. . '• . • Water heater 1 _ ^ 23.32 9.3, 37_
•
Gas fireplace 33.39
A.(9 c/fArt Nb,Clt � —ALL Flue vent for water heater or gas
fireplace 23.32
t9- LA) ^.}n Log lighter (gas) 23.32
�iJ�"t Wood/pellet stove 33.39 —
Wood fireplace/insert 23.32
Chimney/liner /flueJvent 23.32
. ❑. PROPERIY.OWN I ❑ TIEIVANT Other 23.32
Name: S /1 Ll n Environmental exhaust and ventilation:
Address: l/""�'� Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Clothes dryer exhaust 33.39
- Single exhaust (bathrooms,
Phone; ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
• ❑ APPLICANT • ❑ CONTACT PERSON . Attic/crawlspace fans _
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: ( ) Fax; ; ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue _
Business name: Specialty Heating & Cooling Inc
Clothes dryer (gas)
Other
Address: 7500 SW Tech Center Dr Suite #130 MECHANICAL PERMIT PEES* •
City/State/ZIP: Tigard, OR 97223 Subtotal '70. Q 7
Minimum permit fee ($90.00) TO. 043
Phone: (503) 620 -5643 Fax: (503) 598 -0718 Plan review (25% of permit fee) --,- J
COB I ic.: 66578 State surcharge (12% of permit fee) 11 �"°
TOTAL PERMIT FEE � J"""
This permit eppaeanoe expires if a permit Is not obtained within ta0
Authorized signature: days after it has been accepted u complete.
Print name: �.� (!} I Date: C / �/
7 P, � 1 1 a Fee methodology set by Tri- County Building Industry Service Board
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