Permit CITY OF TIGARD MECHANICAL PERMIT
• $ COMMUNITY DEVELOPMENT Permit #: MEC2012 -00160
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/29/2012
Parcel: 1 S 134CB10100
Jurisdiction: Tigard
Site address: 12550 SW EDGEWATER CT
Project: Lafferman Subdivision: MILL VIEW Lot: 1
Project Description: Replace furnace
Contractor: SPECIALTY HEATING & COOLING INC Owner: LAFFERMAN, DAN
7500 SW TECH CENTER DR #130 12550 SW EDGEWATER CT
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 -620 -5643 PHONE: 443 - 683 -1321
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/29/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/29/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/29/2012 $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
Utili 'o t ic - •: • 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 d'. ect questions : OU i by calling 503.232.1987 or 1.800.332.2344.
Issued : : .- I � � r/ / Permittee Signet:
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 /28/2012/WED 01:03 PM FAX No. P.002
Mechanical Permit AppliclECEIVED FOR OFFICE USE ONLY
City of Tigard 2 Received •
Date/By: / Permit No.:
Ii
n 131 W Hall Blvd„ Tigard, OR 972 2 R 8 2012 A' M �ee) ` t' -Ga /
Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1060 Date/By: .r i t;n _ a T7 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: /una: IZ See Page 2 for
Internet: www.tigard -or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
• . TYPE. OF WORK . • . . • • COIylMERCIAL FEE* SCHEDULE USE CHEQCUST • Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials. equipment, labor, overhead, and •rofit.
Value: S
CATECORY'OF.CONSTRUCTION . • . „RESIDENTIAL EQUIPMENT / SYSTEMS FEES* .
)ffl- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special informarion use checklist.
0 Multi - family ❑ Master builder ❑ Other: Description _ Qty, I Ea. I Total
.. •JOB SCI' .:xN1FA MATION ATID' LOCATYON ;:. Air conditioning
ing
Job site address: (requires site plan showing placement) 46.75
Ciry/State /ZIP: Lafferman, Dan R12097 Furnace 100.000 BTU (ducts vents) .1 46,75
•
12550 SW Edgewater Ct Furnace 100,000+ BTU (ducts:vents) 54,91
Suite/bldg./apt. no.: Tigard, Or. 97223 Heat pump
. - (requires site plan showing placement) 61.06
Cross street/directioi (443)6834321 Duct work _ 23.32
—`~ Hydonic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 46,75
Subdivision: , Lot no.; Flue/vent for any of above 23.32
Other. 23.32
Tax map /parcel no.: Other fuel appliances: _
•
DESCRIPTION OF WORK ' ` . • • • • • Water heater 23.32
Gas fireplace 33.39
Flue vent for water heater or gas
I fireplace 23.32
''"'` Lo_li_ ter (:,) 23.32
Wood/pellet stove 33.39
Wood firptlacelinsert 23.32 •
PROPERTY OWNER . I ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: • e1.. Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Fax: ) • Single -duct exhaust (bathrooms.
Phone:
( ) ( toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
- Other: 23.32
Business name: —
Fuel piping:
Contact name: $14.15 for first tour; $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
CONTRACTOR Barbecue
Business name: Specialty Heating & Cooling Inc
cry
Clothes dryer (gas)
Other
Address: 7500 SW Tech Center Dr Suite #130 MECHANICAL) PERMIT FEES*
City/ State/ZIP: Tigard, OR 97223 Subtotal
Minimum permit fee (590.00)1 Cff9, '
Phone: (503) 620-5643 I Fax: (503) 508 -0718 Plan review (25% of permit fee) ---""
CCB lie.: 66578 war State surcharge (12% of permit fee) 4290 pi r TOTAL PERMIT FEE
• Tbls permit application expires if a permit Is not obtained within 180 A
Authorized signature: days atter it has been accepted as complete. .' �,
Print name: 1� Date: 3� / ' Fee methodotofi' set by Tri- County Building industry Service Board
I: Building Permiii MEC -p : wpp.rloc 09 09.10 440 -46177 (11 02 COM•w89)