Permit CITY OF TIGARD MECHANICAL PERMIT
Permit #: MEC2009 -00473
11111 C COMMUNITY DEVELOPMENT
Date Issued: 09/09/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102BCO5100
Jurisdiction: Tigard
Site address: 10675 SW WATKINS PL
Subdivision: Lot: 0
Project: Harms
Project Description: Install furnace.
Owner: FEES
HARMS, DAVE Description Date Amount
10675 SW WATKINS PL Furnaces < 100K BTU 09/09/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 09/09/2009 $8.70
PHONE: 503 - 624 -2510 Minimum Fee Adjustment - Mechanical 09/09/2009 $58.50
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 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: -00�i�� Permittee Signature: 04/
Call 503.639.4176 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.
.. S/04/2009/FRI 01:57 PM FAX No, P. 002
Mechanical Permit Applicatioil EC E Q \I �� • U S 141 OFFICE
City of Tigard Received di Permit xo / ' o/
'+ 13125 SW Hall Blvd, Tigard, OR 97223 SEP 0 4 2009 Plan 11./41,
// 7
' u Phone. 503.639.4171 Fax 503 598 1960 Date/By Other Permir
TIGARD Inspection Line. 503.639 CITY OFTIGAR DoleRoadAY t?l See Page zfor
Internet: wwV,tlgard or.gov
BUILDING DI1 /I�n l f y Notified/Method Supplemental Information
�t��lt:
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❑ New construction I- ' dditionIalteration/rcplaCement Mechanical permit fees' are based on the value of the work
s-.u� performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical matenals, equipment, labor, overhead, and profit
+" ! "? {' 1111! I +tr [ I.t )s;tt a� t' {'u ar���tix•+ i +utyu � u , y S�It f I Ih ,Iii: i .}: ! r 'Value: $
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11th ltl 9 r u,,.uut.,lth. r8,� .:; r9..f ti. Y1l,Gdi∎thi l :3�1t1Iika li. IIY
lj 1— and 2- family dwelling ❑ Commerciai/industrial ❑ Accessory building For special Information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description I Qty Ea, Total
I �l �
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i p r _ Air conditionmg or heat pump
Sob site address:
lQ ( 1 C ,a (,) R r- 'LN 4 1 p k (requires site plan showing placement) 14 00
City /State/ZIP: Furnace 100,000 BTU (ducts/vents) 1 14,00
Furnace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg. /apt. no.. 1 Project name: Gas heat pump 14.00
Cross street/directions to job site; Duct work 10 00
Hydronic hot water system 14,00
Residential boiler (radiator or
hydronic) 14 00
_ Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 14.00
Subdivision: ` Lot no.: Flue/vent for any of above 6 80
Other 10.00
Tax map/parcel no.: k j Other fuel appliances
- 1} 1 , 1r ' 1r i {{ i t ! t •3.1 l i � t ll , 6Ig. t :' ' 1 f" "fi A?'i 1 7 4 . 4 c t ' ::3.1.1:41.1Nilr,t1: 1 1 �� S i' t .111 � W ater heater 10.00 •
, r Gas fireplace 10.00
1) ' `- '�I,GIJ� �� Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10 00
Wood/pellet stove 10 00
{ Wood fireplace/insert 10.00
ilili°Il+k ttl 11 , a ct:''" .!, - ,n� $PtLi iga� o• , I$ �iL41 H81lliill , G !'�1�,:'-u °i,M i �li :!; ;i i f ( � l jv,fil} Chimney/liner/flue/vent 10.00
,1 al�„l Lt , 7,,.,,,olr :c
Name: Harms, Dave R09269 Environmental exhaust and ventilation
Address: 10675 SW Watkins Place Range hood/other kitchen
_ equipment 10.00
City /State /ZIP Tigard, Or . 97223 Clothes dryer exhaust 10 00
(503)624 -2510 Single -duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rooms) 6.80
q l l it. i t+ 1l : h; !� 1ti3 . ` I `1 i i /A1.1.1.55* I 'f ! { ' f J ( 1 � t F l i :' j t 4, ti ; i i t' l°riw+ f i t 1 { l a t , ?� + 1 ' S Attic/crawl pace fans 10, 00 • tAL l us h1 1 ,2 1 ilt4. r;1a ;4 :2. 8 31 4: 11 (1111 1 r ,�r _ ry:u ,r {1iguit tit ,ul4,ltt„t. f 1000
Other:
Business name.
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
—
Address. Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Pax:: ( )
Water heater
Fireplace
E-mail ' Range
I) t +ill i li f t � 1 '1 ° 1 ' i t,']i dll nttib 411 !a R I(! Iirjl l+ llti I t7, �•t! 11t I t' {4 '+1
l ' 2 1 1 11 / ..i� 1 1{ki n t1 F� ,.r i llt i„ Ls�: !1OI i l+' ► {91 111 Barbecue
Business name: Specialty Heating & Cooling, Inc. Clothes dryer (gas)
Other.
Address: 7500 SW Tech Center Drive #130 p I + " ^I 1 I wryest # tl n i i� 1 1 a r, t, ,I s; 8 in
MA I t tljltkik ' itl i p 7` t i i" u �a i ' I rr 11{f'
7 ,-rn,ar d e.it •t t 1 (14:1.::'.1L.1./ dw �f: u I • 1 i. . i.,. 1 r� , 9
City /State/ZIP: Tigard, Or. 97223
Subtotal
Phone: (503) 620 -5643 Fax: (503) 681 -0793 Minimum permit fee ($72 50) /
Plan review (25% of permit fcc) '
,Q/ lic.' 66578 State surcharge (12% of permit fee) j, 78
I �
Al� ' � TOTAL PERMIT FEE • • of
Authorized signature: V Th permit application expires if a permit us not obtained within 180
g o � vY days attar it has been accepted as complete.
Print name: Andrea Dripps Date: (�, `� ° Fee methodology set by Th- County Building Industry Service Board
i\nuitdinglPerndt6 C- PennttApp doc 01/19/07 440 -4617T (11 /02/COM/wEa)