Permit CITY OF TIGARD MECHANICAL PERMIT
•
IS • ' COMMUNITY DEVELOPMENT Permit #: MEC2012- 00604.
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/21/2012
Parcel: 2S103CB05900
Jurisdiction: Tigard
Site address: 12237 SW HOLLOW LN
Project: Pistacchio Subdivision: QUAIL HOLLOW - EAST Lot: 8
Project Description: (1) furnace installation
•
Contractor: SPECIALTY HEATING & COOLING INC Owner: PISTACCHIO, JASON M
7500 SW TECH CENTER DR SUITE 130 12237 SW HOLLOW LN
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE: 503 - 524 -7830
FAX: 503 - 681 -0793 •
FEES
Specifics: . Description . Date Amount
Furnaces < 100K BTU 11/21/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/21/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/21/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Ar'(.. Permittee Signature: Q I PPLJ t ATIoL!
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
From: 11/20/2012 16:53 #135 P.002/002
Mechanical Permit Applicatii 1 IV E I OIt of i 'ii ''''' u L.' �
City of Tigard Received
NOV 2 0 2012 Date,By: e t a i ha Sr P N OEe. a6ra • ago ,-
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
: :, ` : t ; Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Pcnnit:
Inspection Line: 503.639.4175 VITY OF ' WARD e "1: I G i) R . D Date Reedy'By: 62 See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
`° - ,, ` � , ,,,,; ,. t • _ , e . a£ _ y - .--- RGI - F'FE,= .SCIIS - - —cLSE . - -- --- i'
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Mechanical permit fees* are based on the value of the work
❑ New construction Additionialterationireplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: b
ari- rr ink GATECORY,OF "CON_TRUCT - - - a : _ s -,, r a-c :.� .=,.,.:a - -
.$i.- ��;�n � -::::+ 3���' v?........,....., w-::>._.:.. �.. �u,,.. �. �.+ ��. �.:,.,,.<:... a. r .,..�..:,.�:^.,+`- ,S1ei!'' -'$ay a+Tr °.,.a =csC r -+�. -. "_ ,
_ . , _.,_ ... _ �.,._ - ! c, � YRES[ DEPPt7A ,G;EQUIPMENT'I�SYSTEM §EE ES�"�`� =�r
lg I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other. Description . I Qty. I Ea. I Total
g:
;jF ,ayic,a y u'yy: _ •_ _ - _ " -=c�_. a ' i �_ . _ ;aty4i :bii?�x:' %r.,S�j i
R r- ; s °=R� : 4011 SI 00- ORMAT'IOIViA; tk'$CA1')( ..:,, r ' `: •. ;> g . _„e' eat n d ho t i in
+ All conditionin
Job site address: (Z L 3 . 5,3 P ( i U ,-.1 / 14::c_ (requires site plan showing placement) 46.75
City/State/ZIP: • (' ` Furnace 100,000 BTU (ducts/vents) / 46.75
Ti..�[l j 7 2 7 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 0 CI Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: 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.:
Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
'- f, % %N S:Sy�;z -bz >'- :':i.`hf ^','yxP'A'�.- - .. ya.....: := .a,:,.3c3.n:.r� 4.Fr:
�j'��, : �. ial :,L;. „DESCR1PTlON: '. a;:t,n Water he ater 2
,_..i.���;_r` „Nk -...,. -.� „: OlF WQRK -.;� ��': � : ;y+ 3.32
Gas fireplace/insert 33.39
C w�--t Flue vent for water heater or gas
li �yL G x ^e— fireplace 23.32
`,� Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 _
;;,,:;,,. ; - - Wit;° : t,; I - - T :ts Chimney/linec'fiue/vent 23.32
,rr "'PRP,ERTY `O ER`' . Y "... Si � s� ,. .. :
r ,,,.......--_,....4..- a� a w.,44 .`(s - _.. _ -._. _ TEA c t r:sz_1� 23.32
d-. ._ - • � Other:
.--k-• Name: C'=% D"1 e 1 'ire. c'6 v Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Phone: ( ) i '1— 7 . 1 '1.S: - .1 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
;'� "<<<i _ ., �. J p, tiW _ . - - ., .�,- . ' _- a; T.Fs! Atticicrawls ace fans
. _ °s � - ,n,. -: r ❑ APPLICA)V'f� „ .z� :� t, ;,•,,, f �� (~CONTACT�,PERSON P 23.32
Business name: Other 23.32
Fuel piping:
Contact name: 514.15 for first four; 54,03 for each additional
Address Furnace, etc.
Gas heat pump
City /State/ZIP: Wallisuspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
. - �3: -& :=•3 t _= � _ - _, , -Kf.:".%3 � ' s!h- - � .�
3:• ? Wz ,t ; :.> .4 - r " • -::, • r a:'t: ; , >• ;:: r z. z .C,xr BaBarbecue ,.%. ? , �a ini'z;�_�-<..� ' >",li:fa�i �.,:,= ..srti. ,.- _..e.�_,- .- .,, .H,y h Cz� ' F S:; i, E Yi : z�'` �: ....5!.:e'dS_!a^,w',3.i;��V.':;
Business name: Specialty Heating & Cooling, Inc Clothes dryer (gas)
Other
Address: 7500 SW Tech Center Dr #130 >>�•� <-,: �-�= = re ° - • - ..
i;�� �';<�w`i {.fi ��;MEGIlAN1CAPPERMIT FEE •�s� t• "k - ^�; ��"
CityiState /ZIP: Tigard, Or. 97223 Subtotal
1 A Minimum permit fee ($90.00)
,I Phone: (503) 620 -5643 Fax: (503) 598 -0718 Plan review (25% of permit fee)
CCB lic.: 66578 State surcharge (12% of permit fee)
TOTAL PERMIT FEE / Pt' . P
e_ . _- This permit application expires If a permit is not obtained within IPSO
Authorized signature: I / days after it has been accepted as complete.
Print name: Andrea Dripps Date: I ` / lz f / t ' Fee methodology set by Tri -County Building Industry Service Board
t\BuildinipPermits MEC- PertnitApp.doc 03.0712 440 -461 Tr (11/02, COM'WEB)