Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00131
TIG ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/11/2013
Parcel: 2S103AC01700
Jurisdiction: Tigard
Site address: 11180 SW FONNER ST
Project: Schultheis Subdivision: WALNUT GLEN Lot: D
Project Description: (1) gas furnace installation and (1) gas piping
Contractor: SPECIALTY HEATING & COOLING INC Owner: SCHULTHEIS, ERIC D &
7500 SW TECH CENTER DR SUITE 130 11180 SW FONNER ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -5643 PHONE 503 - 789 -7041
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/11/2013 $46.75
Type of Use: SF Fuel Piping 03/11/2013 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/11/2013 $10 80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 03/11/2013 $29 10
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: n P Permittee Signature: - PPLfe_Arlin • . }keilakkif
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: 03/07/2013 13:19 #438 P.002/002
Mechanical Permit AnnlicadZECE1VED
F012 OFFICE USE °NEN'
City of Tigard Received 31TRE .
Date 'By: Permit Nokie_ 3-c ...
IN , 13125 SW Hall Blvd , Tigard, OR 97224,4R 7 2013 Plan Review
' III Phone: 503.718.2439 Fax: 503.598.1960 Date:By: Other Permit:
Inspection Line: 503.639.4175 CITY OF p riGARD
TIGARD Date Ready 'By : AM
I: r_ Fii See Page 2 for
Internet. www.tigard BUILDING DNISION NotNotified/Method. ei7LD Supplemental Information
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Mechanical pennit fees* are based on the value of the work
teNew construction 0 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
:."1 C.0. '''''f'
g i - and 2-family dwelling 0 Commercial/industrial ID Accessory building For special Information use checklist
Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
,": 4iio , , .
),,.,,.., o, Heating/coo ling:
—
Job site address: i I / 9-0 S '') i--- KV & -4— (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts.'vents) i' 46.75
City/State/ZIP: -r-;. ce...,,,A 0 c L or , i Furnace 100,000+ BTU (ducts ems) 54.91
Suite/bldg./apt. no.: U 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
hydmnic) 23.32
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other. 23.32
Tax map/parcel no.: Other fuel appliances:
. - -:.`" ' i '- . -• DESCRIPTioNf WORK • ''. - -:, :, .-, -- , . ' Water heater 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
1/ 6e,-, -P7 fireplace
Log lighter (gas) 23.32
LI 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
. ,, , ,, ,,, ,0, .:: - -..,. , Chimney/liner/flue/vent 23.32
Other. 23.32
Name: C 4 L. 2, `C ..... ... 6 1 4 441-fe,„( /S
Environmental exhaust and ventilation:
Range hood/other kitchen
Address:
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
n Gc Single-duct exhaust (bathrooms,
Phone: (St-) ) (� i — 7o L/( Fax: ( ) toilet compartments, utility rooms) 23.32
litteAlsi '2: '" ':' ..' '-'---:'-' 0 coNTgifiERsoiv -', '''-:, Attic/crawlspace fans 23.32
Other 23.32
Business name:
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Furnace, etc
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail: Range
rONTRACTOlt .---:, ' - ,-"- ,--'-.,--- •- ' . .. , ---.- Barbecue
Business name: Specialty Heating & Cooling, Inc Clothes dryer (gas)
Other:
Address: 7500 SW Tech Center Dr #130 ..',..,,, , .. WOO .t ..‘..:EAMI
City/State/ZIP: Tigard, Or. 97223 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 620-5643 Fax: (503) 598-0718
Plan review (25% of permit fee) ,
CCB lie.: 66578 State surcharge (12% of permit fee)
TOTAL PERMIT FEE il n _ av
Authorized signature: .---L (---( This permit application expires if a permit is not obtained within 180
1 / days after It bits been accepted as complete.
Print name: Andrea Dripps Date: / ' ri ( ) * Fee methodology set by Tri-County Building Industry Service Board
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