Permit CITY OF TIGARD . MECHANICAL PERMIT
111 : COMMUNITY DEVELOPMENT Permit#: MEC2013-00472
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2013
• Parcel: 1 S 133DD02300
Jurisdiction: Tigard
Site address: 12865 SW VILLAGE PARK LN
Project: Kamery Subdivision:'ILLAGE AT SUMMER LAKE PARK NO. Lot: 62
Project Description: Install furnace and a/c. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: SPECIALTY HEATING&COOLING INC Owner: KAMERY, LEE W AND
7500 SW TECH CENTER DR SUITE 130 VINING,JANICE L
TIGARD,OR 97223 12865 SW VILLAGE PARK LN
TIGARD,OR 97223
PHONE: 503-620-5643 PHONE: 971-998-4947
FAX: 503-681-0793 •
• FEES
Specifics: Description Date Amount
Air Conditioning 08/14/2013 $46.75
Type of Use: SF Furnaces<100K BTU 08/14/2013 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/14/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
•
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B : r\`-\ Permittee Signature:4110. e, "feWMP
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
From: 08/12/2013 14:01 #938 P.002/002
Mechanical Permit Applica • , .. ., ,. ,. . . . , : .....,. .. ,._. . ... , .
• - : ,,.. .. „. : . '. FOR OFF,ICE USE O.M..1..
. . . „ . .. . ..
.' .,.. .;-::: City of Tigard D DaRect„ii,vedy: ,i,iiri,5 04,3 Pennit No.:)--eah,/3..-io(.../7
.1114 ‘ • 13125 SW Hall Blvd.,Tigard,OR 9 2 CFI VE
Plan Review
: 11 Phone: 503.718.2439 Fax: 503.598.1960 Datc/By: Other Permit:
.,,,..A,, Inspection Line: 503.639.4175 AUG 1 2 2013 Da.Read)'By: kris: ra See Page 2 for
'...'',"' '.--. Internet: www.tigard-or.gov Notified/Method: Supplemental Information
cITYQFTIGARQ
: -:,,oi.-.r.,..,,,,,,r. • = a " - vg•S4iti"ei,,, .43aAata,,s.at;; -
Mechanical permit fem"are based on the value of the work
0 New construction tffRddi tionfal teration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead.and profit.
I::1'4C Value:$''.A.T9Pilf.f14411*-1`.' ''':,:::-:•:.:..r.:4 ')..gf3 :• :','-- i;...-,• *iiti;0:04-00ttAt/3.**** tktij,:.;:k.N
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
Multi-family 0 Master builder 0 Other: Description
I QtY. i Ea. I Total
"-''''''''S",'''' ''`"'' '-'4%-,1-14-14;zy$.i,,,,-,:poz.
4.::. 415.*14:#11k1.1.05.4li.O.TP.)-1,1VAPIANICA7i:"..'..,P0111,• ..d Air conditionthg j 46.75 4(4.
, i ,
Job site address: ()sto..c-- StA„,) Gi 1 ( ( i " 74 Furnace C1.-A.
Furnace 100,000 BTU(ducts/vents) / 46.75 114-75a
City/State/ZIP: -,,se,-(_,C, 9 7 -a Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg/apt,no.: Project name:
Duct work 23.32
Cross streeL'directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended.etc. 46.75
FlueVent for any of above 23.32
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
;',-;-.i. :■;t5'-.;M'f:.,5,;.;:::'P', q.r.6;-:';:";,:t:ge:0;iii:Aiiisisitig'..icii4ic,,A,::'f:..ii,;A6itNi.5,',&24:Mt-Aite,:fill,if , Gas fireplaceinsert 33.39
,..':."..t.:::.a.-.,..,':•;3:',:e..5.•".:t::.',,, :::;:t`:t,..t., :,..',1....V.. .14-1;"..,..,- .•..t...et...s,._..k):..:a...11.r....t3t,:-.07,',.,,;.1.:.-.A;,!,...4z7,.,a',.,...,..,...-0"4,-;;`:V.,::::'.
Flue vent for water he-ater or gas
fireplace 23.32
iL//lAdotLCti iltA■tAt,14_,t fj Ig-e.— Log lighter(gas) 23.32
Wood'pellet stove 33.39
Wood fireplaceinsert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
sjiO:igktk0q*i:Lg.::Y-:2:iti:t!/#,A ':'gR;'s-aft;:F,S*:fi-:isqg.,:t::)2kg*AY, Environmental exhau„and ventilation:
Name: L-e- (< 44-,,,1 Range hood other kitchen
equipment 33.39
Address:
Clothes dryer exhaust 33.39 ,
CitylState/Ef:.-) Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(11$* ) 9 cif— q 1'17 Fax:( ) Attickrawlspace fans 23.32
YOZatiiiiiitiO'AiiinIRFe0e4i rWICS:Zr iiiietWA'ai*ii00:44#4 Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pum_p
Address:
Wall/suspended:unit heater
City/State/Z1P: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
40 **OiVSSACV:117.i-l'it51;:Vak2kalltg4A Clothes dryer(gas)
Other:
Business name:Specialty Heating&Cooling,Inc
Address:7500 SW Tech Center Dr#130 Subtotal 9 3.sz,
City/State/ZIP:Tigard,Or.97223 Minimum permit fee($90.00) —
Plan review(25%of permit fee) --
Phone:(503)620-5643 Fax:(503)598-0718
State surcharge(12%of permit fee) //.
leti CCB lie.:66578 TOTAL PERMIT FEE
(JJ ID .7P,
This permit application expires if a permit is not obtain4d wit in ISO
Authorized signature: 4---1----- days after it bag been accepted as complete.
Print name:Andrea Dripps r/„ ,
Date: tx.-//3 • Fee methodology set by Tri-County Building Industry Service Board
I.BuildingsPcrmits,MEC_PcnnitApp_040113.dm 440-1617T(II 02/COMAYEB)
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