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Permit CITY OF TIGARD MECHANICAL PERMIT 11 1 111 ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00132 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2011 Parcel: 1S135DB11200 Jurisdiction: Tigard Site address: 11310 SW 91ST CT Project: Foley Subdivision: DAKOTA GROVES Lot: 5 Project Description: Replace furnace and install new heat pump. Unit must meet minimum 3 ft. rear and side yard setbacks. Contractor: ANDERSON HEATING, INC. Owner: FOLEY, CHARLES P 6463 DAWN AVE. 11310 SW 91ST CT LAKE OSWEGO, OR 97035 TIGARD, OR 97223 PHONE: 971 - 239 -1466 PHONE: 503 - 590 -2516 FAX: 503 - 536 -6615 FEES Specifics: Description Date Amount Furnaces < 100K BTU 03/30/2011 $46.75 Type of Use: SF Heat Pump 03/30/2011 $61.06 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/30/2011 $12.94 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $120.75 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 issua• --, or if wor ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon U • y Notification Center. - ules are set forth in OAR 952 - 001 - 0010 through OAR 952 - 001:1090. You may obtain a copy of the rules or direct questions to O : . , ing'503.232.1987 or 1.800.332.2344. .• . Issued By: / ' // i/ /i Permittee Sig A or t,f4 i // ` / /tjZ_A 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. V Fm:MyFax - Art Andersen To:Andersen Heating Permit Application (15035981960) 14:16 03129/11 G MT-05 Pg 02-04 Mechanical Permit Application., .,,.-. . • • 1.1)}1 0.14 t SE OM.1 6 . :: City:, of . Tiprd i i : , . - ! WU -7, • Perm o il N.: iyee 3 . 2 , 1 1 „.,::.1112:SW-Fiall.B1vd.,.'figar 97223 ''' I 'Plan Review !I .,Phone:' 593..639.4i 7i : F .50.3.$9$.1.pqd I , ,,, K r, 2 n 2011 : Date/By: Other Permit: A It 16 I) ': ..$03.639 M .4175 ' • • A Z 9 : -.•0 R eady / By ,. kir*. • - 1111, *Nee 2 for ...Internet:. www.tigard-or.gov blotified/Method: . Simplentental information : CITY OF P3D • • I ..• '.:••••, ::: ' • • ,..,•,•..:::,•:i..• xxig:•:,,py4.4:',1!,...';!.10:•1304.91M11.11111111. l'?,:ii..7,:qitr.4,3,:•:::7;0*'sttOit00;wg 0 ■Itmv construction El..A4ditionta1teration/replacernent ' • Mechaninalpermit based on the valueofthe-work . performed .. indicatethe-vaine(rounded to the nearest dollar) of all 0 Demolition . 0 Other: : mechanical materials, equipmentjairr. overhead, and profit, .:. NN;: ',0,1r;;;.,"!.:.Kci7;3141.1-1111fteratl ' -- ''- ; - v • **. 44" • , .... . ..... . .. . - - ' ' ''.. ••• " ... . M kl. .fs:',;:',.y.` i4034'110a;:::. :1,.. and 27farnily.d u dwelling • Commerciallinthrstrial.: i .0 Aneessory building - .'"'•*.'1.--' 44 1itat$VIEVR.t '''''''' - '' '''"''''' '''''''''''''"':',-,-'-'-,',',.,,'''".---• '' . For :spocjal information use cInscklist. J 0 •Multi.family 0 Master builder other: • Description I Qty, .1 8a. j Total A::*s)*00;*a.,.::W)O,,R:***ptAtotoN::,.. Hea Ong/cooling Air conditioning Job site address; Charles P Foley (reciuirm site:plen showing Placental') 1 . 46.75 e CiiyiSinitilZIP: 11310 SW .91 . Court Tigard, OR 97223 Furnace 100,000 BTU (t) I 4 7 0,- • I 5 . . . Furnace 100,000+ BTU (docislvents) $uiteibidg,/apt, no.: Project name: : Heat pump . I - ' 61.06 ov.oco • • . . . .. . crosl street/directions to job site: " Duct work 332 .. . . , . .• . - - ' ' - • . , - - - - • - - - • ' . - " - • : Hydmnic homaier system • . . :.32 . . , • 'Residentiarboderl(rndiator Or .-. : - -.. • ' . '•: ' : : • r " " • • : • • , • . • r , ,•• • • • • • • • • • • . . • • • .• . . . • . . • , . • • • • Vpitheaters (rno17typc,, not :0;91;10), .: - .. ... ' • -- ' • in.Wall, in•duct;suspendeik'etc. : ' • 46.75 - .tortp/purcel no . . . .. . , • • • ., 1. Flue/vent for any of - -above . 23:32 SubdiVision: .. . ' .. .. Lot no,: . .. Other .., . . . . ... 2332 Ito . . ' - • • • • .... . • • • ' ' .. • .. - . ' - - ;,.:: Otheritiel __________ 1 * . : W , heater.-- . :. ; .. • 1332 3339 • . . Replace 1 and .install new Heat Pump :unit • • vent Tot: svaterheaterorlM :'::" . ' ' .." . ' • . ' ' '' ' ' - ' fireplace 23.32 . . .. .. ... . . • .... .. .. - . , , , . . „ , . . Lot lighter (gas) ...' ' ' ' 23.32 , .. . . . . . .. . . .. . ... ...: ,. . . , ... . . . . , ..: W - : . . ... . , . .. 21313329. • • . • . Chimne) 23 3 :V,Vii0:;,14.16011.11.0 * . W 0 *** 4:4 1: 1 2.1111 . N.40000.0. - 0:PI;•:;!:4 1 .E; - •• ' " - - • 2332 . . -. Name: Charles •:P. Foley ' Environmental exhaust and ventilation - '• • . . . .. ,. .. ii4nse 11004thcrjolc1 : , .., . : , .... , .... ,: . . , A4cireas:11310.$W. 91 ! . equipment .• - - . 3339. ' . • :- : ..Clat4c8 drer xhaLit :" . ' ' . H. . .. .. . . . . :$ingle7dne(c2th*:(hsthroOms,. fhonm:inamo..2516- ' • • • • .. toilet compartments. utility rooms) 1 - 2332 . • -... • :::n4:3:i•: - 1.::gfsi t yc'r , !.i.: i,:‘ : :Aitici6,is,i4e iiiii " ... -.. : " 2. Other. . 2132. 13.usiness.nante: ting, Inc .. , • - .. ... . . . ,.. ., . • . : . , , , . , . Fuel pipi . : Contact paw: Art Andersen . . . 414.15 for brat four; $4 for each additional . . . . , A0dreSs; 6463 Dawn Ave etc ' Furnace Gas heat pump . ...: . . . • - City/StaterlIP: :Lake Oswego, OR 9743.5 . . . • •Wall/suspentied/unit heater , - - " Phono: (971).239•1466 .• 'Fax: (503)536-6615 Water heater • ., . , . • . . • • ....... , .. . . • - : : Fireplace : . . . • E7nmil.: gogreencganttersertheati9Metan f Range ' • , _,. :..:..g:i':,:;d:15.21 . 2 i.ER ',: i 1 : :: : : N. , . : ' ,1 •; : glIg ':, ..P , ii01404.0.01121Militinititteillifffigliog .:::' Ba • , . • •• Clothes dryer (gas) Btr.4iriess name :. Andersen Hating, Inc .. . --.. ,.- .r. . . .. . .. . .,. .. .. : - Other: - . . . . Address: 646313a■vnAve. . ..445;:teige,„•,,, — .-.,„„.,,,„.,,.,... Cityl.Statc/ZIP:: Pike Oswegn, OR 9703$ i . .. . . . . . .minirman'permit fee ($90 : r • 1 Subtotal /07 ' Phone:: (971) 23B-.14156 Ftix ( i...5 5364615 pianjtvi;,,, (25%•of permit-40% ••"'-----• CC13.lic.:1682.14. Air . State surcharge 0 2%:of permit:feel.: • l • . —...............-.....-.......--,........... Op - , - .TOTAL PEIIMITFEE : .? • A This permit application expires if a permit isilor ohlaiined:itlitsin tau uthorixed si fgAtture: • days after It has been accepted as munplate. Print name: Art Andersen Pate: 3/29/11 1 • Fee methodoiogy sot by Tri-County Building Indust:). Service Board _... - 1 1 dbeidinedtrt miiiAIPC.PonnetApp d,:, loolvon 440461 n" (1 IfilliCOMIWHI Fm:MyFax - Art Andersen To:Andersen Heating Permit Application (15035981960) 14:16 03/29/11GMT -05 Pg 04 -04 0 1 E i 1 ! E E ! Q ! � j E -�' - f� : I W c. 1 0 ! n Q 0 C Q 1 E V E MEn mon slam aim= amp _oar slam Ea= me= mune or Emu amp lama am