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Permit CITY OF TIGAR MECHANICAL PERMIT -''- COMMUNITY DEVELOPME Permit #: MEC2011 -00251 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2011 ?-, . - .. ,. g Parcel: 2S114BA01500 Jurisdiction: Tigard Site address: 16200 SW GRIMSON CT Project: Cline Subdivision: PICKS LANDING NO. 2 Lot: 124 Project Description: Install (1) ductless mini -split heat pump Contractor: FIRST CALL INSTALLATION COMPANY Owner: CLINE, JOAN 13150 S CLACKAMAS RIVER DR 16200 SW GRIMSON CT OREGON CITY, OR 97045 TIGARD, OR 97224 PHONE: 503 - 231 -3311 PHONE: 503 - 639 -5299 FAX: 503 - 557 -0919 FEES Specifics: Description Date Amount f Heat Pump 06/07/2011 $61.06 Type of Use: SF 12% State Surcharge - Mechanical 06/07/2011 $10.80 Class of Work: ALT •• Type of Const: Minimum Fee Adjustment - Mechanical 06/07/2011 $28.94 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: OA) Permittee Signature: e(0 o•N/ �/�j /Lr9� /c2 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. JUN -6 -2011 01:34P FROM: TO:5035981960 P.1 Mechanical Permit Applicatio 4 V I. ,0,, (Ii 1It I 1 s1 City of Tigard - Received d 7 � f � - Permit N n 13125 SW Hall Blvd., Tigard, OR 97223 JUN 6 2011 Dater»y. '�, 6 -e , • / - 60°7 S Plan Review a ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: I t: n it t> Inspection Line: 503.639.4175 CITY OF TIGARD Data Ready /By: Hi See Page 2 for ' Internet: www.tigard- or.gov Notified/MeIhod: IES Supplemental Information BUILDING DMVISM I\ TYPE OF WORK COMMERCIAL FEE* SCHEDULE .-. USE CHECKLIST Mechanical permit fees* are based on the value of the work New construction ❑ ®Ad dition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATS GORY OF . CONSTRUCTION Value: $ I 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* • ® y g ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family 0 Master builder 0 Other: Description [ Qty. Ea. I Total JOB SITE. INFORMATION AND LOCATION Heating/cooling Job site address: I W� 0 V� ear! 11 15011. r f Aiq conditioning � � � �� (requires site plan showing placement) 46.75 City/State /ZIP: Furnace 100,000 BTU (ducts/vents) 46.75 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 1 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 :i n -duct; suspended, etc. 46.75 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other duel appliances DESCRIPTION OF WORR K Water heater 23.32 �( I n, 1 ) t t ifess I Ira - it Gas -vent foe 33.39 1 C LI�Ilc� l 1 Flue for water heater or gas 4art t T fireplace 23.32 Lag lighter (gas) 23.32 Wood/pellet stove 33.39 , -Wood fireplace/insert 23.32 Chimney /liner /Flue/vent 23.32 PROPERTY OWNER. ❑ TENANT Other. 23.32 Name: `, Oral CU Environmental exhaust and ventilation Address: ,"' r w Range hood /other kitchen equipment 33.39 City /State/ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (61) ) tON" �9 Fax: ( ) toilet compartments, utility rooms) 23.32 ® APPLICANT © CONTACT PERSON Attic /crawlspace fans 23.32 f e / nyyA Fuel 23.32 Business name: it l �1L yvW Fuel piping Contact name: Diane Mason $14.15 for first four; $4.03 for each additional Address: 13150 S Clackamas River Drive Furnace, etc. Gas heat pump City/State /ZIP: Oregon City, OR 97045 Wall /suspended /unit heater - Phone: (S03) 557.2220 'Fax:: (503) 557.0919 Water Beater Fireplace E -mail: Range , CONTRACTOR Barbecue Business name: First Call installation Clothes dryer (gas) Other. _ Address: 13150 S Clackamas River Drive MECHANICAL ity /State/ZIP: Oregon City, OR 97045 Subtotal Minimum permit fee ($90.00) P (503) 557.0230 Fax: (503) 557.0919 Plan review (25% of permit fee) CCB lie.: 182714 State surcharge (12% of permit fee) inn ‘ .7- TOTAL PERMIT FEE I O n , This permit application expires if a permit Is not obtained within 110 Authorized signature: days after it has been accepted as complete. Print name: Diane Mason Date: • Fee methodology set by Tri- County Building Industry Service Board u,or a. ;,n a tornvna 440- 4617T(1I /02 /COM/WF.B) JUN -6 -2011 01:34P FROM: TO:5035981960 P.2 3 us i v1 • • g i Q I + I o I �"1 I 4 � I O U 7 -5 � I N � I I • ..jQ.. Ui W Fes° i Cl) Q i