Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00280
Date Issued: 06/17/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S110DD90371
Jurisdiction: Tigard
Site address: 10885 SW MEADOWBROOK DR 37
Project: UNDERKOFLER Subdivision: SUMMERFIELD BROOKSIDE CONDO Lot: 37
Project Description: Ductless heat pump installation.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: UNDERKOFLER, TYANA
1005 INDUSTRIAL PARKWAY 10885 SW MEADOWBROOK DR #37
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE:
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Heat Pump 06/17/2011 $61.06
Type of Use: MF 12% State Surcharge - Mechanical 06/17/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/17/2011 $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.
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Issued By: - 'ermittee Signature: / �
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.
06/16/2011 15:30 FAX 5035380165 a002/003
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M hanical PelI12.Rlit A li does n i.(•,Roi
City of Tigard
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. 11 11 1 r4e 13125 Sur Hall Blvd OR 97223 :
ic6.3.1)* Plan Review Mu Perm i•
• r: Phone: 501639,4171 Fooe 503,598A . I C
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. . Inspection Line: 503.639,4175 , • , 0, Deb§113y: _
\i i.. " Pete Reedy/By; 0 See Pmee 2 he
' loictact: www.tigard i S- % Notified/Method: EMI Supplemestel athromelso
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vim Mechanical peen fees* are based on the vtdue of the Neb&
0 New construction • . . iiicailaltenkti i • s ' i ,.... 1L:.;,,. t permed_ Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: V-04 mechanical fl1Ztc e mit, labor overhead and = .
, -.. •-,- . .. Value: $
CATECilit1 " P6j$6110010 i*s
Ittlatr401410j10.11 i giWilitil Ef t OA* 7: . ..' '
17 , 1- and 2-family dwAing 0 Commercial/industrial El Accessory building For special oformalion iLlit C./mai/St- .
a uiti-faMily 0 Master bniklur 0 Other: DttlefiptiOn Qty., Ea. i'otal
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joB Earftl c 1- .) .! iltifit,itin".. )1* , . ,I . : ' HO I . ,_.• MB
. Air conditioning
Job site address: i 0 g hs _ . - • *p ... • • __ ; resuinta sao Jan showio : . , - - - 11.1 4635 11111
- - - • • Furnace 100 000 BTU Olvetfilveuts 46,75
City/State • /ZIP: • i t at, • - 4.
Furnace 100000+ BTU daets/venta 5491 INI •
_._ . Suite/bldg./eV, no.: . ‘11 11111 Project MMO! a ik , . ou • 4 liettM 61.06 . MDR
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Cmss street/directions to job site: Duct work
■ - . 'e hot water : : • MES111.1
Residential boiler (radiator or 1111 23.32 I.
— hydronic
■•■••,...,..■■■•-••-•-■■■■•111•1111. . gi...,.• •■ WRIT Unit heelers (iiiel-type, not electric),
i II •, . . • .,.. etc, 111 4635 111111
Fluefvent for any of Sb°Ve 11111.M1111.11
SttbdiViSiOtt: Lot no Other: 111111 23.32 IMMII
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Tax map/parcel no.: Other flsei aipihmices
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• " :, . Water heater 2332
., IIM 33- EMI
Ilb . .' '''' -.1 _,ae., . 0 ' III ' 90 Flue vent Far water heater or gas 111111111111
ll -• lace
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Log • , t MIMI
3339_.
11111
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. Wood ., , .lacellesert MOM
a , • iner/fitagvent IIIIIIEMIIIIII
ir" PRornar Millet' ;'' '.'... • 11$0. . . , . , - Mill 2332 Mil.
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Name:
0 Ill_Alli e---- Environmental exhaust mai ventilation
i I L.. 4._ m•_ Rine hood/other kitchen
Address:
-L. - 11...-,r_..: 4 ' J. MO , arbWA NuiPment 3339
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City/Stale/ZIP: it Ala ir _, cloth. • , exhaust 11 111 33.39 •
Single-duct exhaust (bathrooins,
Phone= C5f5 , r ... - 7. Fax ( ) toilet own Lauttau ' ' rooms 2332
.- ... --....:- ..- • •■, %. •- ...-:.:. .....,.., , .N ,0004eit i ._ „ ..., : .., Atfickfavrith . . lin MI UNE
L Other: — ' - 2332 FM
Businc5g maw; FOUR SEASOINIS HENTIW3 _.......,
contactname: / , • 1 ;
•ik •ALa 1NG iNC smig for first fmar S4.03 for each additionat
Addreis: Furnaclartc- III.1
is e _ . Oh _ _ ± a ' 4 .. , i Gas hea_lpu,__, 111111111M10.1
City/State/ZIP: Wall/suspended/imit Imam 111.M111.111111
Phone: ( ) Pax: : ( ) Water heater MOINE.
Fireplace IIIIII MEI
• E-mail: 1111•1111EN11111
, =WINE
Business name: F811/113EACIN Nira---- clothes , LI .!■
; Other: 11111=
, Address: --- ANETAIRDNZMONING, INC.
....__. • .. , ' ' .- • i 4P100 ': ' ../...%....
cit 1005 INDUSTRIAL P A i a Sown! IMMO
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Minimum perniit fee 090.00 Qom%
, • lime: ( ) N t : e a :: '-i--
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plan review 5% of permit file) NM.
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CCB lie.; Agri. / 5 — State sorehorsc (12% of penult fee) WI li 11 itilla
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• / TOTAL PERMIT FEE ITA I
, . 'rids permit application expires if it perish b not °bighted within 120
AulhOriZed gistoktute: • .1. ''\ 4
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Pr mac: • Niek. cloys ottze. it hie been accepted as complete.
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. Date: .1101111M * Fee methodology set by Tri-County Bedding hulusliy Sank= Bawd
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