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Permit CITY OF TIGARD MECHANICAL PERMIT ` - COMMUNITY DEVELOPMENT Permit #: MEC2012 -00077 T[GAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/09/2012 Parcel: 1 S125CA06800 Jurisdiction: Tigard Site address: 7480 SW TAYLORS FERRY RD Project: HELGET Subdivision: 1994 -065 PARTITION PLAT Lot: 1 Project Description: Heat pump installation. Unit must meet 5 ft. rear and side yard setbacks. Contractor: ANDERSON HEATING, INC. Owner: HELGET, JAMES H 6463 DAWN AVE. 7480 SW TAYLORS FERRY RD LAKE OSWEGO, OR 97035 PORTLAND, OR 97223 PHONE: 503 - 841 -0742 PHONE: FAX: 503 - 536 -6615 FEES Specifics: Description Date Amount Heat Pump 02/09/2012 $61.06 Type of Use: SF 12% State Surcharge - Mechanical 02/09/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/09/2012 $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 i` — a/ Permittee Signature: ole • 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. FM: nyl-ax - Hrt Hndersen i o:Hndersen Heat i n9 Permit Hpp i i cat i on (1 b133bUblUbil) 1 1: 42 02/08/12 L51 Pg 3-4 ,„„....,......„...,..........., .......,....... ,... .......... ..................,..,......,.........,...,......,......,.........,..........,...... Mechanical Permit Applie .1.: itr; , . r : . • . .„ .. ..„ .. :..... , ,...: ,, ..... ...... .:.."..:.. .,,,,......,:.„. • , .,. , ., , • .. ..... ... .... ...„ • .. .... ........ ,.... , ., .„ ... ..,.......... ,,.... ...., , .. ..., „ .. , _.,,,,.. , .... . .,_...,... , . , .,.., , . .... .,.. ... ,, ,. , ...... . . , ', .. . , I . ■ .. ' . . .. ,, . ,.. , , , . . . . ... ... . ..... . . ■ ... 'Received i:gM: -..: of Tiga rd . .. . .. . . . .. . . i%too-Y ' rio t 1:.gro P er"' ".: 4.F ' : .....,.. -•. .. 1 1 3125 SW Hal1131vd,„ Tigard, OR 0 972t3L- n , i h 'Plan Review •. 2. :. , . : Phone: 503,718.2439 Fax: 503,598..1960 — 0 LU 12 .0ther Permit: ViGARD - Dotejlay: 1 ••''''''''''. inspection I ..me: .503 (19 4175 Date - ' . • - ita4.. - fa ,Ste Page 2 ' .. ,,nt„net: ww wl 1 Prd - °r4 0 v CITY OF TIGIVD • . 1,:044,100.L - . ., i, .., Supplemental laformation 1 I f-_■/ BUIL.r,)1Nri DIVI91010 r '.". - . .:..77.......:.:- . • ..... :.-....,..:.; -, : ,,,, . . •igigtiomitototkoolee.s.000,,*Afstt 'echanwal.pu *ewe based on the. value of the.work I .0 New construction El Addition/alterati Iyl on/replacement performed..Indiote, the.valuefrounded to the nearest .dollat).of 1111 . . 1 Ej Demoiition 0 Other mechanical tnaterials. equipment, labor, overhead, and profit, Value: S . -..... • . :'. . • - CATEOORY:F: „,,............:. ,.......- „.. ., ,—...,-.... • ... - . 4 -.., ... • . .,... ...,.... . . . :=ZZIAOMAIR41,;;4:4Q14,V$P El I- and 2-family dwelling - 0 Commercial/industrial .. 0 Accessory building Forspeeintinfarmation use 'checklist, 0 NI tilli-farni ly 0 Master builder 0 Other: Description Qty. Ea. Total . ..... .. . • " . - -. '. . ' - ":. ' - - --- " . ' . ", '---"' 0 --- • '''' Heating/cooling: .•' .- - - ' ' 48 i$ J1 K 4 N 9 IWA149N4 011 44404 11 0*NM&';pA'A%.;. Air.wnditioning,: . . Job site address: 7480 SW Taylors Ferry - Rd ' (requires siteplan showing. placement) , 46.75 . . Furnace 100,000 PIE (ducts/vents) • 46:75 CiryiStalc/ZIP:-Portinnd • . . Furnace giu (ducts/vents) 54.91 - I ' . ... 1 Suite/hidg,lapi, no.: . , :Project name: :Hem pump • • ' • . ' ;requires site plan showing placement i 1 61.06 " . .., .. . . Cross-street/directions to job site: ' Duct work • :21.32 I ■ • ' Hydronie hot water system . 23;32 1 Residential boiler (radiator. or ' ' I . hydronie) 23,3) Unit . heaters (nektype, not electric), in-wall, in-duet suspended. me. ,...,. _ . 46.75 - ,01110,. . I Flu 'a/vent for any of above ' 1 332 . ..:. . s•-tiivi-issn: . r ill .. ' , . -." ' - • - '" ,._ " - Other: ' : - . 23,32 1 Tax map/parcel no.: - _ , Other fuel appliances: . , - ' ;' ... 1 4l: 15 : 0 0 1 . 1 0 6 *W r atiiatOganga0t040 • waterheawr ' I . ' 23.32 -- . f New:Fujitsu minisplit Sytern w/two wall' mounted. heads and one outdee ... .r • ;' ' '. 1....!91: 33.39 , ... . 1 1 flue vent for, water heater or gas i — . -- • . . .• 1 , ,1 4h . 23,32 , . . , 1 heat pump. I I Log liohter (gas) ' 2332 '• • , ------,---.------, . • .1 1 • 9 . .1 . • . ' . . • - Wood/pellet stove 3339- . Wood/ pellet . , i - " . • -- 2/ lacs „ . . 23.32 Chinsneyfliner/fluvcnj I ' .. 2 L: PR( r E RTY‘OWWA' ,:- :• :::::'' t!' - other • - . . - -23.32 . i Name: It mes.11elget . Environmental exhaust and ventilation: 1 ------,-----7-------- ' • . . , " ' -- • - • - . 'Range hpodkaber kitchen - Addre:,S: 7480 SW '1'.aylor.Ferry Rd. eqUipthent :33..19 i I . . Cit..k,,/State/Z IP:. Portland, o R•97223 ' - Clothes dryer exhaust ..' 17--- • • . . . ... - Single-duet exhaust (bathrooms. l .Pholc.: (541)905 • : • Fax: ( ) toiler Compartments, mil itv rooms) . ,1 23.32 MI t . . . • „.„,, -A e PL ICA N T' : ::,..;.. 1 • ' ' .. ice'f is , 23.32 IIIIIII ' 13tisMe± Heating, Inc Fuel Contact mune: Art Andersen , Address; 6463 'Dawn Ave - - - . . . , l pipinp Ft,4.nacQ. e S tc 1 . 4.15 for first four; $4.03 for each additional I I . . . .. Gas heat pump . i City/State/X1P: Oswego, OF 97035 Wall/suspended/unit heater . -.- 1 • I, Phone: (970239-1466 F Water heater : (503) 536-6615 ' - . - . Fireplace . .. . 1 . _ . 1; gugreep@andersenhpating.com - - ,Raripe ' : , ".--•'''....':: ....' ' ' . , '..:00004 Bark"' - ail • ' ' • - . • • • .. Clothes•Myer (gas) . - 13.5li t ess.natnc ;; Andersen bleating, Inc . ' - Other ' • J — I . • Address; 6463 Dawn .A,ve . ' . - ' 1. FE N .. • Subtotai I ciiy/Stale/ZIP: 1 ake Oswego. OR,97035 - , • Minimum permit fee ($90,00) - Phone: (503) 8414742 ' 1-ax: (503) 536-6615 Plan review (25% of permit feu) , .., 'CCR lie.: 168214 a 1 Agitil . State surcharge (12% fpermit fee) l'Ol'ALPERM1•1 1.LE • iAllthorizettsignawre:__ — _ \\...A „..,---' This permit,applizotion expires if a permit is not obtained -,■vitiip...167 • thi) it accepted as complete, — • Pea methodology set by Tri Building Industry Service 13onid Print name: Art Andersen Data 02/06/12 1".11I,1, doc 0 It 4413-16171' ( I 1152COMAVE13) Fm:MyFax - Art Andersen To:Andersen Heating Permit Application (15035981960) 17:44 02/08/12 EST Pg 4 -4 • f 0 0 0 27 � k N OS to w 3 9 g n a 7