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Permit n CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2012 -00458 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/06/2012 Parcel: 1 S125DB11200 Jurisdiction: Tigard Site address: 7460 SW ELMWOOD ST Project: Fox Subdivision: ELMWOOD PARK Lot: 8 Project Description: (1) ductless heat pump installation Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: FOX, BRUCE J /MARTHA J 1637 SE NEHALEM ST 7460 SW ELMWOOD ST PORTLAND, OR 97202 PORTLAND, OR 97223 PHONE: 503 - 235 -9083 PHONE: 503 - 245 -0772 FAX: 503 - 235 -0454 FEES Specifics: Description Date Amount Heat Pump 09/06/2012 $61.06 Type of Use: SF 12% Slate Surcharge - Mechanical 09/06/2012 $10.80 Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 09/06/2012 $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. r 4 p/ ' A ,� Issued By: Permittee Signature: O L ' I 4 / /" Q_( e- t ! od 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:5032350454 09/05/2012 14:35 #130 P.002/003 E Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard S E P 0 5 2012 Received IN • 131 SW Hall Blvd., Tigard, OR 97223 Date/By: 9 I V(a-. N Permit No4,I6G),O1y # 0 , M �p g�� Plan Review Phone: 503.718.2439 Fax: 503.598.19841 I 1 TIGARD Other Permit: T„-.AR i, Inspection Line: 503.639.4175 BUILDING D? f1SDN Date Ready.'By: lure: ® See Page 2 for Internet: www.tigard or.gov `' � tli 1 ` 7 NotifiedjMethod: .n GP Supplemental Information � �?"�. - '3 .r'. „'�+F "�, °�'� ",° _- ,, :..%�`d� ^ ` . s r _ __ ___i� �^3'-= _�; P_. : -- _ �- z...:c� - § � res..wrr_�. ��' _ - �;� - - x y t ,, `T ` `'' a t zP: �.�t� „- ��'r:: ��"`� y:- � ��9.�,��(�a'� '. ?'?+� 4cu .'�'a; ia:',' �A -;'�s-,- i� ��; xt. _ �.> ;ri.Y:.,-- ��a.= ti.'a ,'f`,^, � :�'C"'r��2�4 Mechanical permit fees* are based on the value of the work ❑ New construction ® Addition / alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. ��.. § �. _ .. _ ;1-e.' a. .... X ...-5,"'7,-...,7: Value: $ • 'j - -^,. � 4 4- 514 �3i` ,,,`.'l�e z. .-,._.'L.v:.^` y'" ` 3 .t c: �z'_= a_>,: a,� p 7. .. - . s4� 3 $ :?o'' -:. . .'r_y-, - . r.,: '�+..+ " =?K� ... � ti -.a:r ,.Yc""G�r?d,_°�x{: �.sjd Yea '^- �� -+r. -- � fd.'',�' •,� �. - .tti *�� ® I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total f 4 yy h v-' 'p a= ' 3S,' n Heatingfcoolt �n 'v g , 6 � ; 6 e. rw: N3f''• � ' p s, ng Air conditioning Job site address: 7460 SW ELMWOOD ST. (requires site plan showing placement) 46.75 Furnace 100,000 BTU (ducts/vents) 46.75 City / State/ZIP: TIGARD, OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: I Project name: FOX Heat pump (requires site plan showing placement) I 61.06 61.06 Cross street/directions to job site: • it work 23.32 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 Subdivision: Lot no.: Flue/vent for any of above 23.32 Other. 23.32 Tax map /parcel no.: Other fuel appliances: s .. - :.=. y ty '"- �+_�:G,-�',�„`' -' us'a�,r, � �i,- .s >s =_a. _r TM e, Water heater :' , ' ^,- S C 1 lY ©)) : ;: - „ e ., er 23.32 r -a�S -. L'�2'h3'r.': ��3 ::A s.�. _ A�%A ' 1 . +. A ': Yfe� .: _. �A; ',l,�N,:.s%+�b.'.���ir ., 3,.; Gas fireplace 33.39 INSTALL MITSUBISHI DUCTLESS HEAT PUMP. Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplacelinset 23.32 It9i O r-- �:� M , a rt , s "{ a ` Chimney/liner/flue/vent 23.32 other 23.32 Name: BRUCE & MARTHA FOX Environmental exhaust and ventilation: Address: 7460 SW ELMWOOD ST Range hood'other kitchen equipment 33.39 City / State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (503)245 -0772 Fax: ( ) toilet compartments, utility rooms) 23.32 . � �APiLA ry3, :, }�1 p t) Attic/crawl ce fans 23.32 4 - . c'r 4..im,, . 9 : a 4z. 3 f,"-. 4 _ ,, or. r s `- .: i A''n` A ♦ ,,, :' 3. Business name: SKY HEATING & AC, INC. 23 -32 Fuel piping: Contact name: TAMI HAGEMAN $14.15 for first four; $4.03 for each additional Address: 1635 SE NEHALEM ST Furnace, etc. Gas heat pump City/ State/ZIP: PORTLAND, OR 97202 Wall/suspended/unit heater Phone: (503) 235 -9083 Fax: : (503) 235 -0454 Water heater Fireplace E -mail: TAMI @SKYHEATING.COM Range ft . �k�;r��r% -^r - � �,, * :5,14--,---,e,= 'F`� + ''�y ?� - "''�� �Fs:E?%,eg'�': .. pp,�, %*1‘3 Barbecue Business name: SKY HEATING & AC, INC. Clothes dryer (gas) Other: Address: 1635 SE NEHALEM ST .f.'.� �= xv 1 City/State/ZIP: PORTLAND, OR 97202 Subtotal 61.06 Minimum permit fee ($90.00) 90.00 Phone: (503) 235 -9083 Fax: (503) 235-0454 Plan review (25% of permit fee) CCB lic.: 50244 State surcharge (12% of permit fee) 10.80 TOTAL PERMIT FEE 100.80 This permit application expires it a permit Is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: TAMI HAGEMAN Date: 9/5/2012 • Fee methodology set by Tri- County Building Industry Service Board I:.Buildins‘Pennits.MEC -Permh App.doc 09 %09/10 440 -4617T (11 COM /WEB) From:5032350454 09/05/2012 14:35 #130 P.003/003 . HOME LAYOUT /SITE PLAN j D.. \ 1 0 L______Jc , r3 .1 7 ,1, < 1 ,. (i?,..<- , . I a- . 4 ". . I -- . )c, \ c. ...... CP , } 4 r "--"-----i G'' P 9 1 1. ■ i