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Permit CITY OF TIGARD MECHANICAL PERMIT a COMMUNITY DEVELOPMENT Permit #: MEC2013 -00073 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013 Parcel: 1 S134AC01500 Jurisdiction: Tigard Site address: 11403 SW IRONWOOD LP Project: Moorman Subdivision: ENGLEWOOD Lot: 43 Project Description: Replace gas furnace and heat pump. Placement of heat pump must maintain 5' side yard setback and approved rearyard setback. Contractor: ABLE HEATING & COOLING LLC Owner: MOORMAN, ELIZABETH J 16285 SW 85TH AVE #105 11403 SW IRONWOOD LP TIGARD, OR 97224 TIGARD, OR 97223 • PHONE: 503 - 579 -2250 PHONE: 503 - 590 -6504 FAX: 503- 620 -3980 FEES Specifics: Description Date Amount Furnaces < 100K BTU 02/04/2013 $46.75 Type of Use: SF Heat Pump 02/04/2013 $61.06 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/04/2013 $12.94 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas 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 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 Notifi . • enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dire . uestions to O ► C • ailing 503.232.1987 or 1.800.332.2344. • Iss d By: L i „-, _ Permittee Sig �ture: - arOtirf, Call 503.639.4175 by 7:00 a.m. for the next available inspec on 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. Mechanical Permit Application RECEV '1 City of Tigard D : III a JAN 31 2013 Date/By: / eBy: / e3 herm Na: /lees1O /3 -06073 • 13125 SW Hall Blvd., Tigard, OR 97223 at Phone: 503.718.2439 Fax: 503.598.1960 Pig Reriew Inspection Line: 503.639.4175 CITY OF TIGARD DatelBy: Other Permit: ric 1i:U BU DIVISIO ate Re� /By: Juno: j ID See Pa e 2 for Interne wn v.tigard- or.g odficd/Method: B Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST lacemlmt Mechanical permit fees' are based on the value of the work ❑ New construction ® Addition/altaation /re Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ • ED 1 - and 2- family dwelling RESIDENTIAL EQUIPMENT /SYSTEMS FEES* g ❑ Commercial/industrial ❑ Accessory building For 6pedallnfor7narlwr use checklist Multi - family ❑ Master builder ❑ Other. Description I_ Qty. I .Ea I Total JOB SITE INFORMATION AND LOCATION Heating/ cooling: Air conditioning l Job site address: 11403.SW IRONWOOD LOOP (requires site plan showing placement) ' 46.75 City /State/ZIP: TIGARD, OR. 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 SuiteibklgJapt. no.: Project name: MOORMAN Heat pump - (requires she plan dimwit g placement) 1 61.06 61.06 Cross street/directions to job site: Duct work 2332 Hydronic hot water system 2332 Residential boiler (radiator or hvdronic) 2332 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: I Lot no.: Flue/vent for any of above 23.32 Other: _ 23.32 I Tax map/parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 1 23.32 I • REPLACE EXISTLNG GAS FURNACE AND HEAT PUMP Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 • Wood/pellet stove 33.39 Wood fireplace/insert 2332 ® PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32 Name: BETSY MOORMAN Other. 23.32 Environmental exhaust and ventilation: Address: 11403 SW IRONWOOD LOOP Range hood/other kitchen ! equipment 33.39 City/State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust 33.39 Phone: (503 )590 Fax: ( ) Single -duct exhaust (bathrooms, toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attidaawispace farts 23.32 Business name: Other: i 23.32 Contact name: Fuel piping: 514.15 for first four, $4.03 for each additional Address: Furnace, etc. I City /Sure ZTP: , Gas heat pump 1 Wall/suspended/unit heater Phone: ( ) I Fax: : ( ) Water heater E -mail; _ Fireplace ' Range CONTRACTOR Barbecue Business name: ABLE HEATI NG & COOLING LLC Clothes dryer (gas) • Address: 16285 SW 85 TH AVE. SUITE 105 Other: MECHANICAL PERMiT FEES* City /State/ZIP: TIGARD, OR. 97224 Subtotal I 107.81 Phone: (503) 579 -2250 Fax: (503) 620 -3980 Minimum permit fee (590.00) Plan review (25% ofpermit fee) — _ CCB lie.: 184392 State surcharge (12% of Permit fee) 12,94 • TOTAL PERMIT FEE Authorized signature: , 60-rify-dt6- - This permit application expires if a permit is not obtained within ISO 7J p I days after it has been accepted as comkre. a ' Print name: KELLY TE I Date: 01 - 28 - 13 I • Fee methodology sec by Tril ouaty Building Industry Service Board �� I: 1 Buildinsteermit AMFGPermitApp.doc 03/07/12 440 (11 /02/COM/WEB) • L'd 086£OZ9£09 Bu11OOD tg' Bul)eeH elgd d6£ :b0 £L L£ uef Air Conditioning Site Plan III IC I 16285 SW Or Ave, Suite 105 Tigard, OR 97224 (503)579-2250 Fax(503)620-3980 cc: Coin., LI.0 Email: info©ableheatingandcooling.com CW1,484392 cy Customer t — MO0 fi Address: kt--t\b WOocitY: Ex e Eli AU.) -=k6i\tiN LJZ)Of' 6u!,000 BuReeH elqV d6£470 uer Z'd 086£0Z9£09