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Permit CITY OF TIGARD MECHANICAL PERMIT 11/1 COMMUNITY DEVELOPMENT Permit #: MEC2013 00182 T [GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/02/2013 Parcel: 1 S135AA01900 Jurisdiction: Tigard Site address: 10250 SW 87TH AVE Project: Nys Subdivision: METZGER ACRE TRACTS Lot: PT 6, PL Project Description: (1) heat pump installation Placement of heat pump must comply with manufacturer's clearance requirements Contractor: FOUR SEASONS HEATING & NC INC. Owner: NYS, STEVEN E 1005 INDUSTRIAL PARKWAY NYS, JANINE L NEWBERG, OR 97132 10250 SW 87TH AVE TIGARD, OR 97223 PHONE: 503 - 538 -1950 PHONE: 503 - 245 -6721 FAX: 503 - 538 -0165 FEES Specifics: Description Date Amount Heat Pump 04/02/2013 $61.06 Type of Use: SF 12% State Surcharge - Mechanical 04/02/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/02/2013 $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 OUN AA.610/ Cby calling 503.232.1987 or 1.800.332.2344. Issued By: t jp Permittee Signature: Dk , 4,0p, I 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: TO:5035981960 03/29/2013 11:30:42 #1316 P.003/005 Mechanical Permit Applict I I M (II I I I `1 LI\ I `1 C. i of Tigard g E C E IVED I , `(s( y( � . ... ved Ptxmn No.: or kp) 1 13125 SW I tall Blvd., Tigard, OR Plan Review 0 Phone. 503.716.2439 Fax: 503.598.1 R O i 2013 i y ' u y 1 I , . 1'. I Inspection I.Ine: 503 639 4175 Date Ready/Hy: luny B See Page 2 fur Internet: www.tigardjr.guv Not itiicd/Mcihod: 1 W Seppieseeslat Isfarmatieo CITY OF TIGARD TYPI �G UIVI510R! _.. _. __.__ COMMERCIAL. FEE . SCHEDULE - USE CHECKLIST 1 -" - -- Mechanical permit Ices* arc based on the value of the work ❑ New construction ® Addition /alteration/replacement performed. Indicate the value (minded to the neamsi dollar) ot'all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and pruGt_._.._..... - Value: S S7,289.00 _ r _ CATEGORY GORY OF CONSTRt1(110N _ RFSIDRNTIAt. EQUIPMENT / SYSTEMS FEL+S' ❑ I- and 2 -1 Mily dwelling ® Commercial /industrial ❑ Accessory building For special (r((ormatiartwe(:atdk(vR --- - . ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. I F.a. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Joh site address: 10251) SW 87 Avenue (requires rite plan stowing placement) 46.75 ---- " " Furnace 100,000 ti'nl (ducIsiventn) 46.75 City/State/ZIP: Tigard, OR 97223 Furnace 100.000 BTU tduras/vcnls) 54.91 Suite/bldg./apt. nu Project name: Nys I lest pump ........... ..._ .............. .. ...__.. (requires sae plan Animus placement) 61.06 Cross situ cl /directions to job site: Duct work 23.32 Ilydronic hot water system 23.32 _-_.. -. ..... _ _. - _. - Residential boiler (radiator or hydronic) 23.32 - _....._-- ... .._ Unit heaters (fuel -type. not electric), `n -wall, in -duct, suspended, etc. 46.75 Subdivision: Let no_____ - Flue/vent for any of above 23.32 ()ther: _ 2.3.32 Tax map/parcel no.: Other fact appliances: DF,aC:RIPI'ION OF WO .._. ..........._.....-- --.. _ ....... ....... ..... ... R( Water heater 23.32 Install heat Pump (ias fireplace/insert 33.39 - -- -- . _ - _ _.._--- .._....... Flue vent fur water heater or gas timelrlacc . _..... - _...._... ._.......:•,_,_,.. 23.32 Log lighter (gas) 23.32 Wrxr/pellct stove 33.39 Wood frrcplacc/inscrt 23.32 _- _.•.-......._ .................: :..� - -._ ® PROPERTY OWNER 1 ❑ TENANT ('him !liner /llur/vent 23.32 . _. ney __,....f.._.,., _.._.....:._ ,_._... ,.._:.._.. Other: 23.32 Name: Steve Nys Environmental exhaust gad ventilation: Address: 10250 SW 87 Avenue Range hood/other kitchen ,...::. _ ..................._ equipment 33.39 City /State /ZIP: Tigard, OR 97223 Clothes dryer axhauu ,.- 33.39 ` "� Single -duct exhaust (bathrooms. Phone: (503)245.6721 Fax: ( ) toilet compartments, utility rooms) 23.32 ® APPLICANT ❑ CONT'AC'T PERSON _Altichcrawlspacc fans 23.32 Ilusiness name: Other: 23,32 our S song Heating Ft ,piPr1 °is Contact name: 8. Air C C)ndit r'lr ton , l lif 514.15 for first four, 54.03 for each additional Address: 1005 Industrial Pkwy Furnace, etc Newberg, Of Z 0/132 -_ _.. _ ..... Gus heat pump City /State /ZIP: WaIUxLL\ nited/unit healer (_ ) _ Fax; ; (503) 538-0165 Water heater Fireplace E d eli ►rah(a'fouruerxon!cLcYtair.eom Range - CON'TRACT'OR Rarhecuc Business name: Four Seasons Heating Ck)thet dryer gas) - -- --- ...__....... _ rhhcc Address: & Air Conditioning, Inc " MECHANICAL PERMIT FEES* 100 lndustripl Pkwy Subtotal 271.53 City/State/ZIP: Newberg OR 97132 - Minimum permit Ice ($90.00) Phone: (503) 538 -1950 Far (503) 538 -11165 -- --_ --. - �,_ - .. Plan review (25% of permit fee) C'CB iic.: 97152 Stale surcharge (12% of permit fee) 32.5K TOTAL PERMIT FEE 314.11 11s permit applicatiou aspires it a permit is sat obtained within 010 Aulhuri' /.C(15igr1ature: �r .� )1 L� 1��.•.! J Lij L days after h has beta accepted as complete. Print name: Deborah Salo mite: �7`. C �' 1 • Fre methist set by'I n'('uun ), Building Industry Service Ron) I x logy I•a1udditatAPermes\Mi( Permit App due 01/07/12 4+0-'6171 I 11102ft 7xwWl:HI jtri). FROM: TO:5035981960 03/29/2013 11:30:54 #1316 P.004/005 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof., to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first. $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1: 113t,ilding \l'crmits \MF'fC_PcrmitApp.doc 03 /07/12 2 FROM T0.5035981960 03/29/2013 11:31:00 #1316 P.005/005 iU / is /LVUO V3 Cl •AA JVJ co O OV10 Four.Seasons Heating & Air Conditioning, Inc 1005 IndustriAl Pkwy Nowi OR 117132 r � _ . E .. tM a Eli N'; i ., , p p.4--i---,---Nt. , - ---- .,,_.„ A © ter' El F 4 • s ' d x 7- r� M Fa :ii' M - Z W rC r I - 0 tz Z r g rrt t 4 i gi ,I�41 lil IP" 1 64. ii• i t , g ( tom to ‘ , ii,. . , r u isir )Jr) . $ . i . I 55, + 10225 w • +0225 j • 4 �� 4 i ;o j. 1 25 iiiit I fit 0225 i. r . r. r w r ( FROM: TO:5035981960 03/29/2013 11:30:25 #1316 P.001/006 4‘ .VPGUE Sg sts ,4. 49 4 , 41 :e/Fro, SEASONS p Q AIR CO 340 FAX DATE: 3/29/13 TIME: 11:30am TO: City of Tigard ATTN: Mechanical Permits RE: This is a Commercial Permit. Our iob is scheduled for Wednesday April 3 If you could issue the permit PRIOR to 4/3/13, we would greatly appreciate it. NUMBER OF PAGES (including cover): 5 FROM: Four Seasons Heating & Air Conditioning 1005 Industrial Parkway Newberg, OR 97132 (am b lf.* Phone: .503 -53& 1950 Ars 9 40. Fax: 503 -533 -0165 er n()))4 Sent By: Deborah E -Mail: deborah(a),fourseasonsheata.r.com Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 10250 SW 87TH AVE, TIGARD, OR, 97223 Residential - Mechanical 699 Mechanical final 04/11/2013 00:00 MEC2013-00182 PASS - No C of O Minor lable358995 Violation Summary: Inspector Contractor