Permit CITY OF TIGARD MECHANICAL PERMIT
13 COMMUNITY DEVELOPMENT Permit #: MEC2013 -00261
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/20/2013
Parcel: 2S110DD90042
Jurisdiction: Tigard
Site address: 10980 SW MEADOWBROOK DR 4
Project: Woodward Subdivision: SUMMERFIELD BROOKSIDE CONDO Lot: 4
Project Description: (1) heat pump Placement of heat pump unit must comply with manufacturer's clearance requirements
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: WOODWARD, LANI E
• 1005 INDUSTRIAL PARKWAY 10980 SW MEADOWBROOK DR #4
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE: 503 - 926 -7952
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Heat Pump 05/20/2013 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 05/20/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/20/2013 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �t ( CIALteLt Permittee Signature: / 9/4 l PL- c. Wv j
U
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM:Four Seasons Heating TO:5035081960 05/17/2013 11:44:38 #2490 P.003/003
Mechanical Permit Application REcE
11111 City of Tigard oatRlYe.C1vCd y: ��o t3 Pencil Nu.S/ e .3v13 QD�d
i 13125 S W Bail Bl vd., Tigard. OR 97223 MAY 2 p 013 '
Phone; 503,71$.2439 Fax: 503,598.1%0 Ilan Review Other Permu
naten3y:
l' I i i A It 17 Inspection Line: 503.639.4175 !Me Ready/By: ,, um la See Page Z for
Internet: www.tigard -or. CITY OF TIGA Nuuiricd /Muthral: y r G I Supplemental Information
BUILDING DIVISION - _ - -- -• _
- - -- -rvrt: OF WORK COMMERCIAL FEE* SCHEDULE - 115E CHECKLIST
„___ .. „ „"'..-." -,...' .,„ "",-" "_"" Mechanical permit fix a• 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, equi�tment, labor, overhead, and profit.
-- - _mechanical Value: $
CATEGORY OF CONSTRUCTION KFh1DF'N'rtAt.F UIPMEN1'rSYfiTF.MS
-- Q FEES*
_
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For.rpertal information use cheekrbr.
El Multi-family ❑ Master builder ❑ Other: Description Fc)ty - Ea. 1 T
JOB SITE INFORMATION AND L(( :A11ON Heatirr})/mTlit ; _ ..............._........- _
-- - Air conditioning 46.75
Joh Nile addnss: 10980 SW Meadowbrook Drive #4 -
100,110(1 ,11 (ducWvenls) 46.75
City /State/ZIP: Tigard, OR 97224 Furnace 100.0001 BTU (ducts/vcats) 54.91
Suite//bldg. /apt. no.: #4 Pmjvvl name: Woodward
Dual w work ... ........ ........................_.... -_ 1 • 6 1. 6 61.06
Cross street/directions to job site: .. Hydmnic hex water system 23.32
- - - - -- -- Residential Mtilcr (radiator in
hydronic) 23.32
Unit heaters (fuel -type, not electric),
---------- ..... --- - ._._.. - - - -• in -wall, in-duct, suspended, cic. 46,75
Flue/vent for any of above 23.32
Subdivision: 11.ot no,: l)thcr: 23,32
. -
-_ . Other ruel appliances: _
"I'ax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
_._....__...._.. ��_.,� -�.._. �.,..,- _,..,w ..............._ _....... .- ._.........._- '.._........,.. - Hue vent for water heater or gas
Install Heat Pump fireplace_ , _ .. :. ..._._._._..----..__.._. ._.__. ....._ - - -. --
------•---- --- •- .----- .-- ..._._._. -_. -__ Log lighter (gas) 23.32
- -- - ._.... ........__ ..... .............................. -- Wood/pellet stove 33.39
Wood tircplacc/inscrt 23.32
C himney/liner /Due/vent 23.32
-....._... .._._...._...�..:..,..,..,,._., .. -- - - -- --- -- - --- _ -- -- other: 23.32
® PROPRRI Y OWNER ❑TENANT' Environmental exhaust and ventilation:
Name: Laid Woodward Range huod/othcr kitchen
Address: 10980 SW Mcadnwhraok Drive #4 equipment 33.39
Clothes dryer exhaust 33.39
City /State/ZIP: 'Tigard, OR 97224 Single-dud exhaust (bathrooms,
._.., _ toilet enmpartments 23.32
Phone: (503)926 -7952 Fax: ( ) Attic/crawlspave fans 23.32
1$I APPLICANT ❑ CONTACT PERSON Other: 23.32
,- - -_
Business name: -- -- Fuel piping:
'ottr - Sea utis Hedtini $ 14. IS for flrslfour S4.03 for each additional - --
l,.ontam name: �, , - furnace, etc.
L Air C.Utlt)JIl(1RiRL},.-1nc - .._.___.._..._..-- ._......_.-.
< oar heal�mLr .
..........._.._.._......,.. ..._...._ ................. - .........,......_........ - . . ..,
Address; 1005 Industrial Pkwy �.i» e
Newberg, cnj y / 1 dL - -- - --
Wall /suspended /unit heater
City/State/ZIP: W heater
Phone: (503) 538 -1950 Fax :: (503) 538-41165 _ Fireplace
-- - -.... . - -- - -- - Range
E-mail: deborah (a?fourseasonsbeatair.com Harhecue
�..Ww -
CONTRACTOR Clothes dryer (gas) _
Ruttiness name: Four Seasons Heating other: - .... _
K en- ditiofri trine- -- _.._..._......._ Y . MECHANICAL PERMIT FEES"
Address: 1005 Industrial Pkwy Subtotal 61.0h
City /State /LIP; Newberg, OR 97132 Minimum permit fee ($90.00) 90.00
Phone: (503) 538- 1950 I Fax: (503) 538 -0165 Plan review (25 %ul permit fee)
State surcharge 1.12% of permit foe) 10.80
C'('13 lie.: 97152 'rOTAI. PERMIT FEE 100.80
This permit application expires if a permit b not obtained within ISO
,) (��/ days after it has been accepted as complete.
Authorized signature: /�/,e_ib.c...dl . %r,so • lee methcdtt set by Try - County Building Industry Service Board
Print name: Deborah Sala Dutc:
I ■uihhngwermits1MIC_PerintApp .0401 I.1 due •1411.4517T ( 11N12ieOM/WEUI
FROM Four Seasons Heating TO:5035981960 05/17/2013 11:44:25 #2499 P.001 /003
QQ , ANLU E /
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SEASONS ..
4 Al R GOAN
FAX
DATE: C)- 11 — t TIME: I I a
TO: City of Tigard
ATTN: Permits
RE: Please issue and fax copy of Permit as soon as possible.
NUMBER OF PAGES (including cover): , 7- 7
FROM: Four Seasons Heating & Air Conditioning
1005 Industrial Parkway
Newberg, OR 97132
Phone: 503 -538 -1950
Fax: 503 -538 -0165
Sent By: Deborah
E -Mail: deborah(aourseasonsheatair.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
10980 SW MEADOWBROOK DR 4, TIGARD,
OR, 97224
Residential - Mechanical
699 Mechanical final
05/28/2013 00:00
MEC2013-00261
PASS - No C of O
Minor 364473
Violation Summary:
Inspector Contractor