Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00296
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2013
Parcel: 2S103AB04500
Jurisdiction: Tigard
Site address: 11452 SW SHROPE CT
Project: GRIEBELER Subdivision: WALNUT GLEN Lot: 3
Project Description: Heat pump installation. Placement of the heat pump unit must comply with the manufacturer's clearance
requirements.
Contractor: SPECIALTY HEATING & COOLING INC Owner. GRIEBELER, LOUIS R & LAURA P
7500 SW TECH CENTER DR SUITE 130 11452 SW SHROPE CT
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 -620 -5643 PHONE:
FAX: 503 -681 -0793
FEES
Specifics: Description Date Amount
Heat Pump 06/04/2013 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 06/04/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 06/04/2013 $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: 1 , Permittee Signature: 4/ /97
yl
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: RECEIVED 06/02/2013 16:40 #667 P.003/003
Mechanical Permit Applica h - 3 2013 I Oil l CL u o . ONLY • , . ' ,
: City Of Tigard l�i�/ E'E1sew' IN • 131 SW Hal BlvdTigard, Olt f J23 OFTIGARD D 3 / Permit No Phone: 503.718.2439 Fax: II G DNISION Other Permit:
Date'By:
T 1 C .41: D Inspection Line. 503.639.417 Date Ready 'By tuns ®See Page 2 for
• Internet: www.tigard - gov Notified/Method: 6" Supplemental Information
COM,MERCIA9r :SCHEDLI E "
Mechanical permit fees* are based on the value of the work
❑ New construct ion [tfAddition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
_ Value: $
' - - CATEGORY OF CONSTRUCTION : -: - - - RE_S1DEivTIAL QlijpMENT % M�;FEES• :
271- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Descnptton I Qty. I Fa. I Total
- JOB SITE INFOR1V ATION LOCATILIJ1 - . _ Heating/cooling:
Air conditioning 46.75
Job site address:
Furnace 100,000 BTU (ducts/vents) 46 75
City / State/ZIP: Griebler, Louis & Laura R13162 Furnace 100,000+ BTU (ducts vents) 54.91
Suite bldg. ;apt. no 11452 SW Shrope Ct Heat pump 1 61.06 6 /•tX
Tigard, Or. 97223 Duct work 23.32
Cross street/directt Hydrontc hot water system 23.32
(503)350 -0207
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 46.75
Flue /vent for any of above 23 32
Subdivision: Lot no.: Other 23 32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DES OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
■ V ,/ ---4 -- -4.. _ l e-IJ --- ('� fireplace 23 32
Log lighter (gas) 23.32
Wood /pellet stove 33.39 —
Wood fireplace/insert 23 32
Chimney /liner; flue /vent 23.32
Other: 23 32
® JPROPHRTY -OWNER ❑ TENA)\T Environmental exhaust and ventilation:
• Name: eyµ.I.i. Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39 _
City /State/ZIP: Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: ( ) Attic/crawlspace fans 23.32
;CI APPLICANT- , . - - ® ".CONTACT.PERSON - , -• =.--- .- Other: 2332
Business name: Fuel piping:
$14.15 for first four; $4.03 for each additional
Contact name: Furnace, etc.
Address: Gas heat pump
WalUsuspended/unit heater
City / State/ZIP: Water heater _
Phone: ( ) Fax: : ( ) Fireplace
E-mail: Barbecue
Barbecue
- - . • CONTRACTO)(t . -1(-: --- - : " : - Clothes dryer (gas)
- Business name: Specialty Heating & Cooling, Inc Other.
` WtOIANICA1 4EWVII °. -. ?` -- -
Address: 7500 SW Tech Center Dr #130 Subtotal
City/State/ZIP: Tigard, Or. 97223 Minimum permit fee ($90.00) 4 g, c ) 0
Plan review (25% of permit fee)
Phone: (503) 620 -5643_ /(J
Fax. (503) 598 0718 State surcharge (12% of permit fee) /6. 30 CCB lic.: 66578 ,// TOTAL PERMIT FEE V„EO r
r � This permit application expires if a permit Is not obtained within 180
`__ days after It has been accepted as complete.
Authorized signature: • Fee methodology set by Tn - Count} Building Industry Service Board
W
Print name. Andrea Dripps Date: 3
I ■BuiMmg /Pemus'MEC_PcimitApp040113 doc 440-4617r (I1■02.COMAWEB)