Permit v CITY OF TIGARD MECHANICAL PERMIT
I I I n CO MMUNITY DEVELOPMENT Permit #: MEC2013 -00407
Date Issued: 07/18/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 7/18/2 D05900
Jurisdiction: Tigard
Site address: 10765 SW PONDEROSA PL
Project: Gunderson Subdivision: BLACK BULL PARK Lot: 20
Project Description: Install gas furnace and A/C. Placement of NC or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: GUNDERSON, MARK A & DENISE M
1005 INDUSTRIAL PARKWAY 10765 SW PONDEROSA PL
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE: 971- 533 -2706
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Air Conditioning 07/18/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 07/18/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/18/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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. A
Issued By: Permittee Signature: DN eP/ G / i 977 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:5035981960 07/17/2013 11:03:21 #6654 P.002/003
Mechanical Permit AnnlicatioNiC ,,,, ‘,. i.,,!,.
City of Tigard
J liEnritlen Pen"' NYtice..20/3 DO go
Ilh 13125 SW Hall Blvd., Tigard, OR 97223 U 1 7 2 -
Plan 1 view
, Re
Phone: 503.7111.2439 Fax 503.598.1960 ()lbw Parmii:
Inspection line: 503,639.4175 Cr TY OF TIGARD DatcBY:
k, , LI Date Ready/By: Mit i , RI See Page 2 for
Internet: www.ligard-ix.gnv BUILDINGDIVISIO Noirk4hud: - supplements! Information
—,- ...
_ — —
TYPE OF WORK COMMERCIAL Yap sonatas - USE CHECKLIST
—
-- hiechanical permit fees* are based on the value of the work
El New construction ZLAddition/rdtcrationficplaccmcnt performed. Indicate the value (rounded to the nearest dollar) of all
D Demolition 0 Other: mechanical materials. equipment, labor, overhead, and profit. . .
---- Value: $
CATEGORY OF CONSTRUCTION - • - -
RF.SIDENTIAL EQUIPMENT / SySTEms FEEst
I- and 2-family dwelling 0 Commercial/industrial 0 Acc building
Multi-family 0 Master builder 0 Other: _______ For special leontrattan use diecillst.
Description FTNT
.. . ,..„..___._
JOB SITE INFORMATION AND IAX:ATWN Heatin n
g/coolig:
Air conditioning 1 46,75 444, 1 57
Job site address: I C3 "-:...1 c- C_I, y \ .8 e y ' X„. c 1 (...,1 . .!, . . , l'untace 100 000 Intl rdueudyenisj i 46.75 tit, 75,1
City/State/ZIP: - i r . y ( -1, (3 (?.... _ (.4 - 1 T). -:)Li Furnace 100,0c0f 131110w2iwyeeK ... . 54.91
._) Heat
Suite/bldg./apt. no.: Project name: Ci LA y \ci v - . s ,L, i.- pump 61.06 %
Duct work 23.32 - •
---- .-.--. . .
Cross Amyl/directions to job site: Hydronic hot water system 2,332
_ .. .
Residential boiler (radiator or
ilydronicl_
__ 2332
____ . . .
Unit heaters (fie not electric),
_________ _ ______ ...... ______ .. __ in-wall. 111 - dua, susPended. etc. 12.7
Flue/vent for arri of above 23
Other, 23.32
Subdivision: L ot no.:
.. ......____. _...... ..________________ ...... . .. .. . .... ... 1 ....._..... . . - Other fuel appliances;
Tax map/parcel no.: _ insen ________ ..............._ . .. , ,
PT
DESCRIION OF WORK 33.39 ____ ..
_ . . , - Flue vent for water hear= or gas
.......--- ,--" k
_r_sA 1L1-Ck, -C-S ) a v r-v),T two= .32
,32
. -
..-.
log lighter (gas) 21.32
,C..) V' \ ( kb LLne,7
Wood/e5Relsteve
... _. 33.39
Wood fireplace/insert 23.2
___ _.... .
Chintey/limv/flue/Yen1 . 23.32 . ..
____
PROPERTY OWNER 1 0 TENANT
_ .... . Other:
-
, , -- Environment!! exhaust and ventilation:
Name: rila V K . j...,t, -v.._.,. CD■A,•-.Nclef, e , .....- .. p. , ---1 , . . , Range m/other kitchen
— equirnOnt 33.39
Address: 1 o 1 (LC ( z., ■,,- ( Ut..\ .9 I_CI.C.. _ Clothmt dryer exhaust 33.39
('ity/State/ZIP: --r 4 ‘.. v ,.. 4 C> Single-duet exhaust (bathrooms,
) 23.32
_......______ toilet compartments utilitimoins
I Fax:( ) AnieJesawLsintce auks 23.32 .
0 APPLICANT El CONTACT PERSON 9 ., .. , . . ......„ .......,— 2332
_
........_
_Fuel piping:
Business name:
. ... ___ 'Four "Se u 1 lb-He:Ming-- .. --- S14.15 for first four; 54.03 for each additional
Contact name: Furnace, etc.
uditianing, inc. . .. ....._..
Uns holt purnp
Address: 1005 Industrial Pkwy
Wall/suspended/unit heater
__ ... ... ...
— F1i.wl'il:rg, OR .. .........
(.:ityistatettiP: Water heater
Fireplace
Phone; (t503 ) (1 3 - 6 -, i ( 1 7i ‘'.3 Fax: : ( i ',33 ) 5 . e, - u f u..:c
— %vs.!
I:-mail hs„,Q,e1;■.f 11t . CE:41,-(\. Barb _ ecue
CONTRACTI./R Clothes dryer (IL%) ._.......—__ —.
........
Business name: Four Seasons Heating Other:
---&-Airer.rtatheMirtOffc MECHANICAL PERMIT FEES*
Address:
_.1.1.10_5_Insdk*trial Pkwy al Subtot
„ . . ..,... - -
City/State/ZIP: Newberg, OR 9713 mwn pennit fee ($90,00)
. , ..,.........__._
Plan review (25% of permit fee)
i Phone; ( 50 4 )5 yi It cr i 5 1 Fax: (50- ) r, 1 L c—
suite surcharge (12% of permit fee) r 1
. . .. _Y.__ ......,2._______
((It lic.: '-j / I lc — TOTAL PERMIT FEE
. " . • ---- - --- -- '... iiin penal applicallon ff a pernTh il la not obtained within tali
days idler it has bem r accepted as complete
Authorized signature: ija-bridt. /\jr0 p /-0 " idl Pee methodology sot by Tri-counry Building indusiry Service Mail
. .. _
[Print name: D S ) ( (,, l Oate: 7 -19--17, 1
• • •
. ,iiftililin PermitApp 0401 Lido. 410-16 1 TT (11/02/COM/WEIS) / 0 V 1 67—
FROM Four Seasons Heating TO 6036981960 07/17/2013 11:03:14 #6654 P.001 /003
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FAX
DATE: 1- I 1 I TIME: _3 rvv
TO: City of Tigard
ATTN: Permits
RE: Please issue and fax copy of Permit as soon as possible.
NUMBER OF PAGES (including cover): 3
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@fourseasonsheatair.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
10765 SW PONDEROSA PL, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
2013-12-11 00:00:00
MEC2013-00407
PASS - No C of O
Electrical minor label number ELS373108
Violation Summary:
Inspector Contractor