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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2013-00544 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2013 Parcel: 1S136CA02003 Jurisdiction: Tigard Site address: 10950 SW 78TH AVE Project: TURNER Subdivision: FAIRVALE Lot: 9 Project Description: Ductless heat pump installation. Contractor: COLUMBIA NW HEATING Owner: TURNER,JOHN A AND PO BOX 622 BALLARD-TURNER,WENDY J SCAPPOOSE, OR 97056 10950 SW 78TH TIGARD,OR 97223 PHONE: 503-543-3624 PHONE: FAX: (503)543-6285 FEES Specifics: Description Date Amount Heat Pump 09/25/2013 $61.06 Type of Use: SF 12%State Surcharge-Mechanical 09/25/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/25/2013 $28.94 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Applicat_ion I Uh t�l nt. i t sl.t)NI l w City off'Tigard w�,. c.,i-\ D.' D t y. q a s1� Permit No,; EC. 13- 00 y nate/R Illi 13125 SW!tall Blvd.,Tigard,OR 9 P/an Review I. Phone: 503.71 8.2439 Fax: 503.598'• `i 3 Dote/By: other Permit: TIC;,s.I:.i.1 inspection Lite: 503.639.4175 _ '� 061! l��01 Date Ready/By: RI Set Page x for Intcrnct: www.tiga d-or,gmv CJ�` D ��t) Notified. cchrnl Supplemental Information 1\G , rah\\ • ' .: ' '. ., TYPE,.OF WO, ,,, - Co1a >12`1A1EE:∎• TJLE ' JSF'C 00,l. ' - � � ' Mechanical permit fees'are based on the value of the work ❑New construction E Addition/alterati rii,: emenl perforated.indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment:labor.overhead.and .rnfit. CAT' Value:S �GCJRY OF CON5C.lttJCII171tii. FEE§" - .. � ;R�.4li;'E'.C+3't1A>G i'�Ultl'M�N'l':7.5Y$'1'B1C4S ® l-and 2-family dwelling 0 Commercial/inclUsCriat [�Accessory building For special information tor checklist ❑Multi-family ❑Mister builder ❑Other Descti.ption Qty. Ea. Total T0l3, SITE.•INFO MATION..AN ..LOCATION% Heating/cooltng: �,,I Air conditioning 46,75 Job site address./0950 SU) l0 q e, _ Fuunate 100,000 13TU(ducts/vents) 46.75 City/State/ZIP;7;a q7). Furnace 100.000t Rn1(sue(sums/vents) 54.91 `JI Heat pump 1 61.06 :/-t9 9 Suite/bldg./apt.no.: Project name:7[Q�t ittiez ' „_ Duct work 23.32 Cross street/directions to job site: cull H o . "c hot water a stem 23.32 Residential boiler(radiator or dronic 23,32 Unit heaters(fuel-type,not electric), in-wall,in-duct,sus.endcd.cic, 46.75 Floe/vent for any of above 23.32 Subdivision: Lot no.: der' 23.32 l Other fuel appliances: Tax map/parcel no.: Water heater • 23.32 ' , 111ESCRIPTION..o WORK '. Oas fircplaeelinaert _ 33.39•C��---��'��• -�- Flue vent for water heater or gas 5L___ . I'11I / ? A fire.lace 23.32 Ix%li_ er(gas) Wood/ llctstove 33.39 Wood fire'lace/insert 23.32 _ Chimney/liner/flue/vent 23.32 l!7 Plio riV 4) It` ,. 1 TENANT Environmental 23.32 Environmental exhaust and ventilation: Name: O j1 u.� - Range hood/other kitchen f[ �[ e• i merit 33.39 Address:/6950 StO 7 ,4 _ Clothes dryer exhaust 33.39 City/Stttrc/ZIP:—n 97s- Single-duct exhaust(bathrooms, 1 wild core rtmcnl>.utility rooms 23,32 Phone:( ) —3049-� Fax:(rja ) ^(4 . 15 tSttic/crawlspace fans 2332 ' • Q I•AiPLICAict..° :..C1 CONTACT' PERSON . . Other: 2332• Foci pig: Business name:Contractor . 514.15 for first four.$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump Wall/suspended/unit heater City/State/7.iP: Water heater Phone:( ) ' Fait::( ) Rant E-mail: Barbecue C;UNTRAC"f tylr hca dryer(•:s El Other: N� Business name:Columbia NW Hearing Nt]�JCFIi4NTCA] pERIWI :FJ;RS'.:. Address:PO Box 622 y Subtotal City/State/ZIP:Seappoose,OR,97 t 056 Minimum permit O.p0 Plan review(23%of permit fee) Phone:(503)543-3424 Fax:(503)543-6235 s - State surcharge(12%of permit fcc) 0.,/ CCM lie.:61947 TOTAL PERMIT FEE /00.'i'7P rah permit eppileatton expires if a permit In not obtained within 180 dove aMr it has been aoeopted an colnplala• Authorized signatu •: 1 t. tee methodnlogy sal by Tri-C aunty Building industry aenice nnnrtl Print name: Cassie Galbraith Date: ' p?u/3 1:1Reim.ac\PermaalMt(: PcrinitApp_040I I:.dac 440-4AI Tr 0IIo/COMM::3) JOB#13T490R TURNER,JOHN 10950 SW 78T#AVE TIGARD,OR 97223 (503)730-8062 • Installation Property Information DIRECTION: r Property Line 5D FT: t4P - Q FT: r—/0 FT: f z_ Fr: Property Line (F=FURNACE) (X=OUTSIDE UNIT) STREET Columbia.NW Heating, Inc. 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 10950 SW 78TH AVE, TIGARD, OR, 97223 Residential - Mechanical 699 Mechanical final 2014-01-08 (null) MEC2013-00544 PASS - No C of O Violation Summary: Inspector Contractor