Permit Support Document CITY OF TIGARD114 MECHANICAL PERMIT
;: COMMUNITY DEVELOPMENT Permit#: MEC2020-00138
TIGARD 13125SW Hall BIvd.,Tigard OR97223 503.718.2439 , Date Issued: 03/11/2020Parcel: 1S134BD05500
Jurisdiction: Tigard
Site address: 11550 SW GLENWOOD CT
Project: POTTRATZ Subdivision: ENGLEWOOD NO.2 Lot: 143
Project Description: Heat pump installation. 3/24/20:REPRINTED permit to include(1)furnace and(1)water heater.
Contractor: OWNER Owner: POTTRATZ, LOUIS A&JULIA E
LOUIS&JULIA POTTRATZ 11550 SW GLENWOOD CT
11550 SW GLENWOOD CT TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-590-2766 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 03/25/2020 $46.75
Type of Use: SF Heat Pump 03/11/2020 $61.06
Class of Work: ALT Type of Const: Water Heater 03/25/2020 $23.32
Occupancy Grp: 12%State Surcharge-Mechanical 03/25/2020 $15.74
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total S146.87
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued Bys`'? _..T Permittee Signature: /, /)
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. (00/
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Anulica ' DIE FOR oPF)C I ()Nil
vLv
Rateived r7
City of Tigard oefr,By, Permit Ne.prciebi3 8
-• 13125 SW Nall Blv'd.,Tigard,OR 972.23
i k� (, Plan Review
'' Phone 503.718.2439 Fax: 503.598.1960 MP,p 4 ;jJ Pa�yyy, Oder Permit:
TJGA, Inspection Li ae: 503639,4175 iV PM,'Rcady;hy; lab: RI Set Page 2 for
I,t err : www hgardwr gov tt{�//, � Yy 41.sd'Methat: Supplemental lafarmation
A f 9 S 9...( (t Y\
. -
--er e">�"" Zk ' Gfiito 'TPE-OSyy-1,0 _ I:,''',4 * , .¢ — s - i - Mechanical permit fees*are based on the value of the work
❑New construction ❑Additiontalteration.rcplaeement performed.Indicate the value(rounded to the nearest dollar)of all
❑Denwlition ❑Other: mechanical materials__eguipment.labor.overhead.and profit. _
Value:$
is i. ° .,ry. 'I EeORY OF. °°°a4 t 73-641 i;t air I)M40 = L '4 s'T . ,a'. s5 5».1
❑I-and 1-family dwelling ❑Commercial/industrial 0 Accessory building For special tnjermarton we checklist
❑Multi-family ❑Master builder ❑Other: Description ! Qty. J Ea. 1 Total
_ r aq r JOB v POik.'sIAT "^sfl J f/C�.� r'`°-t-t'(t�._.'d ."r.�':,j*.".3rsii�� Neath,21d::,hl p:
Job site address: ta�� +�^:r, f.. + , j 1}l .i.
Air canditiooing 40.75
�� I .l ��J t 3 LA! �"P�-��i�t)4 tY �( Pomace 100,()06 BTU fdruwveres) ' 46.75
/� Furnace 100,000+BTU(duets/vents 549I
City/State/ZIP: j8 `' di {` r ) r
lard/
/ [„� �f'�' Heat purr I 61.06
Suite/bldg./Wt.no.: t Project name: 9 10 i I Ir .f z_ Ductwork. - 23.32
Cross street/directions to jab site: Oydronic hot water system 23.32
Residential boiler(radiator or
hvdronic) 23.32
Unit heaters(fe!'type,not electric),
in-wall.in-duct,suspended.etc. .16.75
Flue/vent for any of above - 23.32
Subdivision: Lot no.: Other- 23.32
Other fuel appliances:
Tax map/parcel no.: water heater i 23.32
i^s#'g all,. rt.T ;a; D:SC pnON'3F vOyI `t`,'a-,+ ,m enten/waert 33.39
ple aS e to 7h e tk r ttA (9 Flue at..t forware heater or gas
eat-
q.�- 4 4, i:rcplacc 23.32
IWt PV PQ L" V i7Lt (tor if 1.t Log lighter(gas) 233329
Wood/pelletlightrstave 33.39
VIA e.. (, tti i(2&J 19.er i 1L M I t?'L - OO1 1K w..ifirePimnsn 23.32
Chimneylliner flueJvent 23.32
�, �.rSr Otto 23.32
't=,µ :*i;0> N P:E '\', YA k .` '- x'F_h_>F'a'PT -- - Environmental exhaust and ventilation:
Name I,0 15, i-rate_- Range hood/other kitchen
Address: i '-�*'' ,r,, ' , �t equipment 33.39
i .� -J .] W (dad Cy Clothes dryer exhaust 33.39
City/State/ZIP: `� ,+tryf /> /�j y -$ S+ngle.dunt exhaust(bathrooms.
fg '( s+'t �/ �7 G LL mace comparlaUlats,unlay rooms) 23.32
Phony (3 03),5 !0 04)) y a t t) 6°S r'k,� t$'- f bdt5tr(ttie crawlspace fans 23.32
s`:3}a'i(t l a.6�� ,...v,c r M ii -s- -..' 'c0N'EAG-I PFRA'S4tt '=,".'{�„y+i:h r:_ 23.32
Business name .. .- •. ,•� • - Fuel piping:
$14.15 for fret four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
waWsuspended(unit heater
CityfState/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
Email: Barbecue _
t`a a ,, 7 -�cf3)V'T 1 `st. qai&+ru eTr s a... t.^t.. Clothes drier(gas)
Businessname: Other
Address: Subtotal
Minimum permit fee($90-00)
City/State/LIP:
Plan review(25%of penn(t fee)
Phone:( ) Fax:( ) State surcharge(13%ofpmoirfee)
CCB lie.: TOTAL PERMIT FEE''6,,:07
This permit pplicadan expires If a permit Is not nbtdned within}a
days aster It ha,been accepted as complete.
Authorized sign tore: /� - Fee methodology set by It County Ridding fnduatry^Service Board
Printname ` o t �7�,(444-foray Date: 3,2.r{'241
i:auadmgPermhMRC,PemwApp_040t l3.d `� 44046t7T(I lanerWN11Bt