Permit q CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT Permit #: MEC2011 -00141
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2011
Parcel: 1S134BD00300
Jurisdiction: TIGARD
Site address: 11455 SW HAZELWOOD LP
Project: Ingle Subdivision: ENGLEWOOD NO. 2 Lot: 91
Project Description: Install heat pump & air handler.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: INGLE, TIM
1005 INDUSTRIAL PARKWAY 11455 SW HAZELWOOD LP
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE:
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Heat Pump 04/06/2011 $61.06
Type of Use: SF Other, Heating /Cooling 04/06/2011 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/06/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 04/06/2011 $5.62
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 Noti ion Ce = . These rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct uestions to OUN • . 50 .232.1987 or 1.800.332.2344.
Issue By: , ` i _ Permittee Sig 41111111W
Call 503.639.4175 by 7:00 a.m. for the next available ins ction 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.
04/05/2011 09:33 FAX 5035380165 /2002/003
Mechanical Perm A pp1ic on I " , ," '' 1 ` ., ' c"
City of Tigard Dav 4 7211 72 Nntlit N°.: /ff-c 011
13125 SW Hall Blvd., Tigard, OR 97223 - Plan Review other Permit: -. Phone: 503. 639.4171 Fax: 503.598.1960 ' Date/By:
, inspection Line: 503. 639.4175 Dam Ready/By: 1u19a-
Irlternet: www.tigard- or.gov Notified/method: 1
Mechanical permit fees arc based on the value of the work
❑ New constrttCtion ditiott /altaration/replacetncnt
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
CATECiti Zxifx
Value;
►L.EQ J *ST, ". .
1- and 2- fam dwelling ❑ Co mmercial/industrial El Accessory building For special information use checklicr-
❑ Multi - family 0 Master builder ❑ Other Description 1 qty. I E ta E Total
Jog OE 3P1 7E Ncatin
j �� p
Air ices conditioning ipin
Job site address: { ‘11-1 - � (� �C 4 (requires site plan showing placement) 46.75
City/State/ZIP: ■ • • c A . 0,10 Fuu ace 100,000 BTU (ductalvental 46.75
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt- no.: ' Project name: I y-t d{ i - e -_ Heat puma r 61.06
(boss street/directions to job site: `� Duct work 23.32
•— — Hydronic hot water system 23.32
Residential boiler (radiator or
hydrom 233
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
-- Flue/ventforan of above 2332
Subdivision: Lot no. 23.32
— Other:
Tax map/parcel no.: Other fuel appliances
- . - , * " i , Water heater 23.32 t
s Gas fireplace 33.39
g • a k a I , • 1, " A Flue vent for water heater or gas
• fireplace 23.32
.. - - - Log lighter (gas) 23.32
Wood/ , cllct stove 33.39
Wood fireplace/insert 23.32
..". fl' ' Chimneyniner /fluc/vent 23.32
� �i . , — Other: 23.32
Name: 1 • ' Environmental exhaust and vedtiladon • �� � - Range hood /other kitchen
Address: `�j �•:e , r .� 1),0 r equipment 33.39
City /S : . l' : a • CI-1 Clothes dryer exhaust 3339
- Single-duct exhaust (bathrooms.
Phone: •' • r Fax: ( ) toilet compatuncnts, utility rooms) 23.32
(] APp.liO2ANT .. U' !'FJ l ,�,, Attic/crawlspaee fans 23 -32
.
Others 23.32
Business name: Fuel piping
Contact name: 514.15 for drat four; S4.03 for each additional ,
Addre QNING, INC. Furnace, etc.
Gas beat u
City/StaterZiP: 1006 INDUSTRIAL PKWY Wall /sus ended/unit heater
Water Phone: ( ) NO1�fplliq 1 ) Fireplace
E -mail: Range
Barbecue
Business Warne
FOUR SEASONS HEATING Clothes dryer )
Other
Address: AND AIR CONDITIONING, INC.
City/State/Z1P: 5b3-5 3 C –(95 U subtotal 1,
1005 INDUSTRIAL PKWY--------- _ Minimum permit foe ($90.00) C IO DI
Pie: ( ) _ „ - _ ' ( ) Plan review (25% of permit fve)
CCB lie.: •ter _ K )
/ 3 state surcharge (12% of permit foe) I 0 t
TOTAL PER F EE f m �7
This p application expires it a permit is not ot>tai w:
Authorized signature: _ \ �i .., + : • • - days after it hes bean accepted as complete.
Print name: - Date: S ° Fat methodology am by Tri- County Building Industry Service Board
• lAlluildia0PermilattEC4rarmaArp dac 10101/09 44o- s617r(I1r02.0oohvw»)
04/06/2011 08 21 FAX 5035380165 2002/002
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