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Permit CITY OF TIGARD MECHANICAL PERMIT i COMMUNITY DEVELOPMENT Permit #: MEC2012 -00020 Date Issued: 01/20/2012 'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1 S134DD00100 Jurisdiction: Tigard Site address: 10543 SW TIGARD ST 69 Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2 Project Description: Install (4) ductless heat pumps in units 69, 70, 71 & 72 01/27/2012: REPRINT permit to correct unit numbers. Contractor: THE HEAT PUMP STORE Owner: RICHARDS, JAMES E & SHARON S 985 N MAIN ST BY NORRIS & STEVENS INDEPENDENCE, OR 97351 621 SW MORRISON ST #800 PORTLAND, OR 97205 PHONE: 503 - 606 -9165 PHONE: 503 -624 -9856 FAX: 503 - 837 -0572 FEES Specifics: Description Date Amount Type of Use: MF Permit Fee 01/20/2012 $360.41 Class of Work: ALT Type of Const: VB Plan Review 01/20/2012 $90.10 Occupancy Grp: R-2 Occupancy Load: 12% State Surcharge - Mechanical 01/20/2012 $43.25 Stories: 2 Info Process /Archiving - Sm $0.50 (up to 01/20/2012 $4.50 11x17) Project Valuation: $10,452.00 Misc Administration Fee 01/20/2012 $4.50 Fuel Air Handlers Fuel Types: Units < 10000 cfm: 4 Gas Pressure: Units > 10000 cfm: Furnaces Boilers & Compressors Furnaces < 100K BTU: 0 -3 HP: Furnaces >= 100K BTU: 3 -15 HP: Floor Furnaces: 15 -30 HP: Unit Heaters: 30 -50 HP: Vents w/o Appliances: 50 or Greater HP: Air Conditioning: Heat Pump: 4 Appliances Vent Fans: Vent Systems: Total $502.76 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: Fire /Smoke Dampers: 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 OU - : calling 503.232.1987 or 1.800.332.2344. • Issued By: / Permittee Signature: r 747 / 9--p/Oc..'C1 70 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. 11 ,, CITY OF TIGARD MECHANICAL PERMIT 1 . :- C OMMUNITY DEVELOPMENT P ermit #: MEC2012 00020 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2012 ' Parcel: 1S134DD00100 Jurisdiction: Tigard Site address: 10543 SW TIGARD ST 70 Project: Windmill Apartments Subdivision: , 2004 -050 PARTITION PLAT Lot: 2 Project Description: Install (4) ductless heat pumps in units 70, 71, 72 & 73. Contractor: THE HEAT PUMP STORE Owner: RICHARDS, JAMES E & SHARON S 985 N MAIN ST BY NORRIS & STEVENS INDEPENDENCE, OR 97351 621 SW MORRISON ST #800 • PORTLAND, OR 97205 PHONE: 503 - 606 -9165 PHONE: 503 - 624 -9856 FAX: 503 - 837 -0572 FEES . Specifics: Description Date Amount Type of Use: MF Permit Fee 01/20/2012 $360.41 Class of Work: ALT Type of Const: VB Plan Review 01/20/2012 $90.10 Occupancy Grp: R-2 Occupancy Load: 12% State Surcharge - Mechanical 01/20/2012 $43.25 Stories: 2 Info Process /Archiving - Sm $0.50 (up to 01/20/2012 $4.50 ect Valuation: Mix17) Pro j $10,452.00 Misc Administration Fee 01/20/2012 $4.50 Fuel Air Handlers Fuel Types: Units < 10000 cfm: 4 Gas Pressure: Units > 10000 cfm: Furnaces Boilers & Compressors , Furnaces < 100K BTU: 0 -3 HP: Furnaces >= 100K BTU: 3 -15 HP: Floor Furnaces: 15 -30 HP: Unit Heaters: 30 -50 HP: Vents w/o Appliances: 50 or Greater HP: Air Conditioning: Heat Pump: 4 Appliances Vent Fans: Vent Systems: Total $502.76 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: Fire /Smoke Dampers: 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: 4 AO "- , j - Permittee Signature: / 6,47 �!°�Gi —i�0 Call 503.639.4175 by 7:00 a.m. for the next available inspection date. ', a. 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 Application . FOR OFFICE USE ONLY City of Tigard KECEIVED Received . iffernin Permit No.: Pige , , ., 13125 SW Hall Blvd., OR 97223 1111 Date/By: 1 , . _A-....k■'''' Plan Review- A4 1 . 1 A 1 h i .. il . 1111 1 1110 4 ,,_ 4 ItE : 111 .: Phone: 503.718.2439 Fax: 503.598.19MN 1 3 2012 Date/By: Other Permit: , VII Inspection Line: 503.639A175 TA ci A tt D Date Ready/By: kais. ra See Page 2 for ..;,.. - Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information BI HIDING DIVISION TYPE OF WORK 1 - ., .: - • ' - --- -- -- ''',---- -veixviiiiiiici' IJg - - -- - Mechanical permit fees* are based on the value of the work 0 New construction 5 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit ' ' Value: $ / 932_ D6 CATEGORY 6ONS ' -' TRIldFION' • -.1.Y , :. .,.:_ - . 1 .' , :_ ,C 7 , -- -.;,, , i0 1 4 , 70 - t- rs :074,70-014-01 ,T t szs ,i-6 1, -,, Ti 0 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. g Multi-family 0 Master builder El Other: Description Qty. _ Ea. Total ,, •:•,,,', -- ' ,--,-. --, ' -. , - - 7 . • . Heating/cooling: JOB SITE INFORMATION AND LOCATION -. .7- . , . - - . , '. Air conditioning Job site address: lb 91-3 5 (4) r/67,410 $1" t4)3p7 70 7 / 7 P (requires site plan showing placement) 46.75 /...1 / / Furnace 100,000 BTU (ducts/vents) 46.75 City/State/ZIP: it (Qtdca-D 0 R . s y7 A a 3 co- 73 Furnace 100,000+ BTU (ducts/vents) 54.91 . Heat pump Suite/bldg./apt. no.: Project name: \)■) 'ND ) IQ, A iffitTME)Vrc (requires site plan showing placement) i f 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 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 Tax map/parcel no.: Other fuel appliances: • DESCRlif ION OF• WORK ' Water heater 23.32 . • Gas fireplace 33.39 X ../1Sct if cf M '704.1...0 ›,./C ll-ht 5 5 ,?J' /fr Flue vent for water heater or gas ac.6 e ( -6-2_ Y 0/ , 1-5 CI HO fireplace 23.32 Log lighter (gas) 23.32 eld • 0 1441 1141. q 1 tweivd 1-6 s In/c.boA-4 Wood/pellet stove 33.39 VS/ fi: ftA41.4 (I 4: Cky•-e=" ap/OV-'1 efeiell ef , Wood fireplace/insert 23.32 ' Chimney/liner/flue/vent 23.32 Pi) .rabOirty. OWNER - • ' ' '. . 0 'reSiArtiu ...• Other: 23.32 Name: i 0/1 4 56.rcAi Z rom e 9 5' Environmental exhaust and ventilation: Address: / 0 n 9 k ) . 726 1 4.-ap 5-7 . Range hood/other kitchen equipment 33.39 City/State/ZIP: 7 ,„,,,,,, oe r Ja 3 Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms, Phone: ( co3) ( 3.y_ ,- 7 q5 . Fax: ( ) toilet compartments, utility rooms) 23.32 .. . '. •• ;APpLICANT 111ON CONTACT Attic/crawlspace fans PERSON • p - • r .. .,: ', _ - . . . . . . „ . 23.32 23.32 Business name: th,„,,,,- .F .40161, , ..c 5 dt 1h ll- l 0 - Other: - 101° . Fuel piping: ----, Contact name: 41 1.-1 $14.15 for first four; $4.03 for each additional Address: 7 S 0* / kr 5 -r Fumace, etc. Gas heat pump ._.... City/State/ZIP: C') R-- 1 .5 --1-kot---pt.ibviu(.r Wall/suspended/unit heater Phone: ( 5 z" 6OG ...Ito' Fax: : ( jC 63 - 1 ..- 0 c 7 a__ Water heater . Fireplace E-mail: , e t-t-k_' t \ pdmp 5"juie - cc 't' Range . • . • . -,-,, . -. ", •• . . ..• CONTRACTOR i • .- -..., ,:'-,,, . .. : Barbecue Business name: - 1 /-/ Aiesit chrr. Clothes dryer (gas) Other: Address: ? g 5 Al M4-11j cl- '':'''• :-.''-' ' • ''' ' ''MICRNIdAt PERMIT FEE _, • ' . City/State/ZIP: f n 4 t - ,--- C N - 7 ---- orive„1-: 012 99';1 • Subtotal - 'A) Y C f Minimum permit fee ($90.00) Phone: ( Sc.3 i - DOI , - (1/b Fax: ( 54 ) q3r7„.. 65 7)..._ Plan review (25% of permit fee) CCB lic.: i 9 '- State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: 0 I il l - ' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1 ow l...NAN h.4,05eA,t 6 ...- 1, L 0 Date: I/ / 3 , . Fee methodology set by Tri-County Building Industry Service Board 1: \Building \Permits \MEC-PermitApp.doc 09/09/10 440-4617T (11/02/COM/WEB)