Permit p CITY OF TIGARD MECHANICAL PERMIT
II/ ' COMMUNITY DEVELOPMENT Permit #: MEC2012 00653
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 12/11/2012
Parcel: 2S 111 BA01700
Jurisdiction: Tigard
Site address: 14325 SW 97TH AVE
Project: Mitchell Subdivision:CONDO SUPPLEMENTAL PLAT NO 3 Lot: 32
Project Description: (1) new heat pump installation mini split
Contractor: SANDU INC Owner: MITCHELL, PATICIA
2101 NE 387TH AVE 14325 SW 97TH AVE
WASHOUGAL, WA 98671 TIGARD, OR 97224
PHONE 503 - 740 -1333 PHONE' 503 - 620 -3203
FAX 888 - 340 -6548
. FEES
Specifics: Description Date Amount
Heat Pump 12/11/2012 $61 06
Type of Use: SF 12% State Surcharge - Mechanical 12/11/2012 $10 80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 12/11/2012 $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: o ` I kI l u vl'l /Ad
___
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.
Dec 11 12 06:36a SANDU, INC 888 - 340 -6548 p.1
Mechanical Permit ApplicatfECEIV ED 1 Olt neat I. t "1.O\l '.
City of Tigard Received a y / 1 t )0 f u Permit No. ).i Xis — ( e 53
: 74 41 13125 SW Ball Blvd., Tigard, OR 97223 DEC 1 1 2012 Plan Review
Phone: 503.718.2439 Fax 503.598.1960 Date/By: Other Permit:
T 1, .,, : ;1-) inspection Line: 503.639.4175 TIGARD Date Ready.By: rue la See Page 2 for
Internet www.tigard ow GF TIGA D t<otified.'Method: (( Supplemental 'attenuation
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE'. SCHEDULE - USE CHECKLIST
Mechanical permit fees* arc based on the value of the work
❑ New construction ® Addition /alteration/replacement performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit_
Value: S $8,000.00 _
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES`
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE LNFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 14325 SW 97 AVE (requires site alas showing placement) 46.75
- Furnace 100 BTU (ducts'vents) 46.75
City /State/ZIP: PORTLAND, OR 97224 Furnace 100,000+ BTU (duds/vents) 54.91
Suite/bldgiapt. no.: Project name: Heat pump
� (requires site plan showing placement) I 1 61.06 61.06
Cross streeVdirections 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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other. 23.32
Tax map/parcel no.: Other heel appliance=
DESCRIPTION OF WORK Water heater 23.32
INSTALL NEW MINI SPLIT HEAT PUMP SYSTEM Gas fireplace , 33 39
Flue vent for water healer or gas
fireplace 23.32 .
Log lighter (gas) 23.32
Wood/pdkt stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER 1 0 TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: PATRICIA MITCHELL Environmental exhaust and ventilation:
Address: 14325 SW 97 AVE Range hood/other kitchen
equipment 1 33.39
City /State /ZIP: PORTLAND, OR 97224 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (503)620 -3203 Fax: ( ) toilet compartments, utility moms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 ,
Business name: SANDU INC. - 23.32
Fuel pipinfi: .
Contact name: JOHN SANDI: $14.15 for first four 54.03 for each additional
Address: 2101 NE 387 AVE Furnace, etc.
Gas heat pomp
City/State /ZIP: WASHOUGAL, WA 98671 I Wall/suspended/unit heater
Phone: (503) 740 -1333 Fax: : (888) 3404548 i 1 Water heater
I Fireplace
E -mail: sanda.inc@gmaileom F Range
CONTRACTOR I Barbecue
Business name: SANDU INC.
Clothes dryer (gas)
Other. _
• Address: 2101 NE 387 AVE MECHANICAL PERMIT FEES"
City/StalefZlP: WASHOUGAL, WA 98671 Subtotal 61.06
Minimum permit fee ($90.00) 90.00
Phone: (503) 740 -1333 I Fax: (888) 340-6548
Plan review (25% of permit fee)
CCB lic.: 166011 State surcharge (1 of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized Si attire This permit applia obtained expires if a permit is not oained withhin 100
sign days after it bas been accepted as complete.
Print name: JOHN SANDU I Date: 12/118012 ' Fee methodology set by Tri- County Building Industry Service Board
L1BuddineereitslMEC- Perr'tApp doc 09t091IC 440-4617? (I L'IraCO\SM'EB)
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I NC -HEAT PUMP UNIT SITE PLAN
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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
14325 SW 97TH AVE, TIGARD, OR, 97224
Residential - Mechanical
615 Mechanical rough-in
05/31/2013 00:00
MEC2012-00653
PASS
2-ea wall units
Violation Summary:
Inspector Contractor
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
14325 SW 97TH AVE, TIGARD, OR, 97224
Residential - Mechanical
615 Mechanical rough-in
05/31/2013 00:00
MEC2012-00653
PASS
2-ea wall units
Violation Summary:
Inspector Contractor