Permit •
•
CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2013 -00074
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013
Parcel: 1 S134CD08000
Jurisdiction: Tigard
Site address: 11820 SW SUMMER CREST DR
Project: Swenson Subdivision: BURLWOOD NO.4 Lot: 11
Project Description: Install ductless heat pump. Placement of unit must maintain minimum 5' side yard and approved rear yard
setbacks.
Contractor: ADVANTAGE HEATING & AIR CONDITIONING LLC Owner: SWENSON, LESLIE D & LORRI E
2355 HYACINTH ST SE 11820 SW SUMMERCREST DR
SALEM, OR 97301 TIGARD, OR 97223
PHONE: 503 - 393 -5315 PHONE:
FAX: 503 - 393 -2253
FEES
Specifics: Description Date Amount
Heat Pump 02/04/2013 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 02/04/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/04/2013 $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 • : rules adopted by the Oregon
Utility Notific• 1 Center. Thos- rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. Y. ay a copy of the rules
or direct •estions to c NC b .fling 503.232.1987 or 1.800.332.2344.
Issued = : t 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 App Hellion. FoR or FICE tISE ONLY
• 1
City of Tigard teEIVED . , izriligtrin
, ,, Permit No.: ile_640/3...e
3125 SW Hall Blvd., Tigard, OR 90
III Plan Review .
Phone: 503.718.2439 Fax: 503.598.19T EB 4- 2013 Date/By: Other Permit:
Inspection Line: 503.639.4175
TIGARD Date Ready/By: Juris: IZI See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE kstalaING-DIVISION 2; , 7- ::, -:-. -' 1,-: , 7 v.i!.- :eriAikittauktE#! §tritiouft .= iist.b4kcialsr •
Mec hanical permit fees* are based on the value of the work
0 New construction KAdditiorilalterationfreplacement performed. Indicate the value (rounded to the nearest dollar) of all
I=1 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONS11UJCTION RSEIPMENT / SYSTEMS FEES*
„ -
)Z] 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
El Multi-family 0 Master builder 0 Other: Description I Qt'. I Ea. I Total
• -
JOB SITE INFORMATION AND LOCATION ••, '' , . ". ; Heatsnglcoohng
. _ . . . ._... .. _ Air conditioning
Job site address: i 182.6 —
--- , - -) - 60 DIA-vn mzir 0A-e-st D.,e- (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State/ZIP: — 11 - c p ,v i ()( 91 2.2: Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: I Project name: ( 5 tue_n5zsyk Heat pump
(requires site plan showing placement) 1 61.06 ez, I .(,)4z
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:
DESCRIPTION OF WORK ' - -: -- ": --'. ' - • •-•- •-• . Water heater 23.32
, .
Gas fireplace/insert 33.39
i i/Vc4,1.1 c•IPA ft 1 c.ss kb20-1 ple,rne Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
' - - - El PROPERTY' OVVNER -, I' ., - . . :.- ' 7- ' CIF iriNAi•it: •-' i . : ' : ,2 '.-. Chimney/liner/flue/vent 23.32
Other • 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
:. '• :. . _c% 2 0 1 0 0 4. . : '.,- .- :: : la CoNtA0r• : • 7:: Attic/crawlspace fans 23.32
Other:
Business name: AUCCI-tAc-- l'ti..t-l V--- 4 Ir 1-L.C_. Fuel piping: 23.32
Contact name: 0 0 $14.15 for first four; $4.03 for each additional
Fumace, etc.
Address: ? 3 5 5- 14, , .. ki 0
. Gas heat pump
City/State/ZIP: Se t \ i (ye_ 0 --
nU/ Wall/suspended/unit heater
Phone: 6 ) 3c. ?... 5-3 i s- Fax: : ( r----)-- Water heater
Fireplace
E-mail: cedLt.) OL,L46, e corlAca.31 tic_t Range
• - ' - - • - • •-• ' : - _ CONTRACTOR - - , '..; - - '- - ',, ' ' - - Barbecue
Business name: A-tualiAJ I.- /C1-4.-v u_e_, Clothes dryer (gas)
, Other.
Address: 2555" )4 „-/-4 /) 6 . ,-, •;-::', , _, ',:,,,, ..7 miptEigritaix-ERigri*k§... ::
City/State/ZIP: Sc Lam Orz_ (47 ,1 . Subtotal 4,1, cs(,,,
Minimum permit fee ($90.00) CfC)..CO
Phone:3) 5_ 5 — Fax: ( --)--
Plan review (25% of permit fee) —
CCB lic.: ri (..1 z 6 0 State surcharge (12% of permit fee) ‘,D. 8 0
Authorized signature: V ,0 TOTAL PERMIT FEE lee.)..c,
This permit application expires If a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: I Date:2- I t 1 ( ---. 1 • Fee methodology set by Tri-County Building Industry Service Board
1: \BuildingWermits\MEC-PermitApp.doc 03/07/12 440-46I TT (I I/02/COM/WEB)
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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
11820 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
02/25/2013 00:00
MEC2013-00074
PASS - No C of O
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
11820 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
02/25/2013 00:00
MEC2013-00074
PASS - No C of O
Violation Summary:
Inspector Contractor