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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2013 00095 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/13/2013 Parcel: 25111 DB04700 Jurisdiction: Tigard Site address: 15222 SW ALDERBROOK PL Project: Kaufman Subdivision: SUMMERFIELD NO.7 Lot: 413 Project Description: Replace (1) furnace and (1) heat pump Contractor: TRANTEL HEATING & COOLING Owner: KAUFMAN, ELVIRA B TRUST 2616 SE 17TH AVE 15222 SW ALDERBROOK PL PORTLAND, OR 97202 TIGARD, OR 97224 PHONE: 503 - 553 -9066 PHONE: 503 - 206 -1307 FAX: FEES Specifics: Description Date Amount Furnaces < 100K BTU 02/13/2013 $46.75 Type of Use: SF Heat Pump 02/13/2013 $61.06 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/13/2013 $12.94 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $120.75 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: i y (44 u/ r Permittee Signature: 1111► 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 Application FOR OFFICE USE ONLY RECEIV Received Permit No.: E f 3 4 lig - City of Tigard Date/By: 3 13 g-t / GaD 13125 SW Hall Blvd., Tigard, OR 97223 y �� I Plan Review Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 FEB 13 2013 Date/By: TIGARD Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: . ( Supplemental Information BUILDING DNISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees' are 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: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* I. and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: 1 S,.2 a a 3 W k Aa-r - 'l cnv K., P f, (requires site plan showing placement) 46.75 City /State /ZIP: Furnace 100,000 BTU (ducts/vents) I 46.75 1 / 4 -(4„; - ?c . " t ' �- t 1L i ) '- ')-- Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showing placement) I 61.06 ( -Bic 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 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 23.32 Gas fireplace/insert 33.39 1 2 -c, p / 4 c c- t i r r7 4 c e_ 1 n .."Y " - 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 PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 23.32 Other: 23.32 Name: 0 'L S� 0. .' � INN co....1Th Environmental exhaust and ventilation: Address: \ S �.� \...D �A, .l J. o o l` P L Range hood /other kitchen 5 equipment 33.39 City/State /ZIP: , cl r- L, oiler c ') 2 3 Clothes dryer exhaust 33.39 � Fax: Single -duct exhaust (bathrooms, Phone: ( 3 ) �- to - \ 3 i0� ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans _ 23.32 Business name: �7 Other: 23.32 �`rC� ✓ _F el, . j -c v� I i C t G7 0 t /� Fuel piping: Contact name: _S n.� 1 r, .1 e....1 7 $14.15 for first four; $4.03 for each additional Address: 2(P ( Lo S c f �-', /' \ Gas Furnace, heat etc. I� t Gas heat pump City /State /ZIP: ‘., x-- 1 (3. ' "7 9-0 Wall /suspended/unit heater Phone: (') St 3 - C -D (o co Fax: : ( ) Water heater ( Fireplace E -mail: -SLe. e "Tr 6_n -1 eo. -, 9 ca.v■ CbZ'\ i rl_. , CD b`1 Range CONTRACTOR Barbecue / � Clothes dryer (gas) Business name: f rG. n + 14.c, rs 5 4 Co - o\ t o S Other: Address: 'L� \ t, C I -) .'M A' MECHANICAL PERMIT FEES" City/State /ZIP: \, �� '- ( 'L_ c - 7 oL o - Subtotal 10') g Phone: Minimum permit fee ($90.00) ( ) 5 S 3 a b l Fax: ( ) Plan review (25% of permit fee) CCB lic.: / C s- q Y I Pi 1 1 L3 State surcharge (12% of permit fee) TOTAL PERMIT FEE l,2f7.7 Authorized signature: 1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: _c �,arte ��, 4- a I Date: - P__ I i Z/I - * Fee methodology set by Tri -County Building Industry Service Board I:\Building\Permits\MEC- PermitApp.doc 03/07/12 440 -4617T (l l /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Building\Perrnits\MEC- PermitApp.doc 03/07/12 2 • u ' 1 Q1 5 e / `�a °ct 0 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 15222 SW ALDERBROOK PL, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical final 02/28/2013 00:00 MEC2013-00095 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 15222 SW ALDERBROOK PL, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical final 02/28/2013 00:00 MEC2013-00095 PASS - No C of O Violation Summary: Inspector Contractor