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Permit a CITY OF TIGARD MECHANICAL PERMIT " .a COMMUNITY DEVELOPMENT Permit #: MEC2013 -00140 T IGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/12/2013 .. Parcel: 25111 BCO3200 Jurisdiction: Tigard Site address: 10335 SW VIEW TER Project: Luke -Dorf Subdivision: DOUGLAS HEIGHTS Lot: 9 Project Description: Replace furnace and heat pump. Placement of heat pump must maitain 5' side and year yard setbacks. Contractor: MPS HEATING & COOLING LLC Owner: LUKE -DORF, INC PO BOX 5597 10313 SW 69TH AVE BEAVERTON, OR 97006 TIGARD, OR 97223 PHONE: 503 - 319 -7798 PHONE: FAX: 503 - 746 -6117 FEES Specifics: Description Date Amount Furnaces < 100K BTU 03/12/2013 $46.75 Type of Use: SF Heat Pump 03/12/2013 $61.06 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/12/2013 $1294 Occupancy Grp: Stories: . Fuel Fuel Types: Natural Gas 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 Not in - - • - r. 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 .uestions to OU ■ . ailing 83.232.1987 or 1.800.332.2344. / Issued B , / / Permittee Signature: I I ! . ■ J ,� ``/�. Call 503.639.4175 by 7:00 a.m. for the next available inspec on 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 Applicati0 FOR OFFICE USE ONLY City of Tigard R� ��� , Date/Bya 2j E. Permit No.: M4; /'/p Receive 111111 ° 13125 SW Hall Blvd., Tigard, OR 97223 2 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 MAR 1 �+ 20 Date/By: Other Permit: TI G A R D Inspection Line: 503.639 Date Ready/By: Juris: El See Page 2 for Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION 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* Ei 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checkiist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: Iy,3? 3 yr pf-p n (requires site plan showing placement) 46.75 ion S C C 1 jy �l C Furnace 100,000 BTU (ducts/vents) I 46.75 1 1 4 ' . 76- City/State/ZIP: � `� Z 1 J t 9 y � 1, `.T Furnace 100,000+ BTU ( ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump At (requires site plan showing placement) ' 61.06 id ' Cross street/directions to job site: Duct work 23.32 \ Hydronic hot water system 23.32 . � C. - V\ YO W\ MC— Dcw1c4\A c - 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 �+ I Gas fireplace/insert 33.39 { P"� CC a ruy vtur< q► tit d Flue vent for water heater or gas fireplace 23.32 . Crt Pc m P 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: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 33.39 City /State /ZIP: Clothes dryer exhaust 33.39 Phone: ( ) Fax: Single -duct exhaust (bathrooms, ( ) toilet compartments, utility rooms) 23.32 X APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 t o � h9 A., n ( GM\ ` Fuel 23.32 Business name: �i ` Fuel piping: Contact name: M rlU Y 0 9 50\-c_ \ 0 $14.15 for first four; $4.03 for each additional Address: `7 (?, z 9 °C1 Furnace, etc. VV Gas heat pump City/State /ZIP: 5 .c\ ve V f < - © - 1 9�6 Wall /suspended/unit heater Phone: ( ) 3 l l 1 _ ` l v � / Fax: : ((gip) Water heater E -mail: l Ili "� Fireplace Range CONTRACTOR Barbecue Business name: Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) Plan review (25% of permit fee) I CCB lic.: CI ` State surcharge (12% of permit fee) .1 75- 1 TOTAL PERMIT FEE /90' ��s This permit application expires if a permit is not obtained within 180 Authorized signature: _ il / i 1l /A/ :O ' _i f 1 _ days after it has been accepted as complete. I. Print name: ) g r Date: * Fee methodology set by Tri- County Building Industry Service Board • 1: \Building\Permilsl`�' u C- PermitApp,doc 03/07/12 44 6I7T (I I /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 \Permits\MEC- PermitApp.doc 03/07/12 2 RECEIVED 2 Z013 CM OF TICARD WOK DIVISION kGk 0 1 4tr .)) ‘,0 ‘.3 LC V r() LI)