Permit CITY OF TIGARD MECHANICAL PERMIT
a .. COMMUNITY DEVELOPMENT Permit #: MEC2013 -00220
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/23/2013
TIGARD . g Parcel: 2S104DA19400
Jurisdiction: Tigard
Site address: 13295 SW KINGSTON PL
Project: Stone Subdivision:)UAIL HOLLOW SOUTH TOWNHOMEE Lot: 20
Project Description: (1) heat pump installation and (1) gas line Placement of heat pump must compy with manufacturer's clearance
requirements
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: STONE, CAROL
1005 INDUSTRIAL PARKWAY 13295 SW KINGSTON PL
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 -538 -1950 PHONE: 503 - 746 -5828
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Heat Pump 04/23/2013 $61.06
Type of Use: SF Fuel Piping 04/23/2013 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/23/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 04/23/2013 $14.79
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: r1g C 4- a
`I 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.
FROM:Four Seasons Heating TO:5035081960 04/23/2013 15:04:21 #1081 P.003/003
Mechanical Permit Application RECE I l rlt HI I H I I NI t r\ I l
Ili City of Tigard APR Received Pc mut No.'
ri qp ? 1 , Da td 9 . `f " 1 3 / 3t�/3 ..0
i 13 125 SW W Hall Blvd., 'Tigard, OR 97 3 2 01 Plan • R e v i e w
• Phone. 503. 718.2439 Fax: 503.598.1!X0 Other Permit
I F eteMy'
, , ,\ I I, inspection l .inc: 5113,634.4175 CITY OF TIGARD rate Ready /lay July la flee Pere 2 for
Internet: www.ligard- or.gov BUILDING DIVISIDI�llifled/Mett " "I 71 )., Sn
pplenrenetrl 1 srtrr�aaen
TYPE OF WORK COMMERCIAL FEE* SCHEDULE _, USE CHECKLIST
Mechanical permit tees' arc based on the value of the work
❑ New construction 0 Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ 1)emolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
- -- -
- Value: Value: S_
CATEGORY OF CONSTRUCTION _ RFSIDENTIAL EQ(IIPMENT / SYSTEMS FEES*
0 I - and 2- family dwelling 0 Commercial /industrial 0 Accessory building For speciallnfo ►rmaltan use ttttecklitf.
y ❑ ❑ p .. r ..,_
❑ :,.,....
Multi- IKrrtil Master builder C>ther. Description 1 Qty i Ea. 7 Total
•
JOH SITE INFORMATION AND LOCATION 'leafing/cooling: ..„ -
Job site Air conditioning 46.75
address: 13295 SW Kingston Place - - -- ---_ ..._.
Furnace 100,000
...... ....._..._....- ........ - - -- - - Il,O {K) Rill (duets/vents) 16.75
City /Stale / /IP: Tigard, OR 97223 Furnace 100,000+ 13`Itl (ducts/vents) 54.91
--..- t _ __ .... ... Heat pump I 61.06 61.06
.. ...........
Suite /hld),. /apt. no.: Project name: Stone P
- _ Duct work 23.32
Cross street/directions to job site Hydronic hot water system 23,32
Residential Ixrikr (radiator or
_ hydrunic) 23.32
Unit healers (fuel -type, not electric).
- ...._ in -wall, in et suspended, etc. 46.75
Flue/vent for at of above 23.32
Subdivision: 1 Lot no.: Other: 23.32
111 - - ...._..__ -_
__.......... .. ......._ Other fast appliances:
'lax map/parve) no.; Water healer 23.32
DESCRIPTION OF WORK tins fireplace/insert 33.39
........,,•,.. ,• Flue vent for water healer or gas
Install Heat Pump fireplace 23.32
Run Gas Line for Range
1.1 Iighter _ 23.32
--. Wood /pellet stove 33.34
... -. ... Wood fireplace /insert ... 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER L p __._.._._.. -- Other:
TENANT - .. then: - _,....,,_ .,-:..._.._ _.__..._......._ ............._, _
w - Environmental exhaust and ventilafioa: 23.32
Name: Carol Stone Range hood/other kitchen
. i 33.39
Address: 13295 SW Kingston Place Clothes dryer exhaust 33.39
("ity /Slate /ZIP: 'Tigard, OR 97223 Single duct exhaust (bathrooms,
_._ .- - -.._. �._. --- - -- ...............: toilet compartments, utility rooms) 2 :3.32
Phone: (503)746 -5828 Fax: ( ) Attic /crawlspace fans _23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32 ,
F our eass� ♦
Business mane: {� 11.., Fuel piping:
S .....
„a�... ail t 51416 far first fear 5403 for arch additional
Contact name: & Air Conditioning, Inc Furnace, etc.
1 OO!f It It.Ju'trla1'Pkwy - - (Jas hcal j i
Address: rs ....._ . ,.- -..�....._.-
Newherp Q.. 713: . .... .... .:...__. Wutl /auspe txled/unit heater
City /State/ZIP: Water heater
Phone: (503) 5311 1950 Ll'ax :: (503) 538.0165 I
-
Range I 14.15 14.15
L -mail: delrorshla2fourseaxrrosheatalr .corn f5 - - -
- Barbecue
CONTRACTOR Clothes dryer
Business name Four Au Seasons Heating Other:
- -.._ ..... MECHANICAL MECHANICAL PERMIT FLEES*
Address: .One r1C
111OIlirl
........ _ __. Subtot 75.21
9 t _ review permit ( . $90 .. 00 . ).... _ .._. -_
1PElustf +a kwy-
City /State/ZIP; Newberg, OR 97132
•
Minimum ermlt fee (540 Ul)) 90.(10
..._..._.. o permit fee)
Phone: (503) 5311.1950 I'ax: (503) 538-0165 - •-- _._._.._..__�_,_, .. •, •.
.. _..... w:...._.:.,,._..__ State SUrchargc (12% of permit fee) 10.811
CCB lie.: 97152 TOTAI. PERMIT FEE 100.1W
i 1 ' I �" his permit appYndra empires if a permk is rot ubtalred wttnia ISO
Authorized signature: �(,.V�
//J C� ,/ y days after It has been accepted as complete.
iaJ� . S ...SK
f' • Fee mphaetoiogy set by Tn ('aunty Building Industry Service Board
Print name; Deborah Salo f Date: 4/23/13 I
I '1 ,Id,$aU'a nitaoMI•A: PeYmitApp_tMet 1.1 dot; 440N61 Tr'(I rdgr(:omiwEA)
FROM:Four Seasons Heating TO:5035981960 04/23/2013 15:04:08 #1081 P.001 /003
�
a o
v z
9i FOUR t. SEASONS
0
AIR CONQ>
FAX
DATE: `- -- . 3 TIME: .� � � �;►, �
TO: City of Tigard
ATTN: Permits
RE: Please issue and fax copy of Permit as soon as possible.
NUMBER OF PAGES (including cover): '3
FROM: Four Seasons Heating & Air Conditioning
1005 Industrial Parkway
Newberg OR 97132
Phone: 503 -538 -1950
Fax: 503 -538 -0165
Sent By: Deborah
E -Mail: deborahAfourseasonsheatair.com
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
13295 SW KINGSTON PL, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
05/09/2013 00:00
MEC2013-00220
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
13295 SW KINGSTON PL, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
05/09/2013 00:00
MEC2013-00220
PASS - No C of O
Violation Summary:
Inspector Contractor