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Permit CITY OF TIGARD MECHANICAL PERMIT 1 1_ 2 .n. COMMUNITY DEVELOPMENT Permit #: MEC2013 -00276 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2013 TIGARD 13125 25111 CC01100 Jurisdiction: Tigard Site address: 10155 SW CENTURY OAK DR Project: Thorne Subdivision: SUMMERFIELD Lot: 8 Project Description: Installation of A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance requirements. Contractor: FOUR SEASONS HEATING & A/C INC. Owner: THORNE, OLIVE E 1005 INDUSTRIAL PARKWAY 10155 SW CENTURY OAK DR NEWBERG, OR 97132 TIGARD, OR 97224 PHONE: 503 - 538 -1950 PHONE: FAX: 503 - 538 -0165 FEES Specifics: Description Date Amount Air Conditioning 05/23/2013 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 05/23/2013 $10.80 Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/23/2013 $43.25 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 w - /1-P /02. J e � 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:5035981960 05/23/2013 11:01:51 #2940 P.003/003 Mechanical Permit ApplicatioEC Received City W T igard D eceive s� 4--3 Pcrmit NI /G r a zort . __Qa • 13125 SW Hall B lvd., Tigard, OR 97223 Plan Review i 1,,, 1 ■ . Phone: 503.7111.2439 Fax: 503.5911,196(1 MAY 2 2 2013 6atd■By: Otber Pef,tiit. I I (i , ;In Inspection Line: 503.639.4175 ov Date Ready/By: Internet: www.ti ievx (tilt. p � RI Sec Papc 2 for R CITY OF TIGARD "ui,f,ed /Method •�l Supplemental Information IUILDIN DIVISION - _--- .._-- __ -. -. TYPE OF WORK ^ (:OMMERCIAI, FEE' SCHEDULE - USE (:HE(:KIJSI -- Mechanical permit fees• are based on the value of the work ❑ New construction PO Addition /alteration /replaCCmcnl performed. Indicate the value (rounded to the nearest dollar) ol'all ❑ Demolition ❑ Other: mechanical materials, equipment. labor. overhead, and profit. —_ - -.... _.T....._..... -- - -. Value: $ CATEGORY OF CONSTRU(,'l7ON .,,....,. - .._ -- _...._.__ -_.__. ...._ _._ ._.--- ....- ..,._.,. _ - .•,_ ndustrial RESIDENTIAL'EQIfIPMENI' f sys EMS FEES' 1- and 2-family dwellin' , I I -..- _.._...._, dwelling ❑ Comtnercial /i Ac cessory building F'urspcdol Information use. checiFlCgr. Multi ❑ Mttstcr builder ❑Other: It cription Qty. Fa. Total . JON sITE INFORMATION AND LOC'A'TIO Hcating/eooling: N _ SL. - . .......- Air conditioning, 1 46.7:5 (� 7 ' T -, loh site address: I 0 tr�5 v cC' ry CJC�.k I humaec 100.00(1 H7:Ilsduein/veutY) _ 46.75 - City /State/ZIP: 0 CI Pomace 1(1, 000 n'IU (duets/vents) -- 54.91 - - - - - - - --- Suitelhldg./upt. no.: ' Project name: `� eat pump 61.06 ._ ...... Duct work 23.32 Cross sir l /directions to job site; Hydronic hot water sym - „ 23.32 -' "' -- - Residential boiler (radiator or hvdnmic) . 23.32 Unit healers (fuel -type, not electric). in -wall, in due sus/tended, etc_ 46.75 Flue/vent Mr any of above 23.32 Other: 23.32 Subdivision: Lot nu.: - - -_ - -- her fuel appliances: Tax map/parcel no.: — ._.. _.__.. - ..... Water healer 23.32 -- -- -- - DESCRIPTION OF WORK Gas Fire lalace/insert 33.:19 ___ -- ___-- -._ -..,_ -_-- A _ _, - Flue vent for water heater or gas - .._ _ •_.'.�-�- L_--- .-- a5f_I� _`14.,11t •- -, •U Y',:.4- -- ._..... _ _._._ fireplam -- - .......... 21 32 Log lighter (a 23.32 ---__..._.__ ._ ....... ........ .._..... -..,.. Wood/ pellet stove 3 3.39 Wood fireplace/inscrt 23.32 ('hirune /liner /flue /vent 23.32 �.... 0-1(7-PROPERTY ._......._.__.,w -' --- - -- Other: 23.32 OWNER © TENANT - - Environmental exhaust and ventilation: Norte_._. Range hood/other kitchen _. . .... ,. „_i:a..eC -__ a ui meet 33.39 e ss: ` ”` lljr - -' Addr l V t C, , S1,,-, ( .t'.Ct hA Y\-1 O 1)Y t "J -) _ Clothes dryer exhaust 33.39 . - City/State/ZIP: I e Single-duct exhaust City/State/ZIP: "'� 1 G11. \ft� U c �� � `_+ _ et -- - - - - -- / - -•• � - toilet compartments, utility rooms) 23.32 Phone: ([ t _ O: Fax: T �,) }(p 1 U( ( ) Attle/erAWISPACC fans 23.32 94 APPLICANT 0 CONTACT PERSON Other: 23.32 Fuel piping: Business name; - -- .—.__ ..................._ ...:.,....._....Foui.Sea-Soms_1 .. $ 14_ 15for ffour,.S403 each additional Contour name: & Air Conditioning, Inc: Furnace, etc. Address: 1005 Indu15tnal Pkwy Ga. heat pump _. ............. Nowborq• OR 97132 ---- •--- - - - - -- - Walusu ndcdlunit heater City/State/ZIP; Water huller Phone: (�-j >> 1 . ..5' r �' Fax; . ( L L 7 r. FireElace --- •- --. -- - - ..- .._.... -... C ' , -- - -- - - -- --- - .. Range I`. -mail: y -• _ _..._._- __.- ..- ..__.......... C 4 e.: 4:" u e (. Ir'- (- --, u v' ,, e_ s,,- l i? r :� f� 1 r ' V ..._.......,....., Barbecue CONTRACTOR Clothes dryer (gas) _._.. - - - -- Four Seasons • - - -- ._....._... ...,_.- ..._.....M� ,.. .......__..._.._...... ._ tootle: Other: Business t MECHANICAL PERMIT FEES" Address; - --- - -_- -- . — _...._.__........ ... - -- 495- 4- Rdts4r- ial - F?kwy •.... Subtotal Li � : 7 Pity /State /ZIT': Newbe rc OR X37132 Minimum permit lee ($90.00) ` I p • 5 - -- -- - - - -- ' 2 -- -- .. w_.. - -- _. - -__. review 5 %ofpennit fee) 4. Phone'. (( S 14. - 3 g .: l i:. .-; Fax: (Co)) 5 �� :. Ci R fli S . S trudsurchargc (12% of permit lee) C(.'Il tic,: L' I S 9._ TOTAL. PERMIT FE .1 "o , C 7 1 1 .- --- . / - ._. — 1j - - - - - - -• This permit application expires If a permit is not oldrinrd within ISO days after it has been accepted an complete. Authorized signature: ,1 .11.1p • Fec mLIM,d, logy set by l'ri- County Building lndwaty Service Mont Print name: Date: 1 tiruitding'P•rmitAMEC,.l crmitApp_ WUI Uahx 440 46171(11/n2/COM/WE FROM Four Seasons Heating TO 5035981960 05/23/2013 11:01:38 #2940 P.001 /003 p �v pluE 8g q 1.TOUR `. SEASONS ; Q' ` A c o s , FAX DATE: 5 _ ,:.', ... TIME: G " .. Cx �--a TO: Cit of Ti and ATTN: Permits RE: Please issue and fax cop'' of Permit as soon as possible. NUMBER OF PAGES (including cover): 3 FROM: Four Seasons !leafing & Air Conditioning 1005 Industrial Parkway Newberg OR 97 132 Phone: 503 -538 -19511 Fax: 503 -538 -0165 Sent By: Deborah E - Mail: de borate @fourseasonsheatair.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 10155 SW CENTURY OAK DR, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical final 06/12/2013 00:00 MEC2013-00276 PASS - No C of O Minor label 367953 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 10155 SW CENTURY OAK DR, TIGARD, OR, 97224 Residential - Mechanical 699 Mechanical final 06/12/2013 00:00 MEC2013-00276 PASS - No C of O Minor label 367953 Violation Summary: Inspector Contractor