Permit CITY OF TIGARD MECHANICAL PERMIT
11 1- e COMMUNITY DEVELOPMENT Permit #: MEC2013 -00334
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/18/2013
Parcel: 1 S134DD01700
Jurisdiction: Tigard
Site address: 11835 SW TIEDEMAN AVE
Project: Nofzinger Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: Installation of mini -split heat pump. Placement of NC or heat pump units must comply with the manufacturer's
clearance requirements.
Contractor: A TEMP HEATING & COOLING INC Owner: NOFZIGER, KENNETH RICHARD
16000 SE EVELYN ST 11835 SW TIEDEMANN
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223
PHONE: 503 - 650 -5014 PHONE: 503 - 624 -8484
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Heat Pump 06/18/2013 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 06/18/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 06/18/2013 $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 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: OA/ /5
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.
06/13/2013 16:06 5035572990 A TEMP HEATING PAGE 01
Mechanical Permit Applicatio'RECEIVED vol. . 01:11(.1 I sir. or,,I.,
City of Tigard Received • RN
Date/By: 41gASMAIIII es
N 7 13125 SW Hall Blvd.. Pumit N Y l fgr 2 0/3 -40e33
Tigard, OR 97223 JUN 1 3 2013 ?ha Review
• Phone: 503.718.2439 Fax: 503.598.1960 Dinriny: Other Permit;
1 1 ( ; ,,, i. „ , Inspection Line: 503.639.4175 Dare Ready/13y: I% r , RI see Pagel for
Internet: wwwirgarti-or.gov CITY OFTIGARD Notified/Mobs& .1 1 ('' SapplenscomIntinrrnianon
BUILDINGDIVLSIO
.: - ., : ::,.......i ,'.-,, .: jwii, ......'.,,::::::::::.:::::.:-,.. 77.5_, Ntxt0A.67P7.;(
_
Mechanical percuh fettl ate based On the 17111110 of the ViOrk
0 New construction I.. AdditiOnianentiCalhtpiaCCIMent perfarmed Indicate the value (normded to the nearest dollar) of all
0 Demolition 9 Other mechanical materials, equipment, labor, overhead and profit.
• Value: $
, :'- ,;_. ,•:: . - i' CTGORY- tlireiiiiSC7- - 1 •••;-•:,',. -: • ---.. - - -- -- - - - --
L .-A - - - “ . • ' • - ' " - • • ' • - ''' ' ' - ' • - • • ' . 0,r,4L.:E
1- and 2-family dwelling 0 Commerciallinduslrial 0 Acces ory building Poe vecialinformalicut axe checklag
0 Multi-family 0 Master builder 9 abed Description j Q I EL I Total
: :;:::::: • .•44, kitittroi -::. ..: . , • - -.,
............... Air conditioning
Job site address: I ( '3 c .--
-r;ecz.....,...., A Jo. . (*Pcluiros 5 0 Pi tIll showing rienornom) 46.75
Purnriec 100,000 BTU (ducts/vents) 46.75
City/Statc/ZIP: T L5 a. r i L e :,1 k 7 20
Emu. 100,000+ BTU (111vadvents) 54.91-__
Suito/hldgJapt, no.; Project name: S i ' 44 Bent pump I
(requires site plan showing phrcemont) 61.06 b 1 .06
Cross stroct/directions to job site: Aid work 23.32 . .
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronle) 23.32
Unit heaters (fael•type, not electric),
iti-wall, in-duct. suspended. elc. 46.75
Subdivision: Lot no.:
Flue/vent for any of above 23.32
-
Other. . 23,32
Tax mariloamel no.: Other fad applitatem
' ...:,':' .,§iiirtii*"61#*dtit:. .:, '..,,: .. :; :.'.:::. ...:1• .. .;..: ..': •.,:. Water heater 23.32
in , II ` . 4 . .
1 . Gas fireplace
Flue vent for water bea 33.39
m or gas
1 fireplace _ 23.32
- Loa lighter (au) 2332
Wood/pellet stove 33.39
Wood ftreplace/insert 23.32
;:;:' : ii;1' . ';';;: :; : t1451W .•:',.-:.; ,'. ChinmeY/Urierinueive"t 23.32
" Othen , 73,32
. .
Name: - tvjer Environmental czhaust and yea/nation:
Range hood/other kitchen
Address: 1 I g _S .5 ci) -, _ T (.•c;1 9 fr•-%4v1 Ave. .. equipment _ , 33,39
City/State/ZIP: -/-; ,. _dIE522 Clothes dryer exhaust , 33.39 . .
Single-duet exhaust (bathrooms,
Phone: (to3 ) 6- 24,,seti 5, Fax: ( ) . toilet compartments. utility rooms) 23.32
. ;;;.2.- . , , ;':, - .'t, i '„,.:,::', : '.:,,....%:,;,,.::::, ::...,,,"•;„ .1 ;,:.::,;;,:;;,::',; : , ,i;:rt0 , 000,tiotiviiito, ,-...., ,,:, '-. Attic/crawlspace fans 23.32
, Other: --- [32
Business name:
AVIEMP FP . k 1. 1 T • . had Dip*;
Contact name: 16000 SE Evelyn St. $14.15 For first four; $4.03 for cads additional
Address: Chick/mes OR 97015 Furnace, etc.
- .
.,
11-9 hea MP
City/State/23P: I Wall/suspended/unit healer
Phone: ( ) Fax: : (503 ) 54.1 2 _4/ 0 watar heater
Fireplace
E SlEtar 4 fe A &it . cc Range
.., •
Business name: A-TEMP IIEAMeaANI1CODLINCLii.0 Clothes dryer (gas)
Other: ,
A.daress: 16000 SE Evelyn St.
, .... ......- ....
:„ 0 ; , i N,
Ciiy/SItitesiZIP: SubtothI 6 .-ix ,e
sn3.450-5f114
Minimum permit fee (S90.00) 61 O 00
hone: ( ) F a' 6 D ) ;51.- --1A ctO Plan review (25% of permit fee)
Vcce tic.: , II 11
State surcharge (12% of permit fee) 1 0 r
-, T -• -________ ToTALLIz EFE ci • •, • .
Auth This permit applkatIon expires Ifa permit ts not obtained within within within ISO
orized signature ../Ar -
, - - _ - '___PL_ , , - gar'
tbrysi !Mar It has hero accepted in canrplOk.
Print namc; ri I N i 1. ila '. g.... MI Date: 6 ■ 3 - . Foe methodology act by Tri Bnilding Industry Service Band
T NnundingtomIONSC-PennitAto.dou 09/09/ I O 440.41171 ( 1 1/02/COMAYED)