Permit CITY OF TIGARD MECHANICAL PERMIT
1 1 1- _ • • - COMMUNITY DEVELOPMENT Permit #: MEC2013 -00337
Date Issued: 06/18/2013
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S110DD90312
Jurisdiction: Tigard
Site address: 10940 SW MEADOWBROOK DR 31
Project: Selzer Subdivision: SUMMERFIELD BROOKSIDE CONDO Lot: 31
Project Description: Installation of heat pump. Placement of NC or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: SALZER, RAMONA G
1005 INDUSTRIAL PARKWAY 10940 SW MEADOWBROOK DR #31
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950
PHONE: 503 - 620 -3045
FAX: 503 - 538 -0165
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:,(P Permittee Signature: efry / ef}-770,•(/
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 06/17/2013 14:40:07 #4474 P.003/003
Mechanical Permit Applicat'
City f Tigard Reuel Y � L1J Rel VIA D a t e/ i� �,
Prmtit No.:�y ad /3 D033
• 13 125 S W Hall Blvd.. Tigard, OR 97223 Pln Review
Phone: $09.% 18.2439 has: 503.5 3x.19( UN 1 7 2013 lty Ouwr Permit:
Uatc /lsy:
I I t : A K I ) Inspection Lino: 503.639.417$ Date Ready /Hy: )uso Set Page 2 for
Internet: www.tiRard•or,guv OFrYOFTIGARD Notirx:d/Mctlnxt: ' ] Supplemental Information
1 ,12 ?,- ri�Yt,�t''e: ., 4 iy I . h Y .1t'�,;�,. ,..''_. 9+rY SI.. ,'•YN' , . . , ', ?: 74r W � v S�- �5�"7714' of �•!
M,,hamcttl permit Iee • are based on the value of the work
❑ New construction ® Addition/alteration/replacement pmformed Indicate the value (rounded to the nearest dottar) ut all
❑ Demolition ❑ ()titer: mechanical materials, equipment, labor, overhead, and truck
;(k r S
®I- and 2- family dwelling ❑C'ommercial/industrial ❑ Accessory building Fur eprrlaJ Information use checklist.
E Multi - fancily ❑ Muster builder ❑ ()titer: Description Qty. I Ea. Total
i' Vg'i,Y,tVgla,i e,`r'e `` . I ,.,. •: ., ` •' < i Ilealin cooling__ _.....____ .... _.,....,.,.
Air conditioning 46.75
Job site address: 10940 SW Mcadowbrook !)rive #31
Furnace 100.090 wry (ducwvems) 46.75
City /Slate/ZIP: Tigard, Olt 97224 Furnace 100,0001 BTU (duetsive - 54,91
Suite/bldg. /apt. flu.: Project name: Salter
Heat punt,, I 6L06 61 .on
-- __ -..- -_-- Duet work 23,32
Cross street/directions to job site: H dnmic hot water system 23.32
- ................. . ___ - Residential boiler (radiator or
ytlrOnicI _ 23,32
- ._.._..... . ........... . ........-- ---_._ ........ ..._. Unit limiters (fuel out electric), .,,... ,..........,,.,,..., ..
yP
-- .......................... _._..._.._- -- - �....._..,. ---- in -wall, ,, in -duct suspended, etc, 46.%5
in-wall,, — _..._..
Flue /veait for any ul' bo
ave 23.32
Subdivision: I „ot no.: Other; 23.32
- ...... . ...... -. - __.,........ - Other fuel appliances:
Tax map/parecl no.; Water htmtor 23.32
550d „Ml'iYi5 NN,, ,,' ;i i6•0;;� -�' M ` Gas lire l'ilins i 33.39
Install Heat Pump Flue vtrtt I•n� water heater or gas
1 ht92h5e 21 12
Log lighter (gas) _.._.__,,,.,,.... 23.32
- -•-- ._._- ..__._..._.,...,, - -- ....... Woo ellet stove 33.39
Wood fireplace /insert 23.32
( :himney /liner /nue/vey t 23.32__ -
M ,.,...,,,,., ,;a , Qlhcr, 2132
Environmental exhaust and ventllalion:
Name: Ramona Salter Range hood /other kitchen
- equipment _3339
,
Address; ok Drive #31
s ca >ro ✓____._ __... -- ---- ---- _._ ............. Clothes dryer exhaust 33.39
City /Stale /ZIP: Tigard. OR 97224 Single -duct exhaust thatlu'oums. — - —r
— — -- - ----- toilet eoatpannients• utility rooms), 23.32
Phone: (503)620 -3o4$ Fax: ( ) Attic /crawls ace fans 23.32
ft ` e ,':.*:'E t t) / a fmt4#. P$04Qltit4 + UIhtY. 23.32
Business came: Fuel piping_
_... _.........__....._.___.___...._ Fuu r Seasonb Heating $14.15 for first four; $4.03 for each aJdflfonal_
Contact name: y, n g pomac, etc
--.--... .— _..........._.._...__._ u_G..uI]slllionin Inc ._.:.._,,,...__._--
Address; 1005 Industrial Pkwy Gas heat pump
- - NE'WLlt:t Via. OR t1 1 W
32 — - _ Wa■uspcndcd/unit heater
City /StatelZiP: Water helta -,
Phone: (503) 538.1950 I Fax; ; (503) 538 -0165 Firtplacc
- - -- - ..._._.. -- ....,......__ Ra - -
E-mail: drhurah (a;fourxcasonsbeafaif.conl Liarirecuc
;' ”, g „ , : ie �,: � (:Irnh _s dryer (gas)
Business name: Four Seasons Heating
Other:
tics K Air Condltfonlny
Ac t';rrl i��;%w:�;F
t
S:
--- L9E36cltri it Pkwy Subtotal 61.06
City /Slate /ZIP: Newberg. OR 97132 Minimum permit fee (590.00) 90.00
Phone: ._..- - _____ -- - — ...---- ._.._. . ...
Plan review
P —.-
t ; ( 503 538 -195(1 Fax 503) 538 -0 t 65 - - - - Stott smef
.........:. — ..__,.. '....__..._......... UhA ,/
__. a % )cp.: mit fee) 10.8 {I
CCD lie.: 97152 L PERMIT FEE 1(11X(
applucatuoo expire% If a permit Ix not °intuited within IRO
days after it h, a Iwen acceplr4 RP complete.
Authorized signature: Q. 12. 1,. <JL4 M' • I'ec ulcrhlulutu se' by )'ri.C°Ilnw Building Indu.try Service Ihuud
Print name: Deborah Salo Date: 6/17/13
1 :',iivldinx\fennns,Ml:t I•.,■,In App 0441111,Isc .1'111 1 5 1 7 1 ( 1 1 111 /1 1)M/WPH)
FROM Four Seasons Heating TO:5035981960 06/17/2013 14:39:52 #4474 P.001 /003
. 4:6"
3 _; SEASONS ,
FAX
DATE: CC? - ` 1 — '3 TIME: .. G1 c>,,,
TO: Cit of Ti and
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: deborah @fourseasonsheatair.com