Permit CITY OF TIGARD MECHANICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit #: MEC2013 00378
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/10/2013
Parcel: 2S114BA01600
Jurisdiction: Tigard
Site address: 16180 SW GRIMSON CT
Project: Brod Subdivision: PICK'S LANDING NO.2 Lot: 123
Project Description: Install a/c unit. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: FOUR SEASONS HEATING & NC INC. Owner: BROD, STEPHEN D & YVONNE W
1005 INDUSTRIAL PARKWAY 16180 GRIMSON CT
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE: 503 - 639 -3334
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Air Conditioning 07/10/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/10/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/10/2013 $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 Notifi - . • _ - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir- • questions to O C b -Ding 503.232.1987 or 1.800.332.2344.
Is ued By:
y: •
I ���� Permittee Signatu
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 07/09/2013 10:08:43 #6054 P.003/003
Mechanical Permit A licat n II , 1 0 ,
City of Tigard D to / Rocohcd
Ilataly: 7 3 erza.49 pomittio.: "--/..e
e 3
I ,---- . 13125 SW Ilall Blvd.. Tigard-C/1C 97 3 L. El VE Plan Review
Phone: 503.718.2439 Fax; 503.598.1960 ()her Penan :
Datetty:
Enspetlion Line: 503.639.4175 JUL 9 2013
i.h., ,,,:,, Date Ready/By: RI See Page 2 for
Internet wvAv.tigard-or.gov Notified/Method. CIOF TIGARD •- Supplemental Information
,
TY -• •—•—•—•• • - ._
— , ....,. ... ,,_
------- 'TYPE 011iitiEtNG DIVISKIN COMMERCIAL FEE* SCILEDI)LE - USE CHECKLIST
--- moettuiucal permn lees. arc based on the value oleic v;;;;;i
0 New construction )?1Addition/alteration/replaceineni pc:formed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: ineehanield nialinials. equipment overhead. and profit.. ,
:
CATEGORY OF I:ONSTRU Value $
CTION
RESIDENTIAI.EOIIIPMENT / svgrgms FEES'
______. - ,
0 I - and 2-family dwelling 0 C:ommcreinUindustrial ID AecessOry building For special Information use checklist
0 Multi-Inmily 0 Master builder 0 ()tiler: Descnption
1 Qty, I Ea. 1 Total
_ . ,
— _
JOB SITE INFORMATION AND LlWATION IlestIng/coolinu:
_.__ , — Air conditioninv J 46,75 41,
ryl (..; CI -, ( UlA 4 Funtacc 100.00013TO oncts/vonts) 46 75
..... .
.._ .
._ ._____ • . _._ -..-.
City/State/ZIP: --1--, )(-1_j . C ".‘.7.' C) ' ,..)-'7-
Fumacc loogoi-BTIJouctuivems) . . 54.91 _ .._.....
Suite/bldg./apt. no Project name: _11 Y ..:),,i_.
'
(:ross street/directions to job site: Itdrunic hot wolf swim 23.32
" - ----- '------ . -------- ------- - - Itesidential !viler (radiator or
h dronic) 23.32
.. .. ..._ _
- - ------ • ... • Unit heelers (fuel-type, not elcotric).
in in-duct. stetpmsdecl, cte,_ .. .
__..... ...._.... . ...._
___
---- -- _Flue/vont for any of Orin: ._.. ,.,_. 2132_ .. _.....
. ____
Other: 23,32
Sulxlivision: Lot no.:
..__. . ...... . Other fuel ttPilliances:
................, _.. . ......_ ..
. _Watt./ heater 23 37
Tux map/paroel no.: _ -
_ . .
......-
DESCRIPTION 01 WORK Gas tireplace/inscrt 33.39
__. —... -----.. . — . for '- Flue vent water heater or gas
. ,
_ LL __.Lsick.,1. c.?..v.:\e.v.- I; 1. 23.32 _
1...og_Iigriaas) 23.32
_ 33 39
„____ _ ____ ..._ . _-_-_
Wctod.fireplacchnsert 23,32
_____ . ...._.. ........ ---- - ---
Chimney/liner/line/vent 23.32
PROPERTYO I ..- ...,_1:3 __
. TENANT
_____ ........- Other: 23.32
Environmental exhaust and ventilation; _..._________ _
.___.,.
0 Range hrwd/nther kitchen
Nilille: (,.. e v . Qs (._ vo,v,c. 1 ..._ .._
.— - c. tprucnt 33.39
----- .
/ .
- '
\; _- 11 ( t o n r. C c)i.,‘, 47- +.._ , . „...._ ... Clothes dryer exlmust 33.39
eity /Statc/ZIP: .--- V - - . ‘ U e-- Ci ' D-Li Stir-duct exhaust (bathrooms,
----. ..... .. • - _toilet compartments, utility roeireil
.
Phone: ( C-0' ) li/I)Ok '" 3 . 2, '1 i-i. Fax, ( ) Altic/crawlspace fans
•,.___... ____ ••-••• - - - 23.32
..'--
:
APPLICANT 1:1 CONTACT PERSON Other 2332 --
... — , ......_ ---
..._ .... ..... ........_ _. —..
I tusiness name: S14.15 for Iirst four; S4.03 or each addltional
.--- F15 ii rSt ag511s • Rea ti n g ---- ---. - ---
Furrutec, etc.
(:ontact lame;
________ . ..—•. , ----" • - & Air Goi kini-}-,-Inc: ------- - (las heat pump
Address: 1005 Inciustrial Pkwy ..
N w 66 g , 0 rCgT137 --
t..ity/StaiiITZIP: Water heater
,. • -
.. _ .
.. ,
__.......__.......,...,....._...„ .. ._.. • , Fircpince
Phone: ( r5o; ) S ''S -• 14 c C„.1 lax : : ( ) V ') V - 1(. * S -
• - itangL___
j c , Q.s ...„6,- 1, 4„,:. C.c tj y S: t ..i . e L s(._.1.,„ ,- “ z ,trle.0„.i" . 41,... II- . _(..,_44 _ . Barbecue
CIINTRACI'OR Clothes dryer cuss)
..--- _
Four Other:
Business Mune: Seasons Heating MECHANICAL PERMIT FEES`
j Address: & Air Conditioning, I n• Subtotal
-.-
...___......_ 100.5.--indutiidt Minimum permit ftvz, ($90,00)
City/State/ZIP:
. __....,_..... -.. --__. ...___.NYI.12. ig.,...QB 97122 Ilan review (25% or permit lee)
(Phone: ( ) 1, v , I (.) 56 Fox: ( c.,b l', 0 L c State sun-in:go (12% of permit Ice) 113 • S s',.,?,
- _.... .. .-.
ct.:14 tic.: 91 1 /..j_i., TOTAL PERMIT FEE I c 0
_:...._
___. .. _ Thin permit appfication expires if a permit ia not obtained within IRO
, „ , , (,.. days after it boo been accepted as ennipieth
Authorized silmuture: / _.v t 4 iA-Ii-L) • roc methottnIntsv ma by Tri-coomy niesuo !actuary Service Ronal
{ ... i;int name:-,L ;k_t Ca„I ..t.,3_ 1)ate: 1 - 3
. _
i mtnildaut Tv mita EC Pennii APP 1140113 dm 449 I TI ( I 1/112/(ONVW1€14)
FROM Four Seasons Heating TO:5035981960 07/09/2013 10:08:28 #6054 P.001 /003
Q4elpI: ESpr /S
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FAX
DATE: _7- c1- 1 3 TIME: f c_>
TO: Ci of Ti and
A'I'TN : Permits
RE: Please issue and fax copy of Permit as soon as possible.
NUMBER OF PAGES (including cover): =?")
FROM: Four Seasons lleating & Mr Conditioning
1005 Industrial Parkway
Newberg, OR 97132
Phone: 503-538-1950
Fax: 503-538 -0165
Sent By: Deborah
E -Mail: de borah @fourseasonsheatair.com