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Permit f q CITY OF TIGARD MECHANICAL PERMIT `F ! g COMMUNITY DEVELOPMENT Permit#: MEC2015 00639 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2015 Parcel: 2S 104 BC00500 Jurisdiction: TIGARD Site address: 14065 SW FERN ST Project: Loesche Subdivision: HANDY ACRES Lot: 9 Project Description: Installation of gas furnace,ductless heat pump multi-head system and ductwork through-out the house.Gas lines for furnace and range. Contractor: HUSKY HEATING&COOLING LLC Owner: LOESCHE, JOSH&JENNIFER N 211 E5THST 14065 SW FERN ST NEWBERG, OR 97132 TIGARD, OR 97223 PHONE: 503-936-7980 PHONE: FAX: FEES Specifics: Description Date Amount Furnaces< 100K BTU 09/23/2015 $46.75 Type of Use: SF Heat Pump 09/23/2015 $61.06 Class of Work: ALT Type of Const: Duct Work 09/23/2015 $23.32 Occupancy Grp: Fuel Piping 09/23/2015 $14.15 Stories: 12%State Surcharge-Mechanical 09/23/2015 $17.43 Fuel Fuel Types: Natural Gas Gas Pressure: Total $162.71 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct s ions • •UNC by calling 503.232.1987 or 1.800.332.2344. Issu d By: I /./112-41/1-4-L? Permittee Signature: f ��� � Call 503.639.4175 by 7:00 a.m.for the next available inspe ion date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit AppIEIVED 11,4 City of Tigard tea: : 9 DateBy: � /7 PeamitNo.: /r �p,j • 13125 SW Hall Blvd.,Tigard,OR 97��(� t. Phone: 503.718.2439 Fax: 503.598J�f 21 2015 Date Review other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: la Internet: www.tigard-or.gov CITY OF TIGARD Notified/vi S ethod: See Page tal 2Int BUILDING DIVISION °°p'`�eO "`°r"°°�°" TYPE OF WORK COMMERCIAL FEE" SCHEDULE—USE CHECKLIST ❑New construction Addition/alteration/replacement Mechanical permit fees*are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. CATEGORY OF CONSTRUCTION Value:$ RESIDENTIAL EQUIPMENT/SYSTEMS FEES' A1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: . Description Qty. I Ea I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Job site address: !(4©49 f/ • Air conditioning 46.75 _ SL.J r[ Furnace 100,000 BTU(ducts/vents) r 46.75 4,.'7 5 City/State/ZIP: T i 9 a''12L, cit ci'.2-Z 3 Furnace 100,000+BTU(ducts/vents) _ 54.91 Suite/bldg./apt.no.: Project name: Heat pump 61.06 1,010 Duct work ( 23.32 Z3.229 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 2332 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. _ 46.75 Fluelvent for any of above 23.32 Subdivision: Lot no.: Other: 2t 32 r Other fuel appliances: Tax map/parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace/insert 3339 �t1FE uLt a fi�� / ��S / Flue vent for water heater or gas 1 L DT / -1"14/f awe- / el e,,Me 5s TjjC; rim a 23.32 p Thum!77 a0t,�S i e-44 64 (..0✓, Log Wood/pellet(gas) J 2332 .�-{��y,,/}/,,�, 11.404--e... cj / y,, �•.� Wood/pellet stove 33.39 r( h mtgliwi'� 1 4 5 J/ — 1 i' (2) Wood fireplace/insert 2332 J 0(-Ai.,'Oft-f• Chimney/liner/flue/vent 23.32 g PROPERTY OWNER ❑ TENANT Other. 23.32 Name: 0--e4,1 /h) 5♦�'`t�f„ /,� Environmental exhaust and ventilation: -1k S(/) Wt�S c ib Range hood/other kitchen Address: equipment 33.39 ��0�5 5 W n Clothes dryer exhaust 33.39 City/State/ZIP: TtclGd, sue., et-4..223 Single-duct exhaust(bathrooms, toilet txtmpartments,utility rooms) 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 23.32 (APPLICANT ❑ CONTACT PERSON Other: '! 23.32 Business name: 44 vs j�, f po//>1.51 Fuca piping:t Contact name: "—1 y u�' $14.15 for first four;$4.03 for each additional Qcb E rks)LA- Furnace,etc. ) Address: 2 ft e- 54 Gas heat pump 114.i5 City/State/ZIP: A,t4..)b 6I2„ c�,. Wall/suspended/unit heater "� 3 2 Water heater Phone:(593)936,- /,, Fax::( ) Fireplace E-mail: bet,e hmSEyht.a,fi�„4_4ec/t/Z ). COwt Range 1 Barbecue CO CTOR Clothes dryer(gas) Business name: Wyss? t 7 i-' i„. Other: 3 ii_G MECHANICAL PERMIT FEES* Address: ' 2!( s . Subtotal �� City/State/ZIP: Al,tt-L"041 or(.. q"q-13Z„ Minimum permit fee($90.00) Phone(�a ) rf Fax:( ) __ Plan review(25%of permit fee) 3 -�gaL� State surcharge(12%of permit fee) ! CCB tic.: !ct�se TOTAL PERMIT FEE 1.14.-315- ,/ f This permit application expires if a permit is not obtained within t80 i bl! V Authorized signature: days alter It has been accepted as complete. ' Fee methodology set by Tri-County Building Industry Service Board t Print name: €.0k, ' Lt.„ Date: 'h f 5 I:1BuildingtP'ermilaiMEC_PermitApp JAM 13.doc 440-4617r(11/02ICOM/WEB)