Permit CITY OF TIGARD MECHANICAL PERMIT
• • COMMUNITY DEVELOPMENT Permit #: MEC2009 -00381
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/27/2009
Parcel: 1 S133CA03500
Jurisdiction: Tigard
Site address: 13826 SW ANNA CT
Subdivision: GABRIEL WOODS Lot: 14
Project: McCarthy
Project Description: Add a/c.
Owner: FEES
MCCARTHY, TARA Description Date Amount
13826 SW ANNA CT Air Conditioning or Heat Pump 07/27/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 07/27/2009 $8.70
PHONE: 503 -803 -4525 Minimum Fee Adjustment - Mechanical 07/27/2009 $58.50
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
TIGARD, OR 97224
PHONE: 503 - 453 -4822
FAX: 503 - 968 -7224
Type of Use: SFA
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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 -0100. You may obtain a copy of the rules
or direct • - stions • OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B � � i /L �� _/ Permittee Signatu( � ��
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
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.
•j-ul 24 2009 8:15AM CLIMATE CONTROL INC 5039687224 p•2
Mechanical Permit Applicatiort." City of Tigard q 4 D~;B,3 7 a~f D~ Percut\o :
i " 13125 SW Hall Blvd., Tigard, OR 97223 Re iew
Phone: 503.639 4171 Fax' 503.598.1960 play I,,
pl- ocher Perm t
lnspection Line: 503.639.4175
Aete RcadylBy 10 Set Page 2 for -a 1 Internet: www.tigard-or.gov Ivocified7Nethod SuPPlemental Information
TYPE OF WORK COMMERCIAL FEE; SCHEDULE - IISECHECKLIST
❑ New construction ,'Addition/alterationrreFlacement Mechanical permit fees' are based onthe value of the work
performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical material i men labor, overhead, End profit
CATEGORY OF CONSTRUCTION value: $
Al- and 2-family dwelling ED Commercial/industrial E] Accessory building
❑ Multi-family ❑ Master builder ❑ Other; For spec141140rrrration use checklm
Description Qty Ea, Total
JOB SITE INFORMATION AND LOCATION nesting/cooling
Job site address: ~Z (P ~f ~/t//~ Air conditioning or heat pump (J
rc 'rm situ lm slowing lacernent 14.00 f 7
City/StateiZIP: 9722-3 Furnace 100,000 BTU duccs✓vents 14.00
Suite/bldg.lapt. no.: Project name: C ~,d2r~ Furnace 100,000+ BTU (ducNvents 17.90
l Gas heat pump 14.00
Cross street/directions to job site: .,Ductwork 10.00
H dronic hot waters stem 14.00
Residential boiler (radiator or
dronic 74.00
Unit heaters (fuel-type, not electric),
in-wall, induct, suspended, etc 14.00
Subdivision: I of no.: Flue,veni for anv of above 6.90
Other. 10.00
Tax mapipapcel no. Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
` nn Gas fireplace 10.00
IJL~ Flue vent for water beater or gas
fireplace 10.00
Lo lighter (gas) 10.00
Wood,' llet stove 10.00
Wood fireplace/insert 10.00
Chimne /linerJfluclvent 10.00
PROPERTY OWNER ❑ TENANT Other: 10.00
Name:' Environmental exhaust and ventilation
Address: i382~ tnT Range hood/odier Wcben
equipment 10.00
City/State/7JP: 1 1 Cj0'4 7,;-' 7-3 Ciothes drver exhaust 10.00
Single-duct exhaust (bathrooms,
Phone ( ) 3- ys, Fax ( ) toilet compartments, Utility rooms 6.80
APPLICANT ❑ CONTACT PERSON Attickrawlspace fans 16.00
Busrness name: ~ ~ ~ Fuel Other 20.00 piping
Contact name RO r! $5.40 for first four; 51.00 for eacb additional
Address: S oO 2~_r 4 A-VIE Furnace, etc.
q Gas heat u
City/State/ZIP: cep r- r t (A n G~_ _ 1'7 ;L ~ kj Wall/suspended/unit heater
Phone: (5b3) 5~ { 2 Fax : ( ) 9 (o _-7 z Water heater
E-mail: I } -Fireplace
0()4 C rn or GL n l Inc cc &I Rare ~
CONTRACTOR Barbecue
Business frame: rn AIF- Oc ri 47vL l n Clothes !ter as
.Address: hosoo CC ro rvt Other.
3!/U '"1 V MECHAN]CAL PFJLWT FEES;
City/State/ZIP: ( n 4-7 -2 Subtotal
Phone: `J Fax Minirnum permit fee ($72.50)
Plan review (25% of permit fee)
CCS lic : Ci V' State surchazge (12% of permit fee) 70
TOTAL PERMIT FEE $ J 20
Aathorized signature: 4 This permit application expires if a permit it aat obtained within l8tt
days after it has been accepted as complete,
Print name: ~ rrr' I S Date: 7 ~ f/ e ` Fee methodology set byy/ Tn•Cowty Bull ding Industry Service Board
;'Building,Porm!tsUdEC-PermitAppdon ~Vi9;0~ 40-4E,1~7(1 VC41C0:~7lwE}3) f/~ 9VIZ~
• 3u1 24 2009 8:15AM CLIMATE CONTROL INC 5039687224 p.3
CLIMATE CONTROL 16500 SW 72nd Avenue Portland, OR 97224
Phone: 503-453 -4822 Toll Free: 866- 453 -4822
HEATING & AIR CONDITIONING Fax: SO�;?aaa� � ' � y
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SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE
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