Permit rr
CITY OF TIGARD MECHANICAL PERMIT
r
COM MUNITY DEVELOPMENT
Permit #: MEC2009-00688
, � . ' ENT
Dat
' ` Date Issued: 12/29/2009
Hall Blvd., Tigard. OR 97223 503.639.4171
`TI G'ARD 13125 Parcel: 2S 111 CC 13600
Jurisdiction: Tigard
Site address: 10255 SW HIGHLAND DR
Subdivision: Lot: 0
Project: Cramer
Project Description: Replace furnace.
FEES
Owner:
CRAMER, SHIRLEY J Description Date Amount
10255 SW HIGHLAND DR Furnaces < 100K BTU 12/29/2009 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 12/29/2009 $10.80
PHONE: 503 -620 -6469 Minimum Fee Adjustment - Mechanical 12/29/2009 $43.25
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
TIGARD, OR 97224
PHONE: 503 - 453 -4822
FAX: 503 - 968 -7224
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: AV �� am
(d_ Permittee Signature: Q/ 6 6 / c 2 ? w
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.
sec 28 2009 9: 28RM CLIMATE �NC 5039687224 p 2
16
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Mechanical Permit App
City of Tigard
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Date
DEC 2 2009 B . '�'t'62 -0 a 6�r
�' ° 13125 SW Hall Blvd. Tigard OR 97223
, , y ' � � . �i , - Permit
t - 11 Phone: 503.639. 5 4171 Fax: 9.4175 503.598.1960 Plan Review
X" ^ Inspection Line: 03.63 Datt/By: Other Perrnir.
f 4 Internet: Line: 03.63.gov C OF TIGARD Date Ready By )wis: d See Page2 for
PLANNIN /ENGINEERING " otified /Method: <( Supplemental Information
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❑New construction Addition /alteratiottireplacement Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other:
mechanical materials, equipment, labor, overhead, and profit.
:i` `i'rc+•" kcc 1' 1 , atiadc � r^��-7.- t "0's� ` Value S
V':S_4Art. sa ,. - fwa_ 4 . Viapl`e, -v, P ,�2 5 42.7 = " a.,
Qrl- and2 -famil dwellin r���ti* b 4 J r` MI ,a
y g ❑ Commerciallindusttial ❑Accessory building x � 411 th a•v•st g c. til'Va . W
11 Multi - family ❑ Master builder ❑ Other; For special information use checklist.
Description Qty. I Ea. Total
t-' t,�S.'N ( a ^�•-'.�.,. 7,-n�- �. c , .fir,. s�ti�v =KS�, s . r�
•'34. r Y3_5.tA' aSi�r°LI1 ;t3#wst 1ti is ak- It r 3.aF�' (e�yt� �,�ir c. 417. : le 0
t 3s '�"�_��-.>,, . t N� �_, +c?;, 9eatin rnolln
Job site address: I D 2.55 ,5W i I_, h 1 4 ID T r Air Tres conditioning
�T► t!`t," d./ _ (requires site plan showing placement) 46.75
City/State/ZIP:
Tf b AYD Q r on 2.2.-- Furnace 100,000 BTU (ducts/vems) I 46.75 q6.73
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg./apt. no.: Project name: -i
�r�rM _ Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit beaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no : _ Flue /vent for any of above 23.32
Tax map/parcel no t Other: 23.32
j rt� 1 e-�y �r r, it _ '..t' Z .a7' 3.'T. c u l .:a+ Other fuel appliances
.' :`�_ �o- ."'. 31'�.}r i 1 . t �- d .t 1 ei y+>,e' '- lt., IT M fl il"' ? "`;mo w '`R s " } "7& Water heater 1 � caxtn. ca.. ��v..f�i. .. ,� #s_.... „2:z�, 23.32
1 2 (s-�c: �� r i N 4 e-&--- Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) _ 23.32
Wood/pellet stove 33.39
Wood freplaooinse t 23.32
r 4 � �' . .. ry . .
I t T - s :, $ nx 11r :7 V 2, , ', r roc. -5 fe.. p'� t ' Chimney /liner /flueivent 23.32
r..1: _._,.ty Z ' iki . . ,141 Wit, Y_ r...i ,ir".� ,:a. ;,,._ a'f k �>?+ tiP tN F q , t Y :.; .g -
ti _ �..,, s �_. =: a �r >:,�_? ,. Other: 23.32
Name: '5 h i do/ C r ' h/1
(( Gl l° - Environmental exhaust and ventilation
Address: () 2 S S Elie, 1 � S . r Range hood /other kitchen
c: equipment 33.39
City /State /ZIP: y i b Ay-) 0 f Of _ C lothes dryer exhaust
I� ZZ3 rY 33.39
Phone ( ) (4)7_,C) �� • Fax ( ) Single -duct exhaust (bathrooms,
T , �: � toilet compartments, utt ty 32
' rkf ��., k-'4° e 2 P*.P � si b ," 3 `= F t- eTC. � , .. ' ;1 4,, t A tt i c /crawispace fans I 23.32
v� t tboms ) 23
_...,r... t.L. ;eltz".. L .,,....,Lnrts'.. ,411 0 w ., �t 1,..x ma x_ to -,q=, !te,...,•..3, .tq+ . YL, _....
Business name: C M i � A L o n rroL ! "? Other. 23.32
Fuel piping
Contact name: RO 4 Fbarr r is $14.15 for first four; $4.03 for each additional
Address: 1(0501) 15w --/ ylO 2t , , t om Furnace, etc.
City/State/ZIP: f /"� Gas heat pump
I)4. r 9,223 Wail/suspended/unitheater
-
Phone: (9).3) Lfs3.- yB Z'Z I Fax: :(Sp3)9( -72Zt. Water heater J
E-mail: t 7 Fireplace
a r 'Tt°'E'�; x G a flr t o...4-� c
n, k O n'� �r- o L I n1 e. G Range
►v' _ '
r .ace a . e [t ? 5 jx d Is. ',A .1 Barbecue
Business name:. CLl yl/14 r Co t y L ( r ) : , Clothes dryer (gas)
Address: 10500 ` Other:
c -7 �. n 0 Alit q r , -; � i` a i s
City/State/ZIP:
?OCT - t an or cj.zzq _ Subtotal
y4•
Phone: (57)3) q5, _ Li 7_2_ Fax:( 3) 1 to -ZZZy Minimum permit fee ($90.00) 9G, q6
CCB tic.: 7.4 q / Plan review (25% of permit fee)
State surcharge (12% of permit fee) It) ..Ce U
AO' TOTAL PERMIT FEE f L(jO•'�a 1
Authorized signature: 1 - This permit application expires if a permit is not obtained within 180
L Punt name: 2.F2-.0 I 0 days after it has been accepted as complete.
_ 0 9' [/S Date: I Q m
" Fee methodology set by Tri -County Butidng Industry Service Board
1 Building TPenni ;s',MEC- Pemct!.pp,e 10/D1/09 440 -4517T (1 t /D2 /C