Permit CITY OF TIGARD
MECHANICAL PERMIT
I II` DEVELOPMENT SERVICES PERMIT #: MEC2006 -00307
DATE ISSUED: 7/7/2006
' 41-4F- '. --1 ' 1 ''' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S111 CA -05400
SITE ADDRESS: 09460 SW LAKE SIDE DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.12 LOT: 674 JURISDICTION: TIG
Project Description: Replace gas furnace, add a /c. Job No. 806159
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
JACK HAMILTON Description Date Amount
9460 SW LAKE SIDE DR [MECH] Permit Fee 7/7/2006 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchaq 7/7/2006 $5.80
Phone: 503 968 - 8905 Total $78.30
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97224
Contact #: PRI 503 453 - 4822
FAX 503 968 - 7224
Reg #: LIC 62196
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through O613..952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- - 332 - 2344 : -�
Is ued By: k �a Permittee • ature: , --( 5 ;:f . �� 5t Lei
- -- - - Call 503 - 639 -4175 by 7:00 a.m. for inspections 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.
Jul 06 2006 11:29RM CLIMATE CONTROL INC 5039687224 p.l
M Permit Application T012;OF J(E USL�ONl ' i /' :
City of Tigard Received A y Pemm No.: Ee , o , 'vv,
o e ive 7 [o o(0 7
13125 SW Hall Blvd.; Tigard, OR 97223 - Plat, Review
Phone: 503.639.4171 Fax: 503.593.1960 i+.• it .. @ im.
Date/By: Other Per
r�l i
Inspection Line: 503.639.4175 :t >_ Date Ready/Hy: lux. See Page 2 for
Internet: www.ci.tigard.or.us NotifiecfMethod: , . upplementalInformation
. TYPE OF%%ORK ; :'. ' COMMERCIAL FEE* SCHED E, DSE CHECKLIST work
an ❑ New construction �ddition/alteration/replacement Mechanical permit fees' are based .e the value of the dollar) performed. indicate the value (round to the nearest dollar) of a
❑ Demolition ❑ Other: mechanical materials, equipment, L: bor, overhead, and profit.
V
' • CATEGORY. OF CONSTRUCTION a ue.
l :S
RESIDENTIAL EQUIPME . / SYSTEMS FEES*
isw and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building -
ry $ For specta! infornrati.n use checklist.
■ Multi- family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. Total
JOB S E INFORMATION AND .L � CATION. Heating/cooling 1 11 . i', �, � Air conditioning or heat pump
Job site address: u i. 1 t) Air con site plan i �
>I
City /State/ZIP: placement) I 14.00 �
r- '� ^ , Furnace 100.000 BTU (duets/vents) 1 a
i 14.00 I 4 1
r� .„1,3„. .„1,3„. I
Fumace 100,000+ BTU ;ducts/vents 17.90
Suite/Suite/bldg./apt. no.: I iW 4- V, 1 Project name: Q 9 Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hvdronic) 14.00
Unit heaters (fuel -type, not electric ,
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF. ORK ` Water heater 10.00
fe._ift if ‹. �S GYM. Gas fireplace 10.00
1 Flue vent for water heater or Was
fireplace 10.00
L Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wocd fireplace /insert 10.00
PROPERTY WNER I ❑ TENANT
Chimney/liner/flue/vent 10.00
Other. 10.00
Name: t —
. ! 1 �� Environmental exhaust and vent lation
Range hood/other kitchen
Address: ` i S Meg equipment 10.00
� . _ 1 .
City /State /ZIP -T / _ 9 = , i n -- Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Yhone O Fax:.( ) _toilet compartments, utility rooms) 6.80
)J. APPLICANT 1 >in CONTACT PERSON Attic/crawlspace fans 10.00
Otter 10.00
Business name:' I
e l l IrnQ.. ( ) a 1 Fuel piping
Contact name: y S5.40 for first four; S1.01 for each additional
•
Address: ((tt t�r� 5fv` 7 Furnace. etc.
Litt Gas heat pump
om
City /State /ZIP: \ i Ulm G 7a� Wall /suspended/unit heater
-'1 Water heater
Phone: 3 _ g 1 ^' G � . Fax: L -7 a !
C'4 C7 Fireplace
E -mail:
Range
CONTRACT R , Barbecue
Business namee 1 1 Clothes de ver (etas)
tt t�'`�' Other:
Address: s • MECHANICAL P : RMIT FEES* p�
Tl e� ' tiL �
City /State /ZIP: Subtotal It
Phone: )4. + .I Fax:
Minimum pc it fee (S72.50) 7-
et- ..-.. .. >� �
a —_ _ Plan review (25 °/ of permit fee)
CCB tic.: C C I Ll' State surcharge (3% of permit fee) I
• TOTAL P R\'IIT FEE 7
Authorized sigrtatur + r Till permit application expires If a p rink is nut obtainedwi .ri 18 C0
d as after i days has been ac epted as complete.
Print name: t Da e: • Fee methodology set by Tri- County a. *Ming Industry Service Board
iAlltalding +Permits \MEC- PermitApp dots ^ 440- 4617x(11 /02 /CDM /WEB)
Jul 06 2006 11:29AM CLIMATE CONTROL INC 5039687224 p.2
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CITY OF TIGARD r
BUILDING DIVISION PERMIT #: MF_C2006 -00307
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/7/20)
Phone: (503) 639 -4171 u N @iii�@i�l
Inspection Requests (24 Hrs.): (503) 639 -4175 '__..
INSPECTION WORKSHEET FOR DATE: 7/27/2006 TIME: 7:03AM PAGE: g•f
SITE ADDRESS: 09460 SW LAKE SIDE DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD N0,12 LOT #: 674 TYPE OF USE:
PROJECT NAME: HAMILTON
DESCRIPTION: Replace gas furnace, add a/c. Job No. 806159
OWNER: HAMILTON, JACK PHONE #: 603. 968.8906
CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503 - 463 -4922
Inspection Request Scheduled For: Date: 7/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 033836 -01 503 -453 -4822 N
Corrections /Comments / Instructions:
l rfl //IMP a_ ? K Pau- -2,
, uk.), -
5 AA4P
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_ PASS___ _ _❑__PART_IALAPPRO.VAL _ ❑_CANCEL n._NO_ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G lP Date: '7 -06 Phone #: (503) 718 -0