Permit F ,x CITY OF TIGARD MECHANICAL PERMIT
' g -4 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00184
TK` 3125 S H all Blvd., Tigard OR 97223 503.639.4171
D Date Issued: 04/27/2010 g Parcel: 2S102CCO2800
Jurisdiction: Tigard
Site address: 10330 SW HILLVIEW ST
Subdivision: Lot: 0
Project: Mullins
Project Description: Replace furnace
Owner: FEES
MULLINS, MICHAEL C & JUDITH E Description Date Amount
10330 SW HILLVIEW Furnaces < 100K BTU 04/27/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 04/27/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 04/27/2010 $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 $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Aitutigt/ dkubt Permittee Signature: f`., Off Ite411-0
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Apr 26 2010 6:48AM CLIMATE CONTROL INC 5039687224 p.2
Mechanical Permit Appli a ail. F � t - � � 1. 1.)I�, i `' `
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t �a't�:a . vu�tia„te k n, tea.$
r City of Tigard Date/By:
No.1A / -- 00 (B9-
I N 13125 SW Hall Blvd., Tigard, OR 97j pp
Ai 2 t !1 z Phone: 503.639.4171 Fax: 503.598 %0` 6 2010 Dai Review Other Permit-
r u °�9F: Inspection Line: 503.639,4175 Date Ready/By: Iwis: ® See Page 2 for
its :r Internet: www.ligard- or.gov CITY OF TIGARD Notified/Method: i Supplemental Information
.. M in Ohl .. I\te_ •I■l . �y __ �•• p t
xrr �f'x# p Yp ^ 3a S,F4w.4 y i y 3 3 ? -..^ e - 1W'Vf+ 1F edr 4"`, 3 , :,,. ! ? 61
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12 New construction 3Et Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded 10 the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
-k: ,ti fir a :�r.� t o a r Value $
-, rd y r . e• re, :4 I f(E'.Nlcl' � Rt _ --
'' r .. ! ',,, b .sd�.r_ :r ,. ,, �..�i a • t> i i . ; ` ' t o' i :. u' x'4
�l - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building `'°� � "" t ' '-
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other Description 1 Qty. 1 Ea. 1 Total
wd � .� 0 ji 4 ,� • -`^ i .. ^r : .x.,,:.. n a' , :E� i . c '•, �I r frt3 t- u ``�"'' F 7 ' , `"k YfF
: * i ` s�V.aic.. ; ;. 4 r1„� + .c . ,::5 ei. s s5,. x s'. ' S. Heating/cooling
0 v Air conditioning
Job site address:
10330 „ / V�(� ,67- (requires site plan showing placement) 46.75
City /State/ZIP: -7`--76 -J Ce 9722-3 Furnace 100,000 BTU(ducts/vents) L 46.75 (// .7f
Furna
Suite/bldg./apt. no.: << �� J Project name: T 0 i t2s ce 100,000+ BTU (dactslvems) 54.91
Heat pump ` 61.06
Cross street/directions to job site: Duct work 23.32
Hydranic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 1 23.32
Tax map/parcel no.: Other fuel appliances
3
;' i F Y t �� 4 $ x . rTY r C., ., airy 1. d ,. F N E
t .. x t x e ' 6Y R',."•'�+ t r,, ,3 t t e ✓ -, ' � 3 r 2 1 1. i r, i� 'ees>a,iitza , G Water firep ater 23.32
�"x.hs ,T. .. T ,i .t 4::V,:�.,, :F -tF r; ...�.. ;4,...,. +3..sr , . �''i.- 's_'..,av Te�`.d ,.. Lr�..: ti Gas flt'ep1dCC _ 33.39
& ThrtiAl1C Flue vent for water heater or as
fireplace 23.32
Lag lighter (gas) 23.32
' Wood/pellet stove 33.39
Wood fireplace /insert 23.32
- `i ,� - 4. i s' µ5,-- ,,,i r ''✓�s z 7 gem, ? .Lj' . .' i_Q,i 2 , 0 , t r�tr . .! Chimney/liner /flue/vent 23.32
L' . w o t r �5 a a 'l
- r�{ ?, l,.: t# r...±. ? : ih k3 x,,:..k 8. :i„ a _ r,,>✓..az- .r -,. ,.., 1.ti...� �i,7v. 1; �7
Other: 23.32
Name: ( 1 1 V e v \ l /0s Environmental exhaust and ventilation
Address: C ` b 3, o L) l L I i 1 \ `l y ST Range hood/other kitchen 33.39
� _ equipment
City/State/ZIP: 1' I b O r 9 - 7 0 7 - 3 I Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) g2 - 0 2,.2.-1 Fax: ( ) toilet compartments, utility rooms) 23.32
alle i +! .5 n r r'l . to 7 il ` t � `� i q t T r �- i Attic /crawls ce fans 23.32
tN s t 4 Sf tom , l ea ,� y "- r, .fi li.i0 �..,'1 _. t ', X e ry s` .iy'r
.ea� 2:�..;,... v. _.,.,.. x.. �:h;..ai;zrs:. >m�._s,...�....�. � ,..,,...... ,. ..rar.�+ c ,.. .a: ge?3+ �?: Other: - 23.32
Business name: 1 L MA FE A o n rrDL try_
Fuel piping
Contact name: j Q 1414r f - t . $14.15 for first four; $4.03 for each additional
Furnace, Address: 1WBSU # 5w -- 7'z" �l6- Gas heat pump
City /State/ZIP: P mP
� r Hand, q-1 7-2 .3 W a ll/ suspended/unit heater
503) L 1 53 ` L i ( 503)9(08 --7 Water heater
Phone: ( Fax:
Fireplace
E-mail: CO e - e-eov # r'oLInc Coren Range
r �...SJ `w^ : s: ? `)3:.,, ' A l''�,`�.,: 4ua" trlA ?_ y .'t. : :4. r ' ,V r..4, � Barbecue
Business name: CLl !IA 4- Tom` Co >7 L (n [ Clothes dryer (gas) •
--- Other:
Address: RD Soo Gt..) 7 t r r nr a + x; a:, -�. yr r �t a
1/ Y i .fh9 rcc r l s2; l sr .= s teh i'
CityIStatetZIP: part-1, and or Gf .ZZq Subtotal y( •
Phone: (57)3) (as- L-/$1Z Fax: GI(l _ ?ZZf, Minimum permit fee (S90.00) 9 • d0
Plan review (25% of permit fee)
CCB Iic.: YJ 7.401 L I O\ Zy 1' \ State surcharge (12% of permit fee) (2 Op
TOTAL PERMIT FEE /Q4 )3 )
.Authorized signature: 1Z�VZ This permit application expires If a permit is not obtained within HO
JJ days a f ter it has been accepted as complete.
Print name: Al)? ��f /s Date: Li / z ( / /0 * Fee methodology set by Tri-County Building Industry Service Board
1: 1Building ,MEC•Pattu!App.doc 11'01 /09 44046171 (I1 /02 /COMJ' J3)
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