Permit V - 4' w; , CITY OF TIGARD MECHANICAL PERMIT
P
1 ` I: ,, COMMUNITY DEVELOPMENT Permit #: MEC2010 00209
'' Date Issued: 05/05/2010
TIGARDi 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S110AD01900
Jurisdiction: Tigard
Site address: 14666 SW 106TH AVE
Subdivision: LANG HILL Lot: 16
Project: Haase
Project Description: Install A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
HAASE, JOHN G Description Date Amount
14666 SW 106TH AVE
TIGARD, OR 97224 Air Conditioning 05/05/2010 $46.75
12% State Surcharge - Mechanical 05/05/2010 $10.80
PHONE: 503 - 639 -6543 Minimum Fee Adjustment - Mechanical 05/05/2010 $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: � J j / Permittee Signature: Q,(1 427 [.< ( 77 Tl
,,,(01 CaII 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.
May 04 2010 7:1419M CL IrM- ! ; T ED 5039687224 p.2
Mechanical Permit Applica ' I �� R0L INC
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- G ) Ii U I I II L l ) \I 1, t z •i�} ', . '
, C x 3 City Of Tigard M/ � Received / w t ,_' "t ff',
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� ° 13125 SW Hail Blvd., Tigard, OR 97223 I t! i Da c 51���Q �� r Pennn No��Q DQ 0 �
0 Phone: 503 639.4171 Fax: 503.59 Plan Review 11 ` - L. �Q - 01
T, ,,,,, Inspection Line: 503.639.4175 �I ! Y OF TIGARD Date R Other Permit:
.- 1 Internet: www.tigard- or.gov BUILDING DIVISION N e ® See Page 2 for
.
,t� .fi3t'� Notified/Method-
J Supplemental information
�.Y t R � +d '•fi�ajfs�� $ ,� , yv. y� i•Z' "icUZ i
4 w.s c>a:SerJ3Y1ZF -4'r . .I., -.21 ra�3:,`2 5`r,�g {{n I .I'."'tY �i 1"t y..3.,: � 'a ' {q {r ' j�'� A
't,'Tbi{:.C'P:g4'P�...- .�'1?:'w .1�F A��I�..nik'�Ci1
El New construction ;Addition /alteratio&r laeement ~
ep
Mechanical permit fees' are based on the value of the work
❑ Demolition ❑ Off h performed. Indicate the value (rounded to the nearest dollar) of all
q 3 �
mechanical materials, equipment,
:, wK es:�� <� 1- S ��,. `�i ---s.. ��, s � �� e9 purr ®t, labor, overhead, and profit.
tc ; §'x�:St; ns+r�*w o' if a I n r s? Y r>� Oh s + aa5 Value: $
Fri_ and 2 dwellin a ,`� p� i ;'Yr pj'ij" i �+� ra.,
Y g ❑ Commercial /industrial ❑Accessory building - _r � ?Ia .::+ �, i ei - 1/ a C , . r` '-
Other:
For species! information use checklist.
0 Multi ❑ Master builder ❑
s 3 r� c t ! 4.� �i ` '� �'z c e `� r am a�,� ,t �+.x Des°'ption 1 Qty. 1 Ea 1 Total
Wr vea- :tet.__.�f l` Heatiny/cooling
Job site address: /' /_ (Q f / n / / 0- (requites conditioning
City/State/ZIP: / / � �P � J ! (requites site plan showing placement) ( 46.75 (t/G.7r
dY / 7.2.2 -y _Furnace 100,000 BTU (ducts/vents) 46.75
Suite/bldg. /apt. no.: Project name: / /�t1s� Furnace 100,00(){ BTU (duccs/vents) 54.91
Cross street/directions to job site: ��1/�' Heat pump 61.06
Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
-
in -wall, intact, suspended, etc. 46.75
Subdivision: I Lot Flue/vent for any of above 23.32
Tax map /parcel no.: Other: 23.32
ncy. t a e _ _
.y : ��fi,td f>-,� -�' � v r � � r ,'., - ..s+ ,rig .� 't � .t Other fuel appliances
..1;,.. 1.11 i .- :• <tux'._.ir .il.:c- .:cu'�lu 1�.� ,r�l'ii- .y',; t•M .:i''I Water h
.. _ .. W .4L.�.6C��e 2:.4s!'• . y.;� 23.32
// Gas fireplace 33.39
�/ Flue veer for water heater or gas
C✓ fireplace 23.32
_Log lighter (gas) 23.32
Woodipetlet stove 33.392
yY =2 i F{ F N 4 Wood fireplace/insert -
23.32 _
ti 1 -, �; s . ' I s li`:..-' " _ - +a - < ;. £ r'' " �,: ' z . Chimney /liner /flue/v®t 23.32
Name: a � C r Other: 23.32
0 d i NW/ . Environmental exhaust and ventilation
Address: /1,74, 6 6 / A Range hood/other kitchen
equipment 3339
City/State/ZIP: �� ) UKJ ! /$
!P t:'1 97Z.Z Clothes dryerexhattst 33.39
Phone: ( ) ,3 , S-y Fax ( )
Single-duct (bathrooms,
exhaust
5:4°- At y r yy�ry m , x r, r , E} h toilet compartments, utility -
: ; _ °... �,.i.71 u4 r� : V.itK �' i7a ,T , e.+ ys tyro071LS1 _23.32
,.u. e, .retAC,_* .._-.,. a'.1k' s.741 r 1' °c.: :.rb < ". ,a 1 ri Attie /crawlspace fans
2332
Business name: C MATE Ll o r - rot_ In ,
Other 23.32
Contact name;O el I C 1 _ If-IS Fuel piping
Address- � �S�d � P'fT $14.15 for first four; $4.03 for each additional
✓ 5100 -72.1" O A , `e- - Furnace, etc.
Gas heat pump
City /staCity/State/ZIP: PO r nand `
t� 9 `7 Z'23 Wall/suspended/unit.heater
Phone: (9j) Ll s3 LI B Z Z. I Fax:: ( 933) 968_ -122-Y Water heater
E ma1J (`D G I t tlrb -- el-4-e_ 7 Fireplace
�'rroL- Inc. c
G o n
'��ifil''p {s�`��tC err -u e �. � :r_.�a Conn Range
,r •�f'.liu,` t+-�^ air,, . � %tl it,a1 y `�'Q E i`~' tst".`. •.,f2 .•r..'.�„' s. SP - A,t a t :e g
k ..� e�:��z.ss��a.ri; �!�'i�at -..�' F��:�:�'3�'i��' �...p ' H arbee ue
Business name: CLt yo rT CQ Y?41UL. l ne Clothes er -as
Address: D _ Other: A v Ci /State/ ": r�. F`'I § i '
tY ZQ': Ott S 77._ O �=I t Z Z � 1 c34 bt r a .`.v t'..;,
Phone: (s-03) �3) �b�
/f Subtotal c/o, •"2.1- � . c i y $ 2 Z Fax: ( - - z 2 y Minimum permit fee ($90.00) pD Op
CCB lac.: �` G t / Plan review (25% of permit fee) 1
7 State surcharge (12% of permit fee) ii� 130
Authorized signature: ,I
2 . PERMIT FEE_A ed within 3 a /
/ This permit application expires if a permit Is not obtain 180 f/
Print name: days after it has been accepted as complete.
Q 7 A ryS , Date: S" S/ /o • Fee methodology set by Tri-County
1 1 Buading \Pamits PermitApp.doc 1D/01109 Building industry Service Board
440.4617T 111 /07JCOMPNEB)
A4- 96971'
May 04 2010 7:14AM CLIMATE CONTROL INC 5039687224 p -3
CIIMATE (0 NTRO 16500 SW 72nd Avenue Portland, OR 97224
HEATING & I R t O N D I T i 0 N f N G Phone: 503 -453 -4822 Toll Free; 866- 453 -4822
Fax: 503 -968 -7224
(1_ e/0076,
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SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE
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