Permit ` v CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00360
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/23/2010
:TIGARD ... Parcel: 25111 DB10800
Jurisdiction: Tigard
Site address: 15375 SW OAKTREE LN
Subdivision: Lot: 0
Project: Harris
Project Description: Replace furnace.
Owner: FEES
HARRIS, LEONARD T & Description Date Amount
15375 SW OAKTREE LN Furnaces < 100K BTU 07/23/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 07/23/2010 $10.80
PHONE: 503 - 639 -3267 Minimum Fee Adjustment - Mechanical 07/23/2010 $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: Permittee Signature: ( , N 6 Ce5
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.
_____ Jul 21 2010 2:28PM CLIMATE CONTROL INC 5039687224 p.
Mechanical Permit Applicatio .ECEIVED I ( ul` I ti
City of Tigard Receives
1 ^ DateB / X /� 7. -- Pennii No.: 1
y r 13125 SW Hall Blvd., Tigard, OR 97223 JUL 2 1 (. 0 ! 0 y' " �s2�� " �0 3�
II 59 960 D Plan
Datte/By Phone: 503.639.417] Fax: 503. 8.1 l Date/By. e
Od>cr Permit:
:f i, \ I 1 Inspection Line: 503- 639.4175 CITY OF TIGARD DateReady/By: kris I 0 See Page for
w. a. „ „ Internet: www.tigard- or.gov Not 6edQ 4ethod: -�/
BUILDING DIVISION _ "/ I l/ Supplemental Information
?
"r'.,r{ fr ` - fi ' - =k 'ire: -'. ss -n z _. ar -
.11 s a k , �., x s s
? „ w.,.>;}.Ja:.cY ta:a :dt'kar.•t�.. -.ug. a i' uT G. . a .<. f!,. 3' f ..' 5- � r � G r I I .n 4�; Y .--ir, , 71� : r 2 , .., , 4 a - t 7.4 .� J *, �' '.`.
t.... lv,.._ l:.,r.� , . �� t.a'^-3I4 ,- :'£vv 7Yr . � . :� r. i i:?t a ,..'1. ..n. ..F^.Li,�..w.
Mechanical permit fees* are based on the value of the work
❑ New construction �;Addition/aiteration/replacement
performed. Indicate the value (mended to the nearest dollar) of all
❑ Demolition ❑Qom;
?2 ' ., t equip
man, teal materials mrnt
`1 .,- -tt n° r �•., § g:" , x s r rb . M . IF; U^i3 e z overhead,
f . , , y �: r$ i a , ti u : "� J s fj ,-. 1. - 3 }'1 ,77 ; r v , - a r y! Value $ and profit
+�'a az..i- 1..�,._c {L,.... �� . � �k Y�� .. e..r..- " a ».un;,t., �.. $.5.::�..srx�,._,a,. � t t:�� � 4r��7 fx � � ir. � r , 7� ? f �,. ,
E1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
'41.-?i 240;1: °).fig t of 5.' K' _ fl` ° . 4:wa >., r,.- ' ,a
For special information use checklist
t.
❑ Multi-family ❑ Master builder ❑ Other
t Heatin
t ? �, , �: Description 1 Qty. I Ea. I Total
zc Ka � 7 -p. , Z i r s F , 'E ` i ` V r I a 4 i c '''`ro '. , 1 I r ' ?1
.:., ..._�(...., .1:4714»s., ''k 4.s ' .;^. ~4.. . a:c � : : 4. 1 ht .,. ,�i� ....n_ " .?fl_?1 Wt:oolnR
Job site address: 15375 $ W 1:'4 6 6,0
Atrcoti�ttonmg
(requires site plan showing placement) 46.75
city /State /ZIP: -r 6,4e f cli Z'zK Furnace 100,000 BTU (ducts/vents) I 46.75 6.1
Suite/bldg. /apt. no.: l Project name: ( YfS Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 61.06
Cross street/directions to job site: Duct work 2332
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, riot electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other 23.32
Tax map/parcel no.: Other fuel appliances
F ✓ , Water heater 23.32
0 (' /lll4 ea-- Gas flreplacc 33.39
Flue vent for water heater or gas
fireplace 23.32
Lee lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
c I Y
j{ 4 ^ ,, Chrmney/Ivter /thre/veut
23.32
23.32
Name: _ , I / ` a r Environmental exhaust and ventilation
Address: tS3-?S 51,0 cDLt V Range hood/other kitchen
Cl F- ,Ie -E equipment 33.39
City /State/ZIP: 7 A •> ! l 1 � Zy z Clothes dryer exhaust 33.39
l Single-duct exhaust (bathrooms,
Phone ( ) , 7 Fax ( ) toilet compartments, utility moms) 23.32
- 1 L ..i -,, E t - -.
:'`_ � -: .1, s -_ '4.1 .iti'...`r 3 2T- r y . f ; r ,.. 2 r , @� G w" :4 Attic /cmwlspace fans 2332
Oth
Business name: (L l MA r&- L ) o n rr®L. I Ile- °' 23 32
Feel piping
Contact mate: Rro 4 f4-4 f- r /5 $14.15 for first four; $4.03 for each additional
Address: t ( bb 1 5w 77-n A' I6 - Gas h ee, etc. pump City/State/ZIP: f Hand ( c Gas
eat �� 2'z3 Wall/suspended/unit treater
Phone: ( j) 453 - LIBzZ I Fax: : ( )CTtoB_ -7 vac/ Water heater
E-mail: ( t� 11 Fireplace
A- o.-.k e. c. o +..+r- -0 (_ Inc c o rv-' Range
` t . ` is s 'r - �S� r , �i S: r 1 k _ ar -.s,x4>: ':,r rt'� r Z z.
a,t �..... +.?;v : yx % r„ f , ., c r ,�. ,W -. r fi s"I
�.5. .3�....:, °u�'.a rsse..:c +..:.( -� _ � .. r:i s ...k.,i;�„ `�a� t ... :a- s..v � 7��� F�:�� Barbecue
Business name: &LJ WI -T&- Cc n - i- L In Z . Clothes dryer (gas)
Other:
Address: 1(0500 .earl...) -7',. d
/" V 6.-- rr a i
.p'.S � °�Cfl i -CJx - .i:Li'i T ' �
Cl State/ZIP: : ] :t•INeWstia:,,4- . ."..7.; ) f F .. !..-;r: Y .3. >F rf:4''.:,,,,-:=".'-',1
?crr'IGIn or G"i.zz- Subtotal 1S-
' hone: (57)3) qs- L f Z,Z Fax: (5b3) X10 -' zZ Minimum permit fee ($90.00) 0.06
r �, Plan review (25% of permit fee)
CCB Iic.: SQ State surcharge(12 %of permit fee) 1
TOTAL PERMIT FEE %OD. OD
Authorized signature: L R1 � p i Tbis permit epplieation expires if a permit is not obtained 'withal 180
days after it has been accepted as complete.
Print name: A)0(,/ 14i4fr'S Date: 7/2 4. Fee methodology set by Tri -County Build Industry Service Board
I: tau >7ding\Pauda\NEC- PermitApp.doc I Q/07.'09 4 7T 2/COMAVES)
ibg77 2q