Permit v CITY OF TIGARD MECHANICAL PERMIT
I
11 :- - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00203
Date Issued: 05/12/2009
T 1 GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 1S133AC13800
Jurisdiction: Tigard
Site address: 10875 SW HUNTINGTON AVE
Subdivision: Lot: 0
Project: Monroe
Project Description: Replace furnace, add heat pump.
Owner: FEES
MONROE, CHARLES R JR Description Date Amount
10875 SW HUNTINGTON AVE Air Conditioning or Heat Pump 05/12/2009 $14.00
TIGARD, OR 97223 Furnaces < 100K BTU 05/12/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 05/12/2009 $8.70
Minimum Fee Adjustment - Mechanical 05/12/2009 $44.50
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 $81.20
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
Issued By: ��� Z3 -vvt v Permittee Signature: , , t_ _ _
1 1 ' e� till
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.
:May ,06 2009 10:20A11 CL I M N1 i • " C 5039687224 p . 2
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Mechanical Permit Application , ..
Application . ; . k, • 4 ' Sl t 1' , :` , col ic;;t ( , �''v, ,
t ;a " . City of Tigard MAY 0 6 2009 Received
AT a 13125 SW Hall Blvd., Tigard, OR 97223 DueBy: 6 t ` it, ,•
D Phone: 503.639.4171 Fax: S03.598.1960 Plan Review
r i , j Inspection Line: 503.639.4175 CITY OF TIGARD Date/By: Other Pernik '` 0 Internet: www.tigard- or.gov BUILDING DIVISION ® See Page 3 for
Date ed/Me ho
Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on value of work
❑ New construction ArAddition/altcration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
mechanical materials, equipment, Labor, overhead, and profit.
' CATEGORY OF CONSTRUCTION Value: $
3(1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi- family ❑ Master builder ❑ Other:
For special information use checklist
Description 1 Qcy, I Ea I Total
JOB SITE INFORMATION AND LOCATION
-
Heating/cooling
Job site address: Ds-75 i + n �/ Air condition
/ ' ` " ' i ' ° (requires site plan r Deaf pump
showing Placement) I 14.00 PI
City /State /ZIP: Lib L -D Cr72-Z' Furnace 100,000 BTU (duacnrents) 1 14 1 Li
Suite/bldg./apt . no.: t__t_cL'i project name: �— Furnace 100,000+ BTU (ducts/vents) 17.90
mD Gas heat pump 14.00
Cross street/directions to job site: Duct work i
lo.ao
Hydronic hot water system 14.00
Residential boiler (radiator or i
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: l Lot no.: Fhie/vent for any of above 6.80
Other. 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Wafer heater 10.00
i . Gas fireplace 10.00
` 1 . i ' — At l m/ : 11,i A. Flue vent for water heater or gas
. // fireplace 10.00
J/ I E Log lighter (gas) 10.00
_ Wood/pellet stove 10.00
•
Wood fireplace/insert 10.00
A PROPERTY OWNER 1 ❑ TENANT Chimney/liner/flue/vent
10.00
n �- p � 10.00
Name: a- ,' 1 es 4 Zr- - e la 2 -
R ( � _ Environmental exhaust and ventilation
Address: •45 s-- (� at I ✓ 4 Range bood/od►er kitchen
T equipment 10.00
City/State /ZIP : >� oes dryer exhaust
D • / 2 2 Clth d r y 20.00
Phone: ( ) C g(5400 Fax: ( ) Single-duct exhaust (bathrooms,
_ toilet compartments, utility roorns) • 6.80
APPLICANT ❑ CONTACT PERSON Altic%rawlspace fans 10.00
Business name: /f 1 ,,�1rr — &, 4 in Other: 10.00
�! Fuel piping
•
Contact name: Rc1—j i f -/ S 55.40 for first four; S1.00lor each additional
Address: j ( Soo , 7 fi r, D vb Furnace, etc.
City/StateIZlP: Pa rr(c n d C to .� Gas heat pump
i� Wallisuspended/u»itheeter
Phone: (5215 ) 11 S - 3 i 22 Fax:: (SR13) 9 (eg --7z2 4 Water heater
Q 1 Fireplace
E-mail:
�ll e (. 1 ni a - c � 1 t nc . ce.yy, Range -
CONTRACTOR Barbecue
Business name: ✓r ATE" Co n L i n L Clothes dryer (gas)
Address: 1(21 50 SA.) � _ Other:
��~ O /
4 V , I ' MECHANICAL PERMIT FEES*
City/State /ZIP: p ( Hon 01 or 4' 71 -
j 6 1 SuDtotsl $
Phone 61)3) (/ s L/ I l !� j � I F (V) (1�"� _.-y Z Minimum ieW permit fee ($72.50) ? .2.1.2.515 CCB lie /p
: '"'lI � r (i
i 5 7 / I Plan review (25% of permit fee)
l � i ) S tate surcharge (12 of permit fee) a , .7e>
TOTAL PERMIT FEE g i . j
Authorized Signature: I ti T his permit a pplication e xpires If a permit is slot obtained within 180 t
/ days after it ba been accepted as complete.
1 Print name. 8 • • Y/ 1 s ' Date S I o • Fee methodology set by Tn•Cowty Building Industry Service Board
I.U3w V
ldi, emit .L p loc 01/19/01 44 0.4617T r (I 1i09 /coNtJWEB)
1�1JJ `-'� 1 S
81.2-0
.. 2009 10:20AM CLIMATE CONTROL INC 5039687224 p.3
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CLIMATE CI NATRIA 16500 SW 72nd Avenue Portland, OR 97224
Phone: 503-453-4822 Toll Free: 866-453-4822
HEATING & AIR (ONDITIONING Fax: 503-968-7224
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