Permit CITY OF TIGARD MECHANICAL PERMIT
a • COMMUNITY DEVELOPMENT Permit #: MEC201000510
T 1 G A R. D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/20/2010
Parcel: 2S112CB09700
Jurisdiction: Tigard
Site address: 15286 SW KENTON DR
Subdivision: Lot: 0
Project: Webster
Project Description: Furnace replacement.
Owner: FEES
WEBSTER, STEVEN G & MARJORIE Description Date Amount
15286 SW KENTON DR
TIGARD, OR 97224 Furnaces < 100K BTU 10/20/2010 $46.75
FlueNent For Any of Above 10/20/2010 $23.32
PHONE: 12% State Surcharge - Mechanical 10/20/2010 $10.80
Minimum Fee Adjustment - Mechanical 10/20/2010 $19.93
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 503.246.6• = : i I 344.
Issued By: / Permittee Signature:
03.639.4175 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.
5039687224 p.2
Oct 20 2010 7:44RM CLIMB t�Ol-, C
Mechanical Permit Application 1I ll�V��
FOR ( >fFlc I NI: (hN1 1
1,1 City of Tigard
OCT 2 0 2010 R "ea
• 13125 SW Hap Blvd., Tigard, OR 97223 DatdB 1 '. Permit No _
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review 4��i
1 1 �; A i : I ., Inspection line: 503.639.4175 CITY OF TIGARD Date/By: Other Permit
supplemental Information
N13I0 � of R`�dy�: la see Page 2 for
Internet: www.tigard-or.gov BUILDING D
e��,,,''� oti8ed/Medtod: -7-6 .Sre f yr " Yi.:+�f�.�'.,w''�,.��.: n1v�'Gl�G 9Y.q �.r�G �1�!`Y.�,�`hu � i1- *.'1ZYr'4'�3'�C_4-� a �7 r .,�- i Y
i1: .x .°... w n r.g.�i. 34...1' . r. fe; i 'is`G•;*,' k4�Z S -; 1 I r ig 1 �_.� ! I f j '�" ,, �_
❑ New construction V L �
h 1 .:.. . " C : a
Addition/alteratio M perm fees are based on the value of the work
performed. Indicate the value (rounded to the Dearest doper) of all Demolition ❑ Other;
mechanical equip
materials, rnatt, r, overhead, and
._ -�� d. , r x ! � , at r.. �-7s -;,t r� - a i labo �, profit.
; l i 7* s .P : , f t ��3 s � .:.x: : t'P o2r . '� F ; .-t axi 1 g Value $
�I- and 2- family dwelling ❑ Commercial /industrial 1:1 Accessory building t nc ;T : °,_ ; � ,.; ` ? r . d , L .? v J �z, , ?a
❑ Multi - family ❑ Master builder ❑ Other For special information use checklist.
3R g X , xu't'. i i `' F '�xc Sy r y .. I i .'� i 7�`. - ,� a i- Description 1 Qty. 1 Ea. Total
_. sn _:..�., ?:_ �t - %�.i. I fi:i .,t.C. , a,Ntb i .. ,EF: . .4,.: i }G...,_.,. it r..' Healln(t/Mopng
Job site address: i 5 ,...,3 � (� � (�� ( � i D Air conditioning
(requires site plan showing placement) 46.75
City/State/ZIP: -j-1 6>A-0 or c --7 Z Zy Furnace 100,000 BTU(dactswerm) t 46.75 C I (a :7S
Suite/bldglapt. no.: Project name: 14je��os x Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 61.06
Cross street/directions to job site: Duct work
23.32
Jlydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 2332
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Fhidv ®t
1
Lot aoyof above I 23.32 2
Tax map/parcel no.: 23.32
r L r 6' � f Other tile! appliances
._ ,,;,-a". 11-.. - „ a ; ?,,r- i' .., -, ' t, Water heater 23.32
�(. 7 tom' _ Gag fireplace 3339
Flue vent for water heater or gas
fireplace 2332
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fore place/insert 23.32
4
?� . +.,x,. a 1 ! c t k r e r a Chtn mey /li nea /fl uelvent .
, 23.32
E
Name: 4 1-116-. " A I O f I O 23.32
Lt)e�jSTt�, Environmental exhaust and ventilation
Address: ! 5T7 (O 540 /4E4 � D r Range hood other kitchen
�l equipment 33.39
City/State/ZJP: 77 e fez) err �i 2 2' / Clothes dryer exhaust
I' 33.39
Phone: (ga7j) 0,T Fax: ( ) - Single - duct exhaust (bathrooms,
2 , . toilet compartments, utility moms) 23.32
4. .� ..$ +nr _' . 1 y1,,'. , ' Derr, 3? t - Y . ,T Z( F ! r . c , 1'- rF;:! }°
` -.-...e ,c. .._,.. . . ...=-LIS t. rs .. +a.r. t; rr. •. +¢ ' , ..i4; ' AftiCiCrewl6pace feDS 23.32
Business Warne: L1 MA p n l�lrbL !I }L Other 1 23.32
Contact name: Ro Li r is Fuel Pilling
/ 514.15 for first four; $4,03 for each additional
Address: I (0500 5W -71n0 Ali 6- nuance, etc.
Crag heat pump City/State/ZIP:
T'1d►nci. (? 9-72_2.3 Wawsuspended/unit heater r
Phone: (56 ) Lis 3 - y 8 e? Z 1 Fax: : (Sp3) 4 1(08 - ? 2 Zy Water heater r
C
E -mail: ro re _ I t rrl es.. -e Range
h V , 0 c CO�'1 R
, r
y y rY ta s v .gym. w r Y Barbecue
Business name: Ct....1 04 de Tr" Co 115(2A- 1 n C Clothes dryer (gas)
Other
Address: 10500 c 7...^19 e {
City/Stale/ZIP: ?or -1 a, tic.' or c -f n1 .. F __: T n ` :..x:, ,i t `�4.. 0, .
Su `7 �,, , �
Phone: (5-03) q5-3,- L! ZZ l Fax: ( b5) cili 1? _7Z2y Minimum permitfee(590.00) 90. 00
CCB lie.: l0 71 el /
Plan review (25% of permit fee)
State surcharge (12% of permit fee) /0 , g0
TOTAL PERMIT FEE I , .gb
Authorized signature: ) J�/� This permit application expires If a permit it not obtained WIMIU 180
days after It has been accepted as complete.
Print name: A''' 9 ( - r is I Date: i 0 I z f (6 } • Fee methodology set by Tri- County Industry B Service Board
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