Permit „ CITY OF TIGARD MECHANICAL PERMIT
1 ".:A- COMMUNITY DEVELOPMENT Permit #: MEC2010 -00593
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/17/2010
Parcel: 2S 111 AB02800
Jurisdiction: TIGARD
Site address: 9385 SW MOUNTAIN VIEW LN
Project: Volk Subdivision: ELROSE TERRACE Lot: 24
Project Description: Replace furnace.
Contractor: CLIMATE CONTROL INC Owner: VOLK, VIRGIL
16500 SW 72ND AVE 9385 SW MOUNTAIN VIEW LN
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 453 -4822 PHONE: 503 - 648 -7379
FAX: 503 -968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/17/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/17/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/17/2010 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: (7/17 6 / - 770A/
,/el Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Nov 17 2010 8:25AM CLIMATE CONTROL INC 5039687224 p.1
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FOR OFFICE (SI:':C)N( 1
City of Tigard Received
• 13125 SW Hall Blvd., Tigard, OR 97223 Date/BY: `�f , Permit No a c
' Phone: 503.639.4171 Fax 503.598 1960 RECEIVED Plan
e - f %S
7" 1C 1 Ef'I>: Inspection Line: 503,639.4175 Date/13y: Other Permit:
Internet: www,ttgard or gov Date Ready /By: Ants: ®See Page 21or
NOV 1 7 Soto TotifiedMethod: 1 , 165- Supplemental Information
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5' `� �nrr "'.writ g?., F11 �t- ��s*��•��'!J �r l)� . * Ji a��� , . � ��� �,... �; -+ .
„x '�.'5...�..,,3 „«b,.M. r0: ! q ..., ^:.-_..._,..e 1 :1 t `_i V r.._N .1-
Q New construction XAdditionialtera Mechanical `` e err
,> S. D IV ISION permit fees" are based on t value of the work
Demolition ❑Other Peed. Indicate the value (rounded to the nearest dollar) of all
' , s wC . y nr mechanical materials, equipment, labor, overhead, and profit.
w;` v Value. 5
Ell- and 2-family dwelling . ,.�. ,., � �,: l�
Y g ❑ Commercial/industrial ❑Accessory building s '.' 11«k'• a ik, -', �. fi M, !
❑ Multi- family ❑ Master builder 0 Other: For special information use checklist.
u Ems. - f . • - s �� M. Description j Qty. f Ea. ! Total
,' • t l' • Ott e -t
- �1 � x - .3 h � ° .,,10? ti, k�� v#.>� -; Beating/cooling
Job site address: q S 90 yM I n JJ /� Air conditioning
�
(t t V V t 1 (requires site plan showing placement) 46.75
City/State/ZIP: -- �
1 CA(" or c "1 - 7 Z:2-3 Fumace 100,000 BTU (ducts/vents) 1 46.75 (,I&
Suite/bldg./apt. no.: I Project name: VO jr t Furnace 100,000+ BTU ( ducts/vents) 54.91
Cross street/directions to job site: F~ Duct work woek 61.06
D 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydrooic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. _ 46.75 _
Subdivision: ,Lot no.: Flaedvent for any of above 23.32
Tax map/parcel no,: Other: 23.32
Other fuel appliances
F _
`ixi) rti mar 7 , z 3 z z t t
,.,.._.�,." ... � .., .� �: �....,tuf=� x,.:f(; �. ����':��. ` W heater _ 23.32
((° /` Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
WoodjeIlet stove 33.39
r Wood fireplace/insert 23.32
r ..t art r .. I � :i .y.., gi. 4 ` . ,.1 Y.,p r yr �•. Chitnneyfhner /fluelvent 23.32
Name: �� 7 e. Environmental exhaust ' ,` ".,::'.`u,,. '`. Other:
VI all L y of ` and ventilation 23.32
Address: G'{ ` ? 3 Q � t
Range hood/other kitchen
l t e I,0 }rr /r] fl Vi CO.) I , equipment 33.39
City /State/ZIP: 1-7 Curd G-' Z 7 3
f Clothes dryer exhaust 33.39.
Phone: ( ) / C — �' Fax: ( ) Single -duct exhaust (bathrooms,
- z �� w _ toilet compartments,
x 3`l` k :11 y e -arc Y et ,g :, ii o° 1, t Fc W v P ts, utility rooms) 23.32
r .� ,. 5.. � � .-, mot ? ....m . �+ .-# 'Anic /crawlspace fans 23.32
Business name: COMar - ton nr�.?L Inc- other:
23.32
Contact name: RO t I _ r I � Fuel piping
LTA To ( S14.15 for first four; 64.03 for each additional
Address: 'tDS � 5b0 72" q V6-- Furnace, etc.
City/State /ZIP: p,, i T - I } I r 97 Z23 Gas heat pmnp
Phone: (50")) / r� - I CL WaNsuspended/unit heater
'T (18 Fax:: ( sb3)q4,8-72 Z , Water beater
E marl �+p 1 7 Fireplace
e C. t fna#-e. C o n - r- a te
r‘ InC G plvn Range
... ''.n�..a`, n,. , _. ; "rs' Barbecue
Business name. L( 4 C o r� L / n
�- c Clothes dryer (gas)
Address: X500 �� no Other:
City /State/Zjp: ?o —1 o. n C O � ter..- rsas'ss ss u 3 '
G > r ��.zzy
one: (03) y5-3. O Z? Fax: ( Subtotal 73- 3) (� ' -� Z �� Minimum permit fee (x90.00) tap , oo
CCB tic.: 7__t 9 Plan review (25% of permit fee) I
State surcharge (12 °A of permit fee) trj
` / A
Authorized signature: /��� a. ��
TOTAL PERMIT FEE 9 ,, i A
j � % This permit application expires If a permit is not obtained wltbin 180
Print name: 0 Y ,�j / �/ days after 11 has been accepted as complete.
J Date: t J / U ! 7 1 ' Fee methodology set by Tri- County Building Industry Service Board
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