Permit .. ...... ... .
CITY OF TIGARD MECHANICAL PERMIT
il
` : •, COMMUNITY DEVELOPMENT Permit #: MEC2010 -00628
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2010
,TIGARD ' Parcel: 1S 136AA00900
Jurisdiction: Tigard
Site address: 7015 SW OAK ST
Project: Fuller Subdivision: Lot: 0
Project Description: Replace furnace.
Contractor: CLIMATE CONTROL INC Owner: FULLER, DONALD D & EILEEN M
16500 SW 72ND AVE 7015 SW OAK
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 453 -4822 PHONE: 503 - 244 -6690
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/03/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/03/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/03/2010 $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
issua e; or if w`o 's suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utif 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 •irect questions to OUNC b .Ili ..03.232.1987 or 1.800.332.2344. ■
Is -ued By: D " r "I� 4 , Perm •' nature: 11111 At b es
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.
Dec 03 2010 1:28PM CLIMATE CONTROL INC 5039687224 p. 2
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City of Tigard ��1cE Rec tn
13125 SW Hall Blvd., Tigard, ��� eived
t /'k M� Permit No.: r I 0 do DO /
I N
Phone, 503.639.4171 Fax: 503.598.1960 q DatfB view l(J
Inspection Line: 503.639.4175 DEC 3 k o Date/By: Other permit:
I G 4 R t >
Int
' p U Date Ready/By: 1
ernet: www.tigard_or.gov ® 3ee Page 2 for
NotdietVMethod:
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d a $ Ta_IcGA� don
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w a " `''s '' biw, nr zsf r: ; `i� ,_ 31r 4N1 D g t.`e '-y n " . 1: a - ,;v } ay-ea z._
7.h. -- '"'C.' _ ; 4 ' .,._ _at{) - ! kf rtr. - ? ': ' :.�'a. , �O z F'l` . • s } e s e li'�''d�. value f tI i
❑ New construction � Addition/alteration /replacement Mechanical permit fees" are based on the value of the w ork
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other
! r y dqr �� mechanical materials, , ••If•ment, labor, overhead, and . •fit. Value: S
_ s',kg 1 F 3i4E <'a=" tal G NM7� J 0. i .� ti`A$ } £ `n t ,12, : .. •a'Ct .
Fri_ and 2- family dwelling ❑ Commercial /industrial ' '" '' 7�' "wr y' i - "
❑Accessor buildin �``,....0 s.. R,....., ... _
[] Other: For special information use checklist.
❑ Multi family . ❑ Master builder
Description
t F LL t
': aJ '_ ' a •••-• �F Z 1. ,e. I d -f c I_ Qty. 1 1 Iota]
6 Heatindi oling
7C)/s o4 L 5 , r Air conditioning
Job site address:
1�► (requires site plan showing placement) 46.75
City /State/ZIP: Fbc j'+ aN r � 2 ,
Ct 2-3 Furnace 100,000 BTU (dumsrvents) 1 46.75
Suite/bldg./apt. no.: 1 Project name: � I tel Furnace IOQ000 + B7U (dmr&venus) 54.91
f Heat pump 61.06
Cross street/directions to job site: 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, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 2332
Tax map/parcel no.: Other 23.32
Other fuel appliances •
E w,. �' :5z.�r,...:.t z .a'' ',+ti 4 f � r • ^ z 5x .&, -
' � "�� ` : w._, x .�.a r °zr:rz - ...4: ,..',.,r ` -, .t'.. i G ater e heater
t 23.32
F IL A C6 i t!"N Gasfreplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39 _
Wood fireplace/insert 23.32
r
_
r s F a ;a a ea< t I t ,rte ,' h s er ., C iininejflinerfflue/veni 23.32
;,: i ;.sr .WSU.,ii `r a.* i li. 40 - :l 5 ,.w: .� L :,,, fr .m c z ' -
Name: It/
.�? othe
1 L''G i�l 1 23.32
Environmental exhaust and ventilation
Address; 70 16 O A.V ' r Range hoodlother kitchen
9727-3 equipment 33.39
City/State/ZIP: • port-- ra n d C d r Clothes dryer exhaust 33.39
Phone: (5" 24141 469 0 Fax: ( ) Single duct exhaust (bathrooms,
`f' f , T y ,r g toilet compartments, utility rooms) 1 23.32
:rc. o: �' ri _ 5 � � ,- a i 4 i 3 m itt 'x r €`.
a?ix . ts . :,:z'�. � i « .}#.a , , e . ' Attic /crdwlspace fans 23.32
Business name: au MA >� ea n r roL 1 ( _ °�Z i 23.32
Contact name: RD 4 t I r is Fuel piping
f Tom- _ $14.15 for first four; $4.03 for each additional
Address: 1 (950t) 5w -1')../'° LLA �. Furnace, etc.
City /StatelZlP: r H r / �� Gas heat pump
Phone: (SDI') 4153 - U � �� ZZ� Wall/suspended/unit heater _ .
78Z2_ Fax: : ( b3)9(a8_ -? zici Water heater
E-mail: r G m 7 Fireplace
M a-4-e_ c 4-
;� <'� i`� :`� ° O n r"O L Inc L O tv-1 Range
4• W: - te' • � �! •' Barbecue
Business name: �L,I IR/I 4.it � o ML ( }7C , Clothes dryer (gas)
Address: I SOO -7..._," -� _ Other: �? v City /State/ZIP: pt�r7 - 10. n d ar 2. � t zr t tal L ( a
t--- � � "� � Subtotal 4 •7.J
Phone: (S733) (,j - G Z2_ Fyx, (9)5) p b z2
V Minimum permit fee (590.00) 90 , 00
CCB he.: 2._t O( Lo ! 8 Plan review (25 % of permit fee)
State surcharge (12 % of permit fee) ICI • 8 O
�ti4 TOTAL PERMIT FEE (00. (66 Authorized signature: - 1Z This p ermit application expires if a permit is not obtained within 180
Print name: /// // days after 11 has been accepted as complete.
y l t/fl / Date: /2/3, • Fee methodology set by Tn- County Building industry Service Board
I \ BaOding lPermhs 10/01!0?
440-46 1 71 (I 1/02 K'07,1'WE&)
eI 99010