Permit k CITY OF TIGARD MECHANICAL PERMIT
"1 1 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00643
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2010
Parcel: 2S 112 BA02800
Jurisdiction: Tigard
Site address: 14100 SW 80TH CT
Project: HIBBING Subdivision: WAVERLY MEADOWS Lot: 25
Project Description: Furnace replacement.
Contractor: CLIMATE CONTROL INC Owner: HIBBING, SUSAN A
16500 SW 72ND AVE 14100 SW 80TH CT
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 453 -4822
PHONE: 503 - 598 -7721
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/10/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/10/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/10/2010 $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 ..... - 2.2344.
Issued By: � / Permittee Signature:
'
a .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 09 2010 1:40PM CLIMATE CONTROL INC
. 5039687224 p. 2
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City of Tigard Received
13125 SW Ha]] Blvd., Tigard, OR 9722�s Dzte/By: , 4 ig Permit No.•
® Phone: 503.639.417 1 Fax: 503.
0
oA Plan Review
T 1 Cr A IL`[ Inspection Line: 503.639.47 75 Date/Sy: Other Permit:
Internee www.tigard- or.gov
Date Ready7l3y Juris: See Page 1 for
O C C �� �� O Notified/Method: l .�'t1p I Srgspkm total Information j
;. e 53 ' sa�; rt, r ,,; • a,tt •YP *F VO I��A:, c c �- t r.d s •' .
�_ 0�.4 / F ,-,...7'111‘ _ t ^y . FY �.
a ti �. ,,e �a �� ., ?F.;.._ xr.- a..;:- o a a ,:. :I.1 P a .
❑ New construction 1g Addi tiottlalteratton /1 �� silent Mechanical permit fees" are b s d on e lue ofth
❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of
all
$ t '� i � (��{ mechanical materials, equipment, labor, overhead, and profit.
V.
rrr .7 3 3S i :. =y " r4 : .Witc04 sn l .g 0e k t`' Value: $
�1 and 2-family dwelling ❑ Commercial /industrial El Accessory building 1: a *�il 4 ^cz? r H
❑ Multi- family ❑Master builder ❑Other: For special Information use checklist.
t ,-� }�� Description I Qty. ! Ea. 1 Total
Multi - family
' M7.77. I t of , ,.. e 4 r s a -& ° �a�. . k a Heating/coolin/4
Job site address: Jy/01? g q fi Air conditioning
C� (requires site plan showing placement) 46.75
City/State/21P: 7-7 ,,,,'/ L. q . zZ .! Furnace 100,000 BTU (dncWvents) 1 46.75
� / 'f till" . 7.S.-. Suite/bldg. /apt, no.: 1 Project name: /"f `Ji 61 Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump
Cross street/directions to job site: 61.06
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: I Lot no.: �� ent for any of above 23.32
Tax map /parcel no.: Other 23.32
r w Other fuel appliances
¢�� t u- �S•� -.rr� € s' i�,�'y�r �E&t'a� -i� ` 1 ..R..�, .�..vy,.'� a �' . . , I � 3 1. oue r ,�. � ti '.p
' 3; �.t. .Effi;ac.}.i .. 'a > edc,a '.e.3' :,'.r;.... a , ; �stfa 't �}.J,E,! t I ::. _` �3r< i a k"4:7 Water heater
2332
e-)0/1- lIAJA C4 Gas fireplace 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
i, itil.q" 7 t•' '. f ` , £ s . a lca a , y . i s, m� t r �'y mer /flue/vent 23.32
�.:.�.vz.�P.,t..��..,� 'm - - .aY..�:x�b�.t._�¢�� �ChimneyilL
�Aaa; � ..'Y 3 # thhC.r'.
23.32
Name:
P► in 6127 Environmental exhaust and ventilation
Address: / /Dp O� p �?-- Range hood/other kitchen
City/State/ZIP: D 0 ,t equipment
3339
7 / 6 . 7 4 , - - -' � 9-1 2 7 Clothes dryer exhaust 33.39
Phone: (�(j) 7 2 ) Single -duct exhaust (bathrooms,
g / Fax ( toilet compartments, utility rooms) 23.32
: Pli s p
R �. �4 1 a 34 i ai r gs n. - , , 1Tg Ega r r"Ti._ r t A-.
r "�r„n. FZS ,Rasa. �s 4= - Tr T4 ;l. :31 -ti: =Mi i ii � c5 ` ro ` :
r Attic /crawlspace fans
'-�. r i, ,::?� ~�"�..� 23.32
F
Business name: t^�MAT CDnrro1 II . e ll 2332
Contact name: RO y + I � �'( _ r is uH piping
Address: 1 f _ l0 ��� � $14.15 for firs! four; S4.03 for each additional
5t. ) 7l 0 At-1./E Furnace, etc.
City/State/ZIP: po T-10,48. 0 r 9-72-23 Gas heat pump
Wall/suspended/unit beater
Phone: ( 56 - 3) 1 1s3 „ L IB zz. Fax :;(5p3)e;(4013- Water heater
�E-mail: S�`o €'. c. 1 t r o-4-e. c 0 Rage
'� � " �� per" �^ �'1"O � inc C d t'Yl Range
�� ,: 's r. F .. Barbecue
Business name: CL( I/Vl D.TF- Con-J-10L / ne Clothes dryer (gas)
MI
Address: {JpO t n Q Other.
3' a. :t a"yt s a'M57, t
City /State/21P: e � .,. : s,?: � t subtotal ? o r7._ or cn.ZZt -(
Phone: (D3) ( -/S , 11$22- Fax: ( 3) Bobcats C-�1 S ""
-1O 1 �? ° lIp� 12211 Minimum permit fee 90,00
CCB tic.: �, Plan review (25% of permit fee)
State surcharge (12% of permit fee) /6 • g p
Authorized signature: 41 1Z��/ TOTAL PERMIT FEE /�• r}
Z This permit application expires If a permit is not obtained within 180
1 Print name: A.20 days after it has been accepted as complete.
Y A Date: /2_////e) 1 * Fee methodology set by Tri -County Building industry Service Board
hEiuildnglpermiu'MEC- PermirApp. dos 10/01/C9
400 -46177 (1 1/172/C011. WEB)
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