Permit 4.01‘ CITY OF- TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00110
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/21/2006
PARCEL: 1S136CA-90061
SITE ADDRESS: 10900 SW 76TH PL 6 ZONING: R -
SUBDIVISION: TIGARD WOODS CONDOMINIUMS LOT: 006 JURISDICTION: TIG
Project Description: Replace furnace, install gas fireplace.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
JEAN NICKLEN Description Date Amount
10900 SW 76TH PL #6
TIGARD, OR 97223 [MECH] Permit Fee 2/21/200E $72.50
[TAX] 8% State Surcha 2/21/200E $5.80
Total $78.30
Phone: 503- 968 -0668
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
. PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 453 -4822
FAX 503- 968 -7224
Reg #: LIC 62196
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: L Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business dar.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Feb 20 2006 12:14PM CLIMATE CONTROL INC 5039687224 p.1
M Permit A a 4. • � FOR OFFICE USE ONLY .
"City of Tigard ` .. __ ; - I F7 ® �o o ,' cG$ e a _
yam_ ‘f�- erroit No.: �6 �1. "� 0 /
13125 SW Hall Blvd., .Tigard, OR 97223 plan Review
Phone: 503.539.4171 Fax: 503.398.1960 q , ii DaterBy: Other Permit:
inspection Line: 503.639.4175 FEB S - Ja i , e l I I D : Ready/By: tuns: 0 See Page 2 for
Internet: www.ci.tigard.or.us . Notified/Method: .l(-- Supplemental Information
CITY OF TIGARD .
TY$P1 p91 3 (SIOA#
COMMERCIAL •FEE SCHEDULE USE:CHECIkLIS7
❑ New construction Idition /alteration/replacernenf Mechanical permit fees' are based on the value of the -work
performed. Indicate the value (rounded to the nearest dollar) of
['Demolition ❑ Other: • mechanical materials,.equipment, labor, overhead. and profit.
Value:
_ - ....... -. .....:: OF. CONSTRi1CT10N :. : l "; :. ' : :` . . : ..:
%1" and 2- family dwelling ❑ Commercial/industrial Q Accessory building . RESIDEi\"TLAL EQUIPI4LENT/ SYSTEMS FEESx
• For special it forniarion use checklist.
■ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. Total
. • .. JOB SITE INFORMATION_ AND OCAT1ON: 4:•• Heating /cooling
Job site address: M 1 i1. ( V CL 7L '� ( Air conditioning or heat pump
'� (recuires site plan showing placement) 14.00
City /State/ZIP: � , 97c)...a. Furnace ace 100,000 BTU (ducts vet ts) 14.00 13
f.
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: + 41 , kj Gas heat pump 14.00
Cross street /directions to job site: • Duct work 14.00 _
Hydronic hot water system 14.00
Residential boiler (radiator or
• hydro n ic) 14.00
• Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. •10.00
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Othe: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF. WORK Water heater 10.00 �y
aL� AUrifiCe-,, Gas fireplace 10.00 ® u Flu: gent for water heater or gas
fireplace 10.00
Log lighter (gas) . 10.00
•
Wood/pellet stove 10.00
• Wood fireplace/insert 10.00
. ROPERTY OWNER - • 0 TENANT Chimney /liner /Flue /vent 10.00
1 n Other: 10.00
Name: CALM tr`._, e�- Environmental exhaust and ventilation •
Address: {
`�J • ' • 7 � .,. , (. Range hood /other kitchen
equipment 10.00
City /State /ZIP: ^% e I - • _ Clothes dryer exhaust 10.00 .
r� Single -duct exhaust (bathrooms,
Phone: 63 1/ p $ , , Fax: ) toilet compartments, utility rounrs) 6.80
'1. APPLICANT `a ' . NZ CONTACT PERSON Attic /crawlspace fans 1 0.00
Business name: • 'N '' /t other 10.00 • L at las Fuel piping •
Contact name: . 55.40 for first four; 51.00 for each additional
Address: • f . 1 e ` Furnace, etc.
Gas heat pump
�M ,_ r
City /State /ZIP: ? , Wall /suspended/unit heater • •
Phone: A 1 - / •Fax: � • Water heater
• : r_
- • Fireplace
E - mail: Range
CONTR Barbecue •
•Business name ? • (- � E 1 1 t 1 Clothes dryer (gas)
Other:
� �"
Address: f'} ` ((_S V� 7 �I � a 1 i\4ECH.A.NICAL PEIZhiIT FEES*
City /State /ZIP: 61(4-46 c 6 9' Subtotal . 41., .
Phone: ) f Fax: ( P • Minimum permit fee (£',2.3
�'y
t °? .J Plan review (25% of permit fee)
CC13 lie.: • . _ State surharee (8% of permit fee) ��
TOTAL PERMIT FEE ---f
Authorized signatur-: ^ .. >. , • This permit application expires If a permit is not obtained µ1 ° 150
.•.. 1 days after it hos been accepted as complete.
ry
Print name: . + y 4 r; s. 1 Date: 1 ` Fee methodology set by Tr-County Building industry Service Board
i:'. 2.uilding \PermiLAME,C.- PermilApp.d • ' - • "440 -4517T (11/02 /COM /WEa)
CITY OF TIGARD y
BUILDING DIVISION `s PERMIT #:Pl e-C/1 ,-- '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 � uNpu,i i1,
Inspection Requests (24 Hrs.): (503) 639 -4175 sI:_..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /DID° 7
(((��� l i (P CLASS OF WORK:
SUBDIVISION: I LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: iZ PHONE #:
CONTRACTOR: /�/ 4 PHONE #:
Inspection Request Scheduled For: Date: 8,_ 3_ -6, Pour Time:
Code # Inspection Description Confirm # Contact # Message
0.9 00.9- 4-G4 . ro3 - 453 - Ltea.:2_
Corrections /Comments/ Instructions:
1 g1.
Y I i ■ f . •"--- rw■ (
r7 , P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL F• - INSPECTION ❑ ADDITIO. AL FEES ASSESSED
Inspector: _,, Date. 1. Phone #: (503) 718