Permit CITY OF TIGARD MECHANICAL PERMIT
I I COMMUNITY DEVELOPMENT Permit #: MEC2010 -00692
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/30/2010
Parcel: 2S114BD04100
Jurisdiction: Tigard
Site address: 16565 SW COPPER CREEK DR
Project: Krueger Subdivision: COPPER CREEK NO. 3 Lot: 100
Project Description: Replace furnace
Contractor: CLIMATE CONTROL INC Owner: KRUEGER, JAMES R & MELINDA
16500 SW 72ND AVE 16565 SW COPPER CREEK DR
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 453 -4822 PHONE: 503 - 689 -0129
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/30/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/30/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/30/2010 $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, . e . is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility .tification Cent- Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or di -ct questions to OUNC -,' calli g 13.232.1987 or 1.800.332.2344.
Is. ued By: G /1 u
, / Permittee Sig ure:
Call 503.639.4175 by 7:00 a.m. for the next available insp ction 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 29 2010 8:47AM CLIMATE CONTROL INC 5039687224 p.
••..•••.•a••.i...-Oa a CI 11a1L I
ipli City of Tigard $ 6 ',,,. . .' Received
13125 S W Hall Blvd., Tigard, OR 97223 DateBy: /Z st 9 /O AP Permit No.; J.�� / � 9,2
Phone: 503.639.4171 Fax: 503.598.1960 DEC 2 9 2010 Plan Review i! < `
l 1 G A 1 17 Inspection Line: 503.639.4375 DetelBy: Other Permit
Date Ready
Internet wwwti ardor ov B
g g CITY OF TIGARD Notified/Metlwd: Allis' Page l for
w) r ,. 4fi1r+ yT rrr + r o a a ' a V P' Supplemental loformatios
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Mechanical
New construction Addition /alteration /replacement • are based on the value of the work
permit foes
CI Demolition Otht�
performed. Indicate the value (rounded to the nearest dollar) of all
'v• aeuJ '�rtl�' s spa r materials, equipment, N and
J,�.- mechanical maim born overhead, t� rd.„ P,'1 g e o e ` y t • , : i st*.tr vim S pmfn
g 1 - and 2-family dwelling ❑ Commercial /industrial 3 r '+t t t �`q r � 7 � - v
❑ Accessory building Lds� y . ` ::Z i�f.r: 'B!' X.f`Z'ti. x!3 i, ' y `
❑ Multi -family ❑ Master builder 0 Other:
For special injormarion use checklist.
z JA �s� w ate, ; Description
f 1° rs Ip I y � T.s''� '�1' c c ,x. >rt 7 I QtY• I Total
r" �,lia HeatlnA/cooUng
t) Job site address: 6 J ' , •
Air conditioning
City/State/ZIP: , ar t �� Air con site pin showing placement) 46.75
OY • 2 2-V Furnace 100,000 BTU (ducts/vt:ns) / 46.75 C/6.. 7.5
Suitelbldg. /apt, no,: Project name: - Furace 100,000+ BTU (ducts/vents) 54.91
rU ��� Heat pump
Cross street/direct;ons 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: Lot no.: Flue/vent for any of above
23.32
Tax map /parcel no.: Other: 23.32
` <' a c r , 11� r 4A v t k lI r s ,) a a 1 '� i� 1 a. Other fuel appliance
_� ._ �. _ . .' .. , . r �; , • .1 Wala heater 23.32
/1-44 Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood s tove 33.3
L' t t �, , a x r ( t er Wood fireplace mserl 2332
' stir .gZr •: , 1 t v ..: :;: z ► ' . , i2-,1 -. -' ;i51 f �� llinaltludveat 23.32
O ther 23.32
Environmental exhaust and ventilation
Range hood /other kitchen
City/State /Zip: t 33 39
G �� or
.. 72 Z Clothes t�thaasl
Phone ( ) ( p $g,_ 0 / 2 9 Fax, ( ) Si -duct exhaust (bathrooms, 33.3
�s s* r toyer
� t '' - yc ''� I F �'� f_� �. . - �,,, i x^- �� is U I171 rOOm3 23
-u .. ,,. f_T : I"`t� tib 4- t l ' t ``� C'r C g �� e .t' i'" 6 2' 6 �',�p.. "T -'e�:�r�.�+g
r,_.�z .- ,;3__,�.•...s_,;l,.. +,..._ _._..;r- �.i'7'7. �'_.- i,�4't : ' jr .y u +� .b'�? , 'l �T. s:� Amcicmw
Business name: 23 32
_ ' h 23.32
Contact name: FOu ther : p I r 1S S14.15 for fast four- 54.03 for h
Address: /J• w r0 eac addl tided onal
Address: I - C 1 etc.
taro r s � r ` • '1 �2 Gas heal .
Phone: ( j ) Lis-3 — LIB Z Z. Fax:: (03)9(06- Z VI Water s
a esheater dedhnv► heater NM
E- mail: re" @ G t M O►. �e F : 'lace M
c o n-�- Inc co
p._c«_':asss 'F�s..;1t"'S�s:..'��,.z r `r Barbecue
Business name: LI y i 1 3, 7 - C. Clothes __
4 Address: • 5 sr 0 Gt _ fl 19 A v 6— -
Other
City/State /ZIP: ♦T1 or . Z . b'� L` 'v .,
Phone: (5 s _ � zL Fax: •Z y Subtotal I (r �7
(51 3) city ty - ? zz Minimum permit fee ($90.00) , oU
CCB l;c.: G 9-1 of Plan review (25 °,y of
permit fee)
„de State surcharge (12% of permit fee) D • 04
Authorized signature; TOTAL PERMIT FEE $C1
. Y This permit appfeaiton expires If • permit Is not obtained within ISO
L Print name: Q �l days after It has been accepted as complete.
Aro Date: 2/7 D ' Fee methodology set by Tr; -County Building industry Service Board OP'
1: uNwiine %Permi.v.A¢C•PenniIApp.doc 10/01/09
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