Permit a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00689
TIGARD 13125 SW HaII Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2010
Parcel: 25111 DC07300
Jurisdiction: Tigard
Site address: 9400 SW BRENTWOOD PL
Project: BAUER Subdivision: SUMMERFIELD NO.9 Lot: 491
Project Description: Furnace replacement.
Contractor: CLIMATE CONTROL INC Owner: BAUER, ARLENE M TRUSTEE
16500 SW 72ND AVE 9400 SW BRENTWOOD PL
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 453-4822 PHONE:
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/28/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/28/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/28/2010 $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 ;10.332.2344.
Issued By: Permittee Signature:
Call 03.639.4175 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 27 2010 2:34PM CLIMATE CONTROL INC 5039687224 p.2
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City of Tigard C w Received
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• 13125 SW Hall Blvd., Tigard, OR 972 0 � J Permit No.:
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t Phone: 5 03.639.4171 Fax: 503.598. I1B6B . ,.E, �� — 'r ' '
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Inspection Line: 503.639.4 ] 75 DateBy:
Date Ready
on Other p i
Internet: hire: gard -oReady/By: $° DEC 2 8 2010 Nerified/kf r@ I ® See Page 2 for
736 l Supplemental Information
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❑ New construction �;Addition/alte II . « ' per 4 -�� �� �" "' "
�Si `. ' e : ,
❑ Demolition Other: Mechanical permit fees* are had on the value of th work
❑ performed. Indicate the value (rounded x ,: it r ]r� t ��- g a„ h o mechanical materials, equipment, labor, to Hearst dollar) prfi all k b #' ;;,' . , ! + l t ' , t t I 1 t . i 4 arc Pte; labor, overhead, and profit.
�1 • and 2-family dw 0 ? a C d r r c * 4 ;� t .
$ g ❑ Commercial/industrial ❑Accessory building t; , ;; emu rr , I r k t ,�.
❑ Multi - family ❑ Master builder 0 Other:
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'' fi- c,� •! r i J$o Y'-`� i r E F'`�i�"' �.u�, o `�� .{s�L ?y°.. TIeSCnPtiOA
_,a ? _ Y c v s:., �a,s:'�:�c='i-�- -fir.:'.. 15i. -a, "+tc ilii• }r Qty. Ea. Total
site address: ( L }) r �� �! "' ' = "
1 t O V L A conditioning
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City/State/ZIP: � Q �, � Y , � � Furnace , s ane . an show' :. ���
n 2 - 2.y urnace ]00000 BTU ducwvens Mill 46.75 MTh
Suite/bldg. /apt, no.: Project name: Furnace ]00000+ BTU ducts/vans) —
Cross street/directions to job site: !m 61.06
Duct work 23.32
H • ■ .'c hot water a :, -. _ 23.32 NMI
Residential boiler (radiator or
Unit heaters (het-type, not electric), - 2332
in-wall, in -duet, . ed, etc. 46.75
Subdivision: Lot Flue/vent for an of above Ell no.: Other 23.32
Tax
c ti ,. k y , f Other fuel a. 23.32
ax map/parcel no.:
ti % .z _..,. >°r , ,ate lt` 11,. (tl� -�r1 tl C -; -...i E• 'II \aCe/
_Water h _
. 1, -,�� .. .. t.f�r_.,,: tee.,•: ;f_t� �: ?� 23.32
9 1✓ LA•Ce >v Pk e6 -
WE for _ 33.39
Flue ace for wets heater or gas
!
dace
23.32
23.32
7 �� Wood/ . stow 33.39
. - :..:1 ' _ r . _ .. ° 1 ,. 7 1 z x t mn /liner /ludve t 23.32
r ,, ' 2332 NMI
it 23.32 MIN
3P Environmental exhaust and ventilation
i j 4 , Range hood/other kitchen
City/State/ZIP: a "ot t 33.39
Clothes ' a exhaust
Phone: r3t'} 35 s - Q Fax ( )
Single -duct exhaust (bathrooms,
Phe 3339 _
' 'n o : ( ) � a�, iv j WT\ ..+z a'b i''.$ a r'K J r .. toilet c t i . - . ells li t"
-- .,eL {rests .;'P,:'. 'A'C:!':�4 �., .'ri:. {...�..i.,.s._l�:�xs.� . 4t 1! C t t l c Gr' ^ rc . 1 G S 23.32
. =` ,� °E _; - Attic/craw cefans 2332 NMI _ L/ [ •
Other: 23.32
Contact name: R, f4141- rIS Foe/ .1 , 1
Address: !_ �. �/1 >nC r F $14.15 for first four. $4.03 for each additional
(0 0.,•
City/Stale/ZIP: is . J _ � �
u r C' • '7 223 Wall/. a«/unit heats
Pbone: (so•) y5 Li 8Zz Fax: :(So3)9(4913- ZZy
E •marl Water heater
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Business name: CLI im 4-Tr 1 _` C , _
Cloth . - as
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Address: _ OO n G Ocher.
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City/State/ZIP: e ; ', rl'r w �'h F.' 1 : a `17c '`l
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Phone: (5-03) , ' 70. D
S $ Z2- Fax: (O3) 9 Io - l z z Minimum permit fee (590.00) + 0 . CV
IyCB )ic.: 7__k 9 14
Plan review (25% of permit fee)
State surcharge (12°/t of permit fee)
Authorized signature: , TO , r I
This permit application expires II a pencil is not obldnrd within IRO
Print name; Q I {` � ®� days after it has been accepted as complete.
Date: • Fee methodology set by Tri- County Building Industry Service Board
Iar PermilAPPdor 10 /O1:0y
440.9617T 41 I /02 /COM••WF
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