Permit a CITY OF TIGARD MECHANICAL PERMIT
' s COMMUNITY DEVELOPMENT Permit #: MEC2010 -00678
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/23/2010
Parcel: 2S1 11 AC01500
Jurisdiction: Tigard
Site address: 14530 SW 92ND AVE
Project: Flecker Subdivision: PINEBROOK TERRACE Lot: 56
Project Description: Add heat pump with one ductless air handler.
Contractor: CLIMATE CONTROL INC Owner: FLECKER, ROBERT & MARY
16500 SW 72ND AVE 14530 SW 92ND AVE
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 -453 -4822 PHONE: 503 - 709 -8206
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Heat Pump 12/23/2010 $61.06
Type of Use: SF Other, Heating /Cooling 12/23/2010 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/23/2010 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/23/2010 $5.62
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 . ions to • • C by calling 503.232.1987 or 1.800.332.2344. — .411110 Issue By: / ,/ � �L ` 4 / / Permittee S' � •!!•11/3W
Call 503.639.4175 by 7:00 a.m. for the next available ins • -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 22 2010 4:02P CLI L 5039687224 p.2
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City of Tigard 3 " Received /�
; � • 13123 S W Hall Blvd., Tigard, OR 97223 � r / . ' J Permit No.: Ire ! — t�
Phone: 503.639.4171 Fax, 503.598,1960 DEC 2 2 2010 Plan Review / (0 7 a
T t G ,� I: I) Inspection line, 503.639. 41 75
�+�Y Other Permit
Internet: www.tigasd-or.gov iy tr., Date Ready /By: Lurie: I ® See P
CI T Y u' d �.j "M:�'1..' Notified/Method. I Page 2 for
Dlt 6 Supplemental Information
_{� " a r �,, V o e
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�.. �;u; "� ,,.. �:�n t:�t u ,� tai � c i r � � 3 +� n I a i � '( �.. { _
❑ New construction �Addtttrnv 'alteration /replacement g?-.- tti -., I
❑ New Mechanical permit fees" are based on the value of the work
iislikdrall= -7 ❑O ther performed. indicate the value (rounded to the nearest dollar) of ail
>:t r „; fPy _ mechanical materials, equipment, labor, overhead, and
! s' . t% I c a +. profit.
,. . fir. * d - �• ? _ Value: S
� and2 familydwellin C 0 '` +i � 1 t i-- � c r-�
dwelling ❑ Commercial/industrial Accessory building � .�' :sue=`:at�� ^�����+ �1� ����1 K�R y � —
❑ Multi- family ❑ Master builder ❑ Other: For special injoarrtbrioa use checklist
l i t r i ''' , "� 3 1 ;: Description l Qty. Es. i
u.'.trt`# .. '�.:a; �: ,` .,�4a1 i o c" , ° f t' : 'a fie -. Total
a..: + a�,._r �_._ c 2i' ; r. Healing/cooling
Job site address: J"/530 SG 9.2 n • 4 Air conditioning
City/State/ZIP: 176 /fro/ 1 - t'atu sitetan showing plaoemenQ 46.75
r 'd. c), cr7-2...z. V Furnace 100,000 BTU (ducts/ ems) 46.75
Suite/bldg. /apt, no.: Project name: Furnace 100,000+ BTU (ducts/vents) 54.91
Cross street/directions to job site:
Heat
Dun work / 61.06 (pick k 23.32
Hydronic hot water system 23.32 i
- Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: Flue/vent for any of above 23.32
Lot no.:
Tax map/parcel no.: Other.
Other fu ei appliances D�7L- r i 23.32 12.7 -3 -
�S (. +` r rn el
. �. a ��. 5 rr V,2,I Y5. 11 T ._. v _.t � y , �-., r Water
- r.� � 2332 heater
�(�H7 (U D e Gas fireplace 33.39
(�
f f . I7 Flue vent for wales heater or gas
Di/Crie 'S / / ,JLe- - fireplace
Log lighter 23.32
(gas) 2332
Wood/pellet stove 33.39
w y' t S 1 ' t, Wood fireplace/insen 23.32
..__..d_.,.. :_�.,.. , ti ! ' l ..�w� � _ ,...�.:. } iIL ,x ,z tiA--:;-'2,--'37'7:7;'',"...:3';'-?7i Chtmey /liner /tltre/veet 23.32
% x, O
u, ` Oth
)971 f �f = !� CI . _ _. 23.32
Name:
/ Environmental exhaust and ventilation
Address: / / — 3 Si ' 9,Zr' 41/4— flange hood/other kitchen
City/State/ZIP: 71-76,4_,--‘1 equipment
3339
9 2 ?. Y Clothes dryer exhaust
3339
Phone: ( ) 709 - f � 4, Fax: ( ) Single duct exhaust (bathrooms, -
� z t n s T rL j \ , d + x F i a +. ; c toilet comparimans, utility rooms) - 23.32
t. ..r ?. ....1r 4 : ie,lvt�+ Z :" ,. Yi °yv4 ,: it c - Auic/clawis p acefai ts , 23.32
Business name: au MA l� Ll o n r roL !Ile-
Other.
23.32
Contact name: R0 4 LL B — r is Fuel piping
x14.15 for first four; $4.03 for each additional
Address: i (p5 5G0 7 O AV Furnace, etc.
City/State/ZIP: ��►j r Hand Ws
heat pump
9w7 223 wan/suspended/unit heater
Phone: (503) 9922 '{ r Fax: :( b3)q(08- -7Z. Water heater
E -mail: / � / r 0 e G ex.-1 c to r1� (t F •lace
�, y 25 ro Inc • cor Ran
'',, ,x i � S'".3st '� rLr�z ,y,a "' As.�+s x„ ,r*- � � ti
b �c.er 7.. , ' �...:- 1,1 4•VI- ..` i j..s Yr. a .iW S ws • '- ..• Barbecue
Business name: CLI V�/1 C1, Con L / hC Clothes
as
Address: 1(0500 SP. - ?2P A V&
Other:
Addre ate/ZIP port l t l re st �, 7 '��i`'`x 't@;- :027Zs f :6
(5�3� cc-) Subtotal g . 3 ,
L /S3 — y$ Za. Fax
I 5b C - ?zzy Minimum permit fee ($90.00) rjO.
Phone:
- CCB tic.: 74 0 c
Plan review (25%ofpermit fee)
State surcharge (12% of permit fee) /4, -: g O
Authorized signature: 1R /i� � TOTAL PERMIT FEE Ott 1 '0
This permit application expires if a permit is not obtained within ISO
��r� days after It has been accepted as complete
Prim name:
deo y S ] Date: fg z(A) ° Fee methodolog set by TN-County Building Industry Service Board
: ' Permi1App.dx 10/01 /09
0-2 4617T(1 OMM'EB)
po 1493W
Dec 22 2010 4:02PM CLIMATE CONTROL INC 5039.68722 p.3
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