Permit q CITY OF TIGARD MECHANICAL PERMIT
III 3. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00147
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/06/2009
Parcel: 25111 BA11700
Jurisdiction: Tigard
Site address: 14270 SW 97TH AVE
Subdivision: BINGHAM PARTITION Lot: 1
Project: Ransdell
Project Description: Replace furnace and heat pump.
Owner: FEES
RANSDELL, DAVID & SALLY Description Date Amount
14270 SW 97TH AVE Air Conditioning or Heat Pump 04/06/2009 $14.00
TIGARD, OR 97224 Furnaces < 100K BTU 04/06/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 04/06/2009 $8.70
Minimum Fee Adjustment - Mechanical 04/06/2009 $44.50
Contractor:
CLIMATE CONTROL INC
16500 SW 72ND AVE
TIGARD, OR 97224
PHONE: 503 -453 -4822
FAX: 503- 968 -7224
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue
Total $81.20
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 -0100. You may obtain a copy of the rules
Issued By: ` ('In Q � t '1 Permittee Signature:< Q �i�{ � J
)\ ^^ 1 1 On
\
�j l y c 111 �� J3 ►/ ��lUU Jtt`
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 1 �'11�� "
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.
Apr 06 2009 6:51AM CLIMATE CONTROL INC 5039687224 p.2
i.
r Mechanical Permit Application FOR of t: 1 51: tl.l.
City of Tigard ` ED Received 4 • " 13125 SW Hall Blvd., Tigard, Old V p � Review • ~
Phone: 503.639.4171 Fax: 503, 9 .. DatslBy: Other Permit.
Tit 1;1 t Inspection Line: 503.639.4175 I, l: Date Read
Internet: www.tigard- or.gov AP - 6 2009 y�Y Supplemental Page for
R Notified/Method: Supplemenul Ioforma6oa
TYPE OF WORKOF F k COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
New construction �' jfrYet V Mechanical permit fees* are based on the value of the work
❑ Addition/alttratioiV a P
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit. _
CATEGORY OF CONSTRUCTION Value: $
XII- and 2- family dwelling ❑ CornmerciaUindustrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi -famil For special information use checklist.
Y ❑ Master builder ❑ Other: Description
Qty. Ea, Total
JOB SITE INFORMATION AND LOCATION Heating/cooing
Job site address: / /,Z 70 S-� 9 7 >LA �, �v /6- Air conditioning or heat pump - � y
(requires site plan showing placement) _ / 14.00
City /State /ZIP: 76 )4yj�i %' C� 7 z2q - Furnace 100,000 BTU (ducts/vents) / 14.00 /y
/] Furnace 100,000+ BTU (ducts/vents) 17.90
Suite bldg. /apt_ no.: Project name:
iele751V7 // Gas heat pump I 14.00
Cross street/directions to job site: Duct work I 1 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14,00
Subdivision: Lot no.: Flueivent for any of above 6.80
Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater _ 10.00
i - e � , d � - ® - �� 7 _, Gas fireplace 10.00
�FC- f
c /� /� T/!r/ Flue vent for water heater or gas
*I /tent/44e /ere fireplace 10.00
I - Gvir-e o7 Log lighter (gas) 10.00
Wood/pellet stove 10.00
^ Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10.00
(g PROPERTY OWNER ❑ TENANT
/ ,l Other: 10.00
Name: 3 A I1r
t � Jul ///1 fi 4 Environmental exhaust and ventilation
Address: f y z 76 . g r z Range hood/other kitchen
equipment 10.00
City /State /ZIP: 7-2, L� ek- rJ.'.7 j 2- y Clothes dryer exhaust 10. D0
Phone: ( ) 5 3 e'2_4,0 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility moms) 6.80
APPLICANT CI CONTACT PERSON Atticicrawlspace fans 10.00
Business name: /4 I +_ ;- Li 0 � if) Othe
C 1 10.00
Fuel piping
Contact name: Roll t .., s $S.40 for first four; 51.00 for each additional
Address: J liV S o - -- o /1
Furnace, etc
Gas heat pump
City/State /ZIP: a0 t - ( n a or 97 2- - -'L'1 Wail /suspendedhmit heater
Phone: (93 ) LI s 't..1 2 ZZ I Fax: : (03 ) 9 b' _- z 1 Water heater
E -mail: a e- ' i vn C-0 � of 4.€ n - �ry l t nC . c4 on Range
H G
-
t CONTRACTOR Barbecue
Business name: 6,' 1 ter Ate' 00 r, 47.6L 1 a L Clothes dryer (gas)
Other:
Address: 1)1,0)1,050C � So � n0 -7 A14-1-- A14-1-- MECHANICAL PERMIT FEES*
City /State/ZIP: f c. r ria 6 a I Q`r 4 -22- Subtotal 2 9
Phone: (fib)) its-3 It k ZZ� Fax: (5 eta -72-2-V Minimum permit fee ($72.50) 7 2- 5
CCB lic.: ?.....1
li
Plan review (25% of permit fee)
State surcharge (12% of permit fee) 8 .
471.444,9 TOTAL PERMIT FEE $ 1. 2e
Authorized signature: al This permit application expires if a permit is not obtained within IM
days abler it ban been accepted as complete.
Print name: kL rel3 I Date: 4{ / 1 * Fee methodology set by Tri- County Building Industry Service Board
rl BuildinglpermiulMEC- PermiUPp.doc 02/19/07 440 -4617T (I l/02/COWW&B)