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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00113 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/17/2011 Parcel: 2S103CB02900 Jurisdiction: Tigard Site address: 12245 SW MARION ST Project: Blaisdell Subdivision: Lot: 0 Project Description: Furnace conversion (oil to gas), new gas line and flue. Contractor: CLIMATE CONTROL INC Owner: BLAISDELL, LAURA 16500 SW 72ND AVE 9405 SW BUTTE AVE TIGARD, OR 97224 VANCOUVER, WA 98664 PHONE: 503 - 453 -4822 PHONE: 503 - 358 -3085 FAX: 503 - 968 -7224 FEES Specifics: Description Date Amount Furnaces < 100K BTU 03/17/2011 $46.75 Type of Use: SF FlueNent For Any of Above 03/17/2011 $23.32 Class of Work: ALT Type of Const: Fuel Piping 03/17/2011 $14.15 Occupancy Grp: 12% State Surcharge - Mechanical 03/17/2011 $10.80 Stories: Minimum Fee Adjustment - Mechanical 03/17/2011 $5.78 Fuel Fuel Types: Natural Gas 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 • rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N 'cation C ter. Those rules are set forth in OAR 952 001 - 0010 through OAR 952 001 - 0090. You may obtain a copy of the rules or dire questions to O N calling 503.232.1987 or 1.800.332.2344. l � ` Issues y: s JQ Permittee Si , x,11 eel Call 503.639.4175 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. Mar 16 2011 10:31AM CLIMATE CONTROL INC 5039687224 p.2 — •..+•.awaa x. W Hull 1% ill:14 I OIZ OFrio l;`1.O\ City of Tigard# F Receives Q ] 3125 SW Hall Blvd,, Tigard, OR 97223 1 6 j a Zp 1 PI1n Re , o! /11, 1 Permit No.: ! `_�! / Phone: 503.639.4171 Fax: 503.598 1960 Plan Review L R D Inspection 1_ioe: 503.639.4175 . ,, ^ Date/By: Other Permit T I t i n mtemd www.ttgard- or j 9.41 iO t DateReady /By: } �'it } /a0i!o f l r, /rte l+ Notified /Method: C See Pate 2 for �l ''�"'R"c 0 L �, - ,. � ! St7Plemenhll /ormanon a kv � prr�o 5'! � h q �'+ 5 . x e 1 , ' �'., t 5 ■ °e..F- "^ ° °'e > ?FL '-r 3 i ?. pa G t1�,Y,ri{ 1 t 1 J v P7 r 1 ' �: Additionlalterati txl /replacement Mechanical permit fees* are based on the vahte o the ^ work ❑ New construction ❑ Demolition 12 Other: performed Indicate the value (rounded to the nearest dollar) of all z aa*x K ; ;e mechanical materials, , u' , ment, labor, overhead, and , 6t. e . �. .. ° ° •; alue 3 "t `� air}q.o a V . 0 1 in R v. ❑ Accessory building * .:.:,.::..: ` i _ a" .. , 'C„cat.l x 1 s r`tx T. 2C1 and 2- family dwelling ❑ Commercial/industrial Master builder g ❑ Multi - family ❑ M Y :� _ 0 �wj � '� � ray ..+�,. ,�.Ttc x -^E }y�,,�,�. "�R_ # 1 } •t j 1 � ! 0 ` Y C'� �•j i �1�F R �•p < 6 wr- . , Description .. i 6 : 1 : - i rya'' K ati �' .-,I ',. 2 s1V -1 1 . w -'sS Qh • Fa. Total /2 � �`S' � '`:' " "�� Job site address: � , 7 S' 4a/eon r Air conditioning City /5tate/Zip; - � ` 4r � Oe•uacasite.LaBhDW t ,lacemern 46.75 c✓ elr 97 Z Furnace 100,000 BTU (ducts/vents) gm 46.75 MEM Suite/bldg. /apt. no.: J Project name: /� Furnace 100 000+ BTU (ducts/vents k /lam 45,66.--a_ 5 4.91 Cross street/directions to job site: 61.06 _ Duct work 23.32 H , . is hot waters : tem 23.32 Residential boiler (radiator or h ro 23.32 in-wall in-due t et sus, - ded not electric), - in -wll indct sus, etc. 46.75 Subdivision: Flue/vent for an of above Lot no.: Mill 23.32 Tax map /parcel rt01her: 23.32 o.: ?j a >.is. �: • z . : o i.g _e e r J e 1 ' C ,,� a j '-•+ Water' heater fiances 4c'� -- itl.?c �.: ' r 23.32 / � (O/ /7v 6,4s 1 4e...t.i f�eAt S ., 33.39 L //74 Flue vent for water hater or gas F/ VG t AM i]s-7 Ld rd/+- - .lace 23.32 23.32 r stove 33.39 Wood fir .. etinsen 23.32 Name: / q .. Othv; G— �7�'I 86 4'5 bell NM 23.32 Environmental and ventilation Address: /7 Address: R u 1 �t' 4- z , e , �!r - - _ aL Rang e kitchen Vaf/iny..a,/ War.) h t "d - Q C/ V 33.39 Phone: (5z3) 35 334,6.-j-- Fax: /© . 7 Single-duct exhaust 33.39 ax ( ) (bathrooms, - '° 1 R-';. ,. >xx x9 . ( .,, , _ t t>? l . A ._ I �: a ''; ` r { �` :, s s ` € I 1 � roller com , : tarts, tab rooms . 23.32 Business name: L a ,ti _ [ • n e..,._ tic_ _ 2332 Contact name: R • r IS Address: $14.15 for first four- $4,03 for each addidenal 411110 (/J '00 . .ut t Furnace, etc. a City/State/ZIP: r, 1— , h { Gas , tu n, = C1 r r • -� Z23 Phone: (9:3) 11E3— U ZZ Fax: : (Sb3)Q(OS - -7 , Zy Water heats ro @ C- t M ta..kte co n4 in c c o r,.� r E - mail: a�..�, � _ a ' •:E .>~a'f's�'�`:i�e��''eF t:`S ` a:'�.�V"'"' ` B � , " o becue Business name: ��� CL(n� are C. n� _ n c , Clothes ,, er as _ Address: P e w Other: -- City /State p: on—land O �� n � � v t ° F I � t . V r � . �f O r r T'- °t. -Y.7 - + �5 . TL t. q'',112,',, . a Phone: (S-03) 4 /S ' fl Fax: ( ' C ` ` D CO CCB tic.; 1 w 3) ' � Z Z Minim permit fee (590.00) ' IZ� tIJ Plan review (25% of permit fee) se /IF State surcharge (12% of permit fee) r /0. Authorized signature: r TOTAL PERMIT FEE �l7' 1 This permit application expires if a permit I not obtained within 18a 3?/ Print name: r7 /4�h days after It bas been accepted as complete. Date: i3 , . Fee methodology set by Tri- County Building Industry Service Board �� 1; Budding Team , sMEC•PernmApp.doc 10/01/05 440 -46177 (11 /02 /CONVWEE) P4 t'II Cho / .?to