Permit CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: MEC2009 -00228
Date Issued: 05/22/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S 134DA01500
Jurisdiction: Tigard
Site address: 11125 SW 106TH AVE
Subdivision: NORTHERN PINE Lot: 6
Project: leigh
Project Description: Alter a /c.
Owner: FEES
MOMARLS LLC Description Date Amount
BY NANCY LEITH, 8405 SW 158TH PL Air Conditioning or Heat Pump 05/22/2009 $14.00
BEAVERTON, OR 97007 12% State Surcharge - Mechanical 05/22/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 05/22/2009 $58.50
Contractor:
CLACKAMAS HEATING & COOLING LLC
15115 SE PENNY LEE CT.
CLACKAMAS, OR 97015
PHONE: 503 - 658 -4808
FAX: 888- 500 -2912
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
or direct questions to by calling 503.246.6699 or 1.800.332.2344.
Issued By: 4 ��st ;0 ` 0 ) .c . n n d■ ) Permittee Signature: /(1 Q , C `CV
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
4 Fm:Ciackamas Heating & Cooling 1888500 t )I 00:22 05/19/09GMT - 07 Pg 01 - 03
M- ,ech i ea t Pe it '
,,..,. t"I!'! AAD�I 1. OR OF Ft( t: t ... its ,
City of Tigard MAY 19 2009 i5
131255W Hall t31vd,Turd OR 97223 `� 12_ cll. • Q0 2
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: a Phone: 503.639.4171 Fax: 503. ., , P ° a.:~i`W Other Pc:nait:
T 1G =: ^ 0 luau Line: 503.634.4175
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❑ New construction tion IN Additionlalte tionimplacemuitt Mechanical permit fees* are basal oe the value (Adze work
Q Demolition Other: performed_ Indicate the value (rounded to the nut dollar) deli j
mechanical materials equipment, tabor, overhead, and profrt�___
®1- and 2- family dwelling Q Cot> ial mr ttl [j Accessory bolding t ?
❑ Multi - fatally 0 h boulder ❑ Other: F c mss!
Description r
r ,.. �: ;t- :i .,`'" �` . R . - '., s ,�- #, ;„s, +wds.. �; 'i c2'i rr.. � S„ t � _.�
} Qty. { Ea. f Total
lob site address. 11125 SW 106Th Y < trees P
, (repines site phut showing placcseat ) 1 14.00 14
CitySShsteM1P: TIGARD, OR 97TEI Furnace 100,000 Rill (daerih 1400
Furnace 100,0001 BTU Oh crowd. } ' 1740
Suiteibldg.tapt. on.: : Project MUM
Cos beat pump 14,00 '
Cross liars to job site: Duct waft ; 10.00
11yerestie hot water system 14.00
Residential boiler (radiator or
, hydmnic) 14.00
- Unit bmiters (fuel-type, not electric ), _ ..._...
' in-vm , in -duet. a 14.011 ,
Subdivision: I Lot ma: Fhtetvent for any ofabove 6.80
Other: 10.00
Tax mapfpan el no.: Other hid app€aaaces
Waft—heater 10.00
Cass flreplaoe 10.00
A/C ADD-ON �. _ __ __ _ _ Flue vent for water or g
* 1900: i
: fireplace Log lighter (gm 10:00
Wood/pellet stove 10.00
y v Wood fireplace/inert - 10.00 .—.
t ,ebx:.t . _ s ;n S.* .�' ' `' c y . f; Yi.'r` r M „ jlineg YGl/f 10.00
�,t...N.. .r.. a.s.,< ,.,,..,..,, .,, t ()flier 10.00
Name LEECH, NANCY E..1 esassst sad vatttbt*las
A 11125 IafrTli' _ • Range homdtod rkitchea
1000 .
City /StatoJZlP: TIGARD, OR 9722 Clothes dryer exhaust 10.00
Phone: (949)7352725 Fax ( ) � utility warn) 610
o. b , s Akit �, . Attior fans 10.00
aA ei. is § t rig..ia. 3 <, 't„ fr - rt . 4
Business CLACKAMAS HEATING & COOLING L
s 10.00 ie
]list gip
Contact name. VLAIDIMIR MIKIIATS S6*Mirliaet fluor; S) .419 for ertele additlaaal;
Furnace, etc.
Adibess:15115 SE PENNY LEE Cr.
heat p
City/State/ZIP: CLACKAMAS, OR 97115 Walwlsta t twin
Phone: (501)6511-401101 Fax:: (SW) 500.2912 Water heater
E CHCLLC(e*Cf)1WA$LNEi _ t 4 Rang" e .. 63.', ter. ± &': r `4 t� .A .w.._, . .,.... r .,.?'s:..'i'•: ` � �^ ` • • w•A" Bezbecite
.',A _.
t name: CLACKAMAS HEATING & t:0OLING LLC
Clothes dryer (gas)
Adams: 15115 SE PENNY LIZ CT. 't T e , p .�
City/Shift/ZIP: CLACKAMA , OR 15 Subtotal ` 14.00
Phone (MO) I1a. (910131100.291/
- Minimum permit fee (S72.50) , 7250 }
Platt review poi permit
CCB Tic.: 165630 State surcharge (12% of permit fie) 070
- - -- - PERMIT RMIT FEE , 8120 t
Attt6prizee3 signature j,�,c ✓' ' 'o p a to expamea Ws permit is Nut abating wits* to
_� ^__- _, - _ - _ ZEi [ e5ars , stltGCitlors heat seeepmertaxos
Print name: V I ADIMIR 1 I
ATS Dote: U5.t9:09 * Fee mrtbxxdoksgw aFet try Tri'- County By lfing Tadu*try Sezv ee Board
t. a ildiostPermitatMEC -ProsutApa.doe 01n9/01 440-46177(11)02/0:164/0/11 .
Fm:Clackamas Heating & Cooling 18885002912 (15035981960) 00:22 05119/09GMT -07 Pg 03 -03
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