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Permit k. C ITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00179 g'' i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/2/2006 PARCEL: 2 S 103 B B -09900 SITE ADDRESS: 12040 SW 122ND CT ZONING: R -4.5 SUBDIVISION: YE OLDE WINDMILL LOT: 020 JURISDICTION: TIG Project Description: Furnace and AC install. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Owner: FEES JOSEPH, HENDERSON AND JUDY Description Date Amount 12040 SW 122ND COURT TIGARD, OR 97223 [MECH] Permit Fee 5/2/2006 $72.50 [TAX] 8% State Surcha 5/2/2006 $5.80 Total $78.30 Phone: 503 - 590 -2938 Contractor: CLIMATE CONTROL INC 16500 SW 72ND AVE PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 453 -4822 FAX 503- 968 -7224 Reg #: LIC 62196 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: 64,4,14447,44 Permittee Signature: U 11 u .zip_. f2 , �_ -, y ` - . Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day. 1+ 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. Kay 02 200G 11: 06RM L INC 5039687224 p. 1 M i FOR OFFICE USE ONLY Permit Application 1 *r! 2x06 f'.' Received / Permit No // Aty of Tigard Date/By: ` y: % �j • % . - - r � -- 3125 SW Hall Blvd., Tigard, OR 97223 Plan Renew Other Permit: rhone: 503.639.4171 Fax: 503.598.1960 CITY OFTIGA..,: t, Date/By: • nspection Line: 503.639.4175 • BUILDING DIV „lg.> All Date Ready/By: CM 21 See Page 2 for nternet: vntitv•ci.tigar Notified/Method: Suppletneatal Information o - CHECKLIST TYPE F- �VORK lace I� DCJLE USE CIIECikLl AL FEE* SC _ , , .. ,, COAIA4ERCL Mechanical permit fees* are based on the value of the work ❑ New construction tidition /alteration/ ion/alteration/rep em en performed. Indicate the value (rounded to the nearest dollar} of all ❑ Demolition • / ❑ Other: : ' mechanical materials, equipment, labor, overhead, and profit. value: $ • ' ''.::.' • CATEGORY OF CONSTRUCTION •.:;;.:':. • • RESIDENTIAL EQUIPMENT / SYSTEMS FEES a ►2.4 and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ' For special information use checklist. ■' Multi - family ❑ Master builder - ❑ Other: Description Qty. } Ea- Total . .. • JOB SITE INFORMATION AND LOCATION - Heating /cooling • MI Air conditioning or heat pump I 14.00 Job site address: .. O , _ �� (requires site plan showing placement) Itet + Furnace 100.00D BTU (ducts vents) 14.00 City /state /ZIP: ...MI ` Furnace 100.000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 • • • Hydronic hot water system 14.00 Residential boiler (radiator or • hydronic) 14.00 Unit heaters (fuel -type, no: electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 10.00 Subdivision: ' Lot no.: Other: 10.00 Tax map /parcel no.: • Other fuel appliances DESCRIP ON OF WORK . . . Water heater • .10.00 ' Gas fircalace 10.00 0 a ` ' / Q ■ _ Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.0D ' Wood /pellet stove 10.00 Wood fireplace /insert 10.00 Chimney/liner/flue/vent 10.00 ROPERTY OWNER' . TENANT • Other: 10.00 • Name: 11�, . — MI t — .' • t, i i Environmental exhaust and ventilation e� ui �ment i - ,. ■ _ n nge hood/other kitchen 10.00 Address: City /State /ZIP: -r • 6 A= � Clothes dryer exhaust • 10.00 Single -duct exhaust (bathrooms, Phone' . • Q b . — ._ , rooms) r tax: ( ) toilet compartments, utility oms) 6. 80 APPLICANT NICI CONTACT PERSON Attic /crawls l ace fans . 10.00 1 Other: 10.00 Business name: & 4 • 1l,ri A 1 Fuel piping • Contact name: S5.40 for first four; S1.00 for each additional Furnace. etc. • Address: SA Gas heat pump y City /State /ZIP: trMI A a � . 7t ia Wall /suspended /unit heater , Phone: : A . 1 _ 1 Water heater / ♦ = Fax: : S • # r ....-e — Fireplace E -mail: Range • CONTRACT IIR , . Barbecue t I Clothes dryer (gas) Business name lfi� 9 ( Other: • Address: - 7 ( 1 —)(1. - _ 11ECHANICAL PERMIT FEES* City /State /ZIP: - O 9'�7 Subtotal l�a „Si Phone: \ )4. - *- r � j' Minimum permit f ee ($72.50) • 7 e x , I � _ Fax: (_ . _ . Plan review (25% of permit fee) g CCB lie.: (2 tl 9 Lc 1 . State surcharge (8% of permit fee) • . T OTAL PERMIT FEE v This permit application expires if a permit is not ohtain w trrl£0 Authorized •Sig atur _ ` AM, _ clays after it has been accepted as complete. Print name: T .� [ Date: Il ( ' Fee InethodoloC, set by Tri- County Building Industry Service Board i' nri ,,inn'nrrmirs\MEC.PCrmiIAno.do „ - 410 4617T(II /02 /_OM /WER) Way 02 2006 11: OGAM CLIMATE CONTROL INC 5039687224 p.2 VI CLIMATI- CONTROL 16500 SW 72nd Avenue Portland, OR 97224 s Phone: 503-453-4822 Toll Free: 866-453-4822 HEATING & AIR CONDITIONING Fax: 503-968-7224 ‘ , \ I \ ..... _ 4to- _ ____----------' - ___.--- 4 2--C -------4.. 11-V-Lj - — — — — \\ \ % z- --------- - OE _ - - - - , ---1--, , 1 - - - - i :.? \ OGLS'Z \ \ I rs\ \ c-A \ 1 .. ,...._ ----2 , , ‘ \ 1 , SYSTEM DESIGN ' INSTALLATION SERVICE MAINTENANCE climatecontrolinc.com j 2ft 14- 1 -ec� - 1 - t,-iaAvr ut i CITY OF TIGARD ' BUILDING DIVISION PERMIT #: MEC2006 00179 13125 SW Hall Blvd., Tigard, OR 97223 ,''`, DATE ISSUED: 5/2/2006 Phone: (503) 639 -4171 votipiAil Inspection Requests (24 Hrs.): (503) 639 -4175 .09 IL INSPECTION WORKSHEET FOR DATE: 5/4/2006 TIME: 1:0 AM4 PAGE: 67 SITE ADDRESS: 12040 SW 122ND CT CLASS OF WORK: SUBDIVISION: YE OI..DE WINDMILL LOT #: 020 ' TYPE OF USE: PROJECT NAME: JOSEPH ' DESCRIPTION: Furnace and AC install. OWNER: JOSEPH, HENDERSON AND JUDY, PHONE #: 603- 590 -2939 CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503-463 -4822 Inspection Request Scheduled For: Date: 5/4/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 029237-01 503 - 463.4822 N Corrections /Comments /Instructions: 0, , 4(31-ef /e/tAinec-c...6 5 037 4297 .ate? 7679' 7 .. r :/(/11-1-€L(- [X PASS 1 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL _ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: 441- Date: 4 Phone #: (503) 718- 7' ©,42