Permit CITY OF TIGARD MECHANICAL PERMIT
,
COMMUNITY DEVELOPMENT
Permit #: MEC2009 -00226
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/22/2009
Parcel: 1 S 133AD09700
Jurisdiction: Tigard
Site address: 10741 SW 127TH CT
Subdivision: AMART SUMMER LAKE NO. 3 Lot: 153
Project: Hoak
Project Description: Replace fan coil.
Owner: FEES
PLUEDEMAN, CARIN K Description Date Amount
10741 SW 127TH CT
TIGARD, OR 97223 Other, Heating /Cooling 05/22/2009 $10.00
12% State Surcharge - Mechanical 05/22/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 05/22/2009 $62.50
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
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: z it , • : Permittee Signature: Q Q I ; n n, ` V ,^
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. v � `•W I 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.
¥ May 18 2009 2:22PM CLIMATE CONTROL INC 5039687224 p.2
Mechanical Permit Application 1.012 01.F1(T USE OMN
City of Tigard �' Received
Da RC q Permit No.. •• • a Q
.1 13125 SW Hall Blvd., Tigard,OR 9^,223w1, - - 19 2009
Phone: 503.639.417] Fax: 503.598.198a Plan Review
t l c; n r, D Inspection Line: 503.639.4175
Date/By; Other Permit
Internet: www.tigard- or.gov CITY OF TIGARD Note Notified/Method'
I See page 2 for Sappkmeatal Information
RI HI PIING DIVISION
TYPE OF WORK COMMERCLkL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees" are based on the value of the work
❑ New construction ' Addition/alteration/replacement
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: _mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
A l- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
i ❑ Multi -family ❑ Master builder .0 Other: For special information use checklist
Description I Qty. l Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /d 2y/ 5 /A 7/A Cr" Air conditioning or heat pump
(requites site plan showing placement) 14,00
City / State/ZIP; 7 ,, oil. 972-a3 Furnace 100,000 BTU (ducts/'vents) , _ 14.00
Suite/bldg./apt. no.: / Project name: —t / Q Furnace 100,000+ BTU (ducts/vents) 17.90
J 1 A k „cd 1 Gas heat pump 14.00
Cross street/directions to job site: Duct work
_ 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
Subdivision: J Lot no : Flue/vent for any of above 6.80
Tax map /parcel no.: 1 Other: Fo ce d 10.00 to
Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
e_01-C— _ Gas fireplace 10.00
C- t7i� rrit / Flue vent for water beater or gas
fireplace 10.00
Log lighter (gas) 10.00
^ Wood/pellet stove 10.00
Wood fueplace/insert 10.00
RI PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 10.00
Name: �AwXS (� � � Other. 10.00
(J 1 Environmental exhaust and ventilation
Address: 7 q ��- (� / �� > Range hood/other kitchen
J ! J _ equipment 10.00
City/Stale /ZIP: EE -t,o fpii B/1- 97ea8 _Clothes dryer exhaust
10.00
Phone: ( ) 6 Y4 7� 0 fi'� 1 F ax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
JA Y'
APPLICANT ❑ CONTACT PERSON Anic/crawlspace fans 11'100
Business name: /o t-1 yi 4-1 eo e) - 10C-, Other. 10.00
Contact name: { J ��,, Fuel piping
Roil t t " rl 55.40 for first four; 51.00 for each additional
Address: ) (G 5 QO 'SPO "7'22' o tag Furnace, etc.
City /State /ZIP: PO (-Aria n cl or 197 �,) Wail
"f Gas / eat
pump
isuspended/unitlieater
Phone: (5a3) ti S 1 { 7 22 J Fax : () 9 ( S/..... --/Z / J2 2 t,/ Water heater
•
E -mail: CO 9 e. 1 -, rri et 71 �- n ' 1 nC co R in Ranangeace
v Range
CONTRACTOR Barbecue
Business name: - e ^ 1 1 (, _Clothes dryer (gas) c .
Address: hOSOO SM.; -]fins fir✓ Other
M
I I J 4i, EC1L4NICAL PERMIT FEES*
Pt) r o r pt
City /State/ZIP: r ( 'h 22 y
J `? J Subtotal
Phone: (�7j ) i1 9 k /s �L 1 I Fax: ( ) /�j 8 ' 7,ZZY Minimum permit fee (572 50) - 72. 5
! Plan review
;--1 CCB lic.: (25% of permit fee)
State surcharge (12% of permit fee) 63 .
f / TOTAL PERMIT FEE 1 ^ 'Zit) 'Zit) Authorized signature:
f This permit application expires if a permit is not obtained within 180
I Flint name: days after it Las been accepted as complete.
Y✓ Date: 0 ! • Fee methodology set by Tn- County Building industry Service Board
113ui g\Permits��¢C• tApp.doc 0]/13/07 9 -} r r7 77(71 /02/CCMIwEB)