Permit v CITY OF TIGARD MECHANICAL PERMIT
11 11, COMMUNITY DEVELOPMENT Permit #: MEC2009 -00274
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/10/2009
T1 GARS Parcel: 2S109AD03000
Jurisdiction: Tigard
Site address: 14627 SW 130TH AVE
Subdivision: WOODFORD ESTATES Lot: 22
Project: Voydat
Project Description: Replace furnace, and exchange a/c with heat pump.
Owner: FEES
VOYDAT, JOSEPH B & BETHANY L Description Date Amount
14627 SW 130TH AVE Air Conditioning or Heat Pump 06/10/2009 $14.00
TIGARD, OR 97224
Furnaces < 100K BTU 06/10/2009 $14.00
PHONE. 12% State Surcharge - Mechanical 06/10/2009 $8.70
Minimum Fee Adjustment - Mechanical 06/10/2009 $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
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: a ► x � Permittee Signature:
,`, ��� -- --" I I I 4.6*
1 '
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.
Jun 08 2009 6: 4319M CLIMFITE CONTROL INC 5039687224 p.2
M echanical Permit Application
RECE�' FOR OFFICE (.11: C)Ni 1 <
v r ` _
City of Tigard e ce i ved
y No.
n 13125 SW Hall Blvd., Tigard, OR 97223 p p DatelB : Pemmu O �'z , U l (1L?
Phone: 503.639.4171 Fax: 503.598.1960 ! UN v 0 O ZnnsDe DateR a Review ■
y Ot Permit: ` `
Inspection Line: 503.639.4175 y
ead !By:
T7 G AltD p CI luris' ® See Page 2 for
- w
Internet: ww.tigard- or.gov TY OF TIGq� Notified/Method: BUILDING DIVISION �`) Supplemental Information
• TYPE OF WORK COMMERCIAL 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, tabor, overhead, and profit.
.CATEGORY OF CONSTRUCTION Value: $
t - and 2- family dwelling ❑ Commercial /industrial RESIDENTIAL EQUYPMENT / SYSTEMS FEES*
❑ Accessory building
❑ Multi - family 12 Master builder ❑ Other: J
For special information use checklist.
Description 1 Qty. I Ea. I Total
•
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 Li 002.77 5w J31 Air conditioning or heat pump
(requires site plan showing placement) 1 I 14 00 J L
City /State /ZIP: T (6 f4-1 c ' 9 7.--z--`1 Furnace 100,000 BTU (ductstvents) I 14.00 1
4 /��T Furnace 100,0004- BTU (ducts/vents) 17
Suite/bldg./apt. no.: I Project name: U
Gas heat pump 14.00
Cross street/directions to job site: Duct work
10.00
Hydronic hot water system 14
Residential boiler (radiator or
hydronic) _ 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6
Tax map /parcel no.: Other: 10.00
Other fuel appliances
DESCRIPTION OF WORK Water heater I 10.00
_ /7 r Gas fireplace 10.00
� L 0 c- Yk, 4,t r • K E' wLA Ak w I ' Flue vent for water heater or gas
I v fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10 00
Wood fireplace/insert 10.00 •
• PROPERTY OWNER ❑ TENANT Chimney /liner/flue /vent 1000
Name:
Other: 10.00
`SoE 0 i�ta
Environmental exhaust and ventilation
Address: I ci L 2_-7 esi,u, 3 14v� Range hood /other kitchen
City /State /ZIP: 77 / Ado
equipment
�J Z'Z Clothes dryer exhaust 1010 .00 00
-- -� / _ Fax: ( ) Single-duct exhaust (bathrooms,
Phone: ( ) 5-9 O
i gt W toilet compartments, utility rooms) 6.80
APPLICANT ❑ CONTACT PERSON Atticierawlspace fans I _ 10.00
Business name; f) 1 v - 0 ,rt /� zi „� I0 ( Other: f 10.00
D 'T r) Fuel piping
Contact name: R
$5.40 for first four; $1,00 for each additional
• Address: 1 00 „p n. Furnace, etc.
City /State /ZIP; po „--)-(c4 , d ear 9 7 2_ Wa
L' j Gas heat pump
ode
1 I 111suspendedhuut heater
Phone: (523 ) (- s q 2 2 Fax:: (S
} ) 9 b _--722, 1 _Water
heater I
E-mail: (-01 - CAD r1 - ry 1 i fl ireplace
1 �- f- I PYI.a Co G Yy .1 RanSe I
CONTRACTOR Barbecue
Business name: • J 1 a50 � C � y . (I O � 16 L Clothes dryer (gas) t
Address: ll , J • l) . - 70 1 C 4 1 :3/ � � M ---
Outer: i I
ZIP: ! ✓f
City/State/ZIP: MECHANICAL PERMIT FEES'
�� rr( ac 4"7 2� l Subtotal
Phone: 6 - B)) 5-3 Li
k Z�.- I Fax: ( ) ,..� ZZti _ Minimum permit fee ($12.50) — 1 z. s'7)
CCB lie.: (p __I q Plan review (25'/, of permit fee)
State surcharge (12% permit fee) , e, ,- U
j TOTAL PERMIT FEE , $ I . 2
Authorized signature: 110\1 This permit application expires if s permit is not obtained within 180
4;14/0-0 days after it has been accepted as complete.
� Print name: ,y l 1`F') $ Date: / s/ Service Q 1 ' Fee methodology set by Tri- County Braiding Industry Se Board
I t BuildinelPermit s \�fEC- PerrnitApp -doe tin 5107
1111 I
440 -4617T (1 I /02/CCM/WEB)
Jun 08 2009 6:43AM CLIMATE CONTROL INC 5039687224 p.3
`f> " 16500 SW 72nd Avenue Portland, OR 97224 CLIMATE CONTROL
I A T l G & l R CONDITIONING 91 T I Q I� 9 N G Phone: 503 -453 -4822 Toll Free: 866- 453 -4822
Fax:503- 968 -7224
,yLk — ?o1 )90
19627 5 130 Ave_ i szt
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SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE
climatecontrolinc.com