Permit CITY OF TIGARD MECHANICAL PERMIT
¢' °'! COMMUNITY DEVELOPMENT Permit #: MEC2011 00540
•
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/29/2011
Parcel: 2S103BB00700
Jurisdiction: Tigard
Site address: 12545 SW 124TH AVE
Project: YINGER Subdivision: BROCKWAY Lot: 7
Project Description: Furnace and heat pump replacement.
Contractor: CLIMATE CONTROL INC Owner: YINGER FAMILY REVOCABLE TRUST
16500 SW 72ND AVE BY YINGER, KENT L & DEBORAH LYN TRS
TIGARD, OR 97224 12545 SW 124TH AVE
PORTLAND, OR 97223
PHONE: 503 - 453 -4822 PHONE:
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/29/2011 $46.75
Type of Use: SF Heat Pump 11/29/2011 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/29/2011 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By • - Permittee Signature:
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.
Nov 28 2011 10:03AM CLIMATE CONTROL INC 5039687224 p.2
City of Tigard RECEIVED Received _ _ ._ ,
iii,„ . 13125 SW Hall Blvd., Tigard, OR 97223 natdBy: PermicNo.: /►�,��.)�V
Phone: 503.639 4171 Fax: 503.598.1960.. , 8 q Plan Review
1 Ii: A R I) Inspection ction Line: 503.639.4175 8 .. [ O Date/ Other Permit
Internet www•tigard- or.gov Date Ready/By;
y':s`1 M X' R Notified Method. )� pp mentalInformation
��. +•:_ ,,,, -, .�..�i . .� ^., �a s+x g �. LT i �{ 111
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CITY OF T Page for
Intend.
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❑ New construction ' IgAddition /alteration/replacea Mechanical pt
performed. Indicate the value (rounded to permit fees* are based an the a the nearest dollar) ""
o Demolition ❑Other the ar) of all
and
mechanical materials, equipment, labor, overhead
� ":- r t§°: ° ; R .! 7:72,67:11 , fi
s41; ,:t ha4.141,t sK_4i` ... ,`. e f 4 d l profit.
} : ,> Value $
.
Ell- and 2- family dwelling ❑ Commercial /industrial --4-., .
❑ Accessory building 3 ` 4 ; -. ° ±aft i4b.g ' '-;.,•. sts
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist
v ;° Fjt,* ' .may '� e j ^ i r 6 c c ; t y Descnpvon 1 Qty- 1 Ea. 1 Total
> . t_ f •,-• ',tir Beadn; coolin:
Job site address. /;,/ S - /,2 3/ ,4w Air conditioning r
City/State/ZIP: (requires B ite plan slowing placement) 46.75
776,47,v Og 97Z Furnace 100,000 BTU (ducts/ vents) I 46.75 Lk,- 7.(
Suite/bldg./apt. no.: Project name: �/ / ,y Furnace 100,000+ BTU (ducts/vents) 54,91
Cross street/directions to job site: Heat pump / 61.06 (mlUtj
Ihmt work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, is -duct, suspended, dc. 46.75
Subdivision:
1 Lot no.: Flue vent for any of above
23.32
Tax map /parcel no. :� 23.32
"'x r Other fuel appliances
. . 111 1. : v�.� ... -.r'r� u�, _iti lti t1(� c1 3.ir) 1 , -r r..::7 2332
wxe .z.._.,..... 6 .,_� �- .,�.. ....�,� - -r� �� tt�,�.,. �., �: :c� � � n T : " Water heater
/Qs r - - 44.-../L�4e- -- t l06i Q Oa dace 33.39
IYrt Flue vent for water heater ox gas
fireplace 23.32
Log lighter (gas) 23.32
Woodlpellet stove 33.39
�" 5 t i 3 o %is t /t s C Wood fireplace /insert 23.32
' t ; s , ti r .. ?s2t - r.. 1T 11 X -1 T- ,:t J =r p`� c -s , i t ; ,� Chimney/liner/flue/vent nt 23.32
� > vim;
" ` Other: 23.32
Name:
0.177- y�� Environmental exhaust and ventilation
Address: /-Z fit, /1y Range hood /other kitchen t
City/State/ZIP: 774
equipment 33.39
rvf' 9' 7z �3 Clothes dryer exhaust 33.39
Pi
( )/ � / /. Fax ( ) Single-duct exhaust (bathrooms,
i ii " S ) f �t. �a` <`4 i{ e• f 674E Z X "7 t ..d E f{' �+ x t,, ' w "+-�' ifi , -c 3„ v+ toilet Co. i s ■ ants mill moms 23.32
3 : e., ,....0 x . t'a`. x....: ci . .. t L .:.,. _ :...- r e ti r err : r .. a "t t x %rawlspa
R_. h .mot,s,' Attic ce fans 2332
1 1 A rE ton rnaL I r7G Other: 23.32
Business name: 6
Contact name: Ro 4 1 - r - i Fuel piping
�TT�7 $14.15 for first four; $4.03 (Cr each additional
6500 r5GI
1P 0
furnace, etc.
Address: 1
CitylState/Zlp: E�rrland r Gasheat
(sa3) 5 9 � 2 23 Wall/suspended/unit heater
Phone: y 3 LIB Z z. Fax:: ( St '3 )9(0e - - V/ Water heater
E (+p @ G t M a .� � G ea n Fireplace
- =. 4eec3L 1r1c. C e01nel
1�'';,��n� .,r -" �"' ^ {�,` ��r rte- ra s � �.� Range
3 .. ..-t? ` .4 :uiz . 5:: .- c 'S'�1 1 ei£; }'" j tlY-Y', n e .'" Barbecue
Business name: �L1 . /
e.. bn - _ me . Clothes dryer (gas)
Address: 1(a Sou S e. - ^7.. tl f, AV Other:
�4t T` �i'eT' 1 { 1 GF�' �'t" :. ++ -=.
City/Statc/ZlP: ? Y 0. /i or �+' � � Xt s i,I t P
"1 � •2Zq Subtotal ld 7.,57
Phone: (5-0 ci53_ y$ Z L j Fax: (Sp y) Minimum p
7 o' Lo 0 .- Z Z y Mt nit fee ($90.00)
CCB lie.: 2,4 C L / //� Plan review (25% of permit fee)
,
` / ///l State surcharge (12% of permit fee) fat - e/i/
Authorized signature: or ��� 4 _ TOTAL PERMIT FEE J20, 7
�Gt�� iLiff 1�bbb This permit application expires if a permit is not obtained within 110
Print name:p days after it has been accepted as complete.
r 4 c/ Da te: / / ,2Q // ' Fee methodology set by Tn -County Building industry Service Board
I. tBudelteelennititMEC•PermiEApp doe 10/01!09
440.461 7T 4) 1 /02 /COM WEB) Pb + 4 co-2/