Permit - CITY OF TIGARD MECHANICAL PERMIT
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II_ 2 ' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00507
131 25 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09!29/2009
L , . ... Parcel: 25102CCO2800
Jurisdiction: Tigard
Site address: 10330 SW HILLVIEW ST
Subdivision: Lot: 0
Project: Mullins 1
Project Description: Replace water heater with tankless water heater system (plumbing is on minor label); add A/C,
unit must meet 3' minimum side and rear yard setbacks.
Owner: FEES
MULLINS, MICHAEL C & JUDITH E Description Date Amount
10330 SW HILLVIEW
TIGARD, OR 97223 Air Conditioning or Heat Pump 09/29/2009 $14.00
Water Heater 09/29/2009 $10.00
PHONE: 12% State Surcharge - Mechanical 09/29/2009 $8.70
Minimum Fee Adjustment - Mechanical 09/29/2009 $48.50
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: Permittee Signature: 6"/ e/ 4,/ (' i9- j /d
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.
Sep 25 2009 8:27AM CLIMATE CONTROL INC 5039687224 p.2
-' Mechanical Permit Application RECEIVE'. •R eceived ... FO'OFFICE USE O NL\' .
. City of Tigard P trmitNc C�
• 13125 SW Hall Blvd., Tigard, OR 97223 Da njtc sw /" i ♦ /�t2'�Q(� - , - .4015.0 Phone: 503.639.4171 Fax: 503.598.1960 S E P 2 5 2009 P'a Re ew
Date By: Other Penal:
TIGnttl) Inspection Line: 503.639 Date Read /B : iuris;
.. Internet: www.tigard or.gov CITY OF TIG ' ') I NotificdlM y y 77 See Page 2 for
ath od: 77 S upplementalInformation
BUILDING DIVISIo 1
TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
❑ New construction Addition/alteration/replacement Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
mechanical materials, equipment, labor, overhead, std profit.
• . , CATEGORY OF CONSTRUCTION • Value: $
] -and 2- faint] dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Y g ❑ Commercial /industrial ❑ Accessory building
❑ Multi- farm}}' 0 Master builder For special information use checklist.
❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND 'LOCATION Heating/cooling
Job site address: J3 514.) J �, (l U (� Air conditioning or heat pump
t — t r 5� (requires site plan showing placement) / 14.00 / 7
City/State /ZIP: fl (� 4-{ C) 0 e_ - 7 22-3 Furnace 100,000 BTU (ducts/v= ents _ 14.00
Suite/bldg./apt. no.: Project name: �� (r '�S Furnace 100,000+ BTU (ducts /vents) 17.90
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: Lot no.; Fluelvent for any of above 6.80
Other: . 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water beater
/ 10.00 /v
Gas fireplace 10.00
•
A DID Alc- - a-pc...7,c -7 4
�,s,,� Flue vent for water heater or gas
t1 9 - 72_ G� 7-19P-7 / 6_ . C / 4irl Oil fireplace 10.00
Log lighter (gas) 10.00
41.4vl ( eZ ) Wood'pellet stove 10.00
Wood fireplace /insert 10.00 .
Q PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent _ 10.00
// � Other: 10.00
Name:
Mf F- �1 /0,5 Environmental exhaust and ventilation
Address: /a 33 D Range hood /other kitchen •
�� `' //vi �� equipment 10.0
City /State /ZIP: X7 As.-4 Ce — 91 2 z3 . Clothes dryer exhaust 10.00 .
/ Single -duct exhaust (bathrooms,
Phone: ( ) fo g y'- 0227 ( ) toilet compttttinents, utility rooms) 6.80 _
. 0 APPLICANT ❑ CONTACT PERSON Atticicrawlspace fans ' ' 10
Business name: AL) rn 4t? 4 0L... /6 C Other: 10.00 .
�,,/ Fuel piping
Contact name Ra { rl $5.40 for first four; $1.00 for each additional
Address: ) (, S OO fn y(.,) —7 .�h D /l e-, i Furnace, e tc, ,
heat
City /State /ZIP: Pa to n d Q( 7 9- �� Gat 1 _Wall/sussus -
r peridedhulit heater
Phone: (5 ) ti S 7 _1- q 2-2 I Fax:: (73) C1 � _ -7 Z z LI Water heater
E -mail: 06 € C'_-' I YYl G t 4 c u n -l-yv l Inc . co to Range 1 g e
CONTRACTOR Barbecue
Business name: I T ATE- 00 l 4,61,_ j 1 n c Clothes dryer (gas) Address: �/-S�L� ^ C l T�OC Other:
IICC J — 7. 1 .- r° I /1 LS- MECHANICAL PERMIT FEES'
City /State /ZIP:
0 r H0 P1 ,4 Or 4-7 72- Subtotal 2 y
Phone: (SZ ) • 2.2- . I Fax: (5n } ,Z2-y Minimum permit fee ($72.50) 72 -.ft)
J Plan review 25% of permit fee
CCB lie.: . I �I q ( ( P )
State surcharge (12% of permit fee) F.-70
-7o
• TOTAL PERMIT FEE 8(.20
Authorized Signature: I ` This permit application expires if a permit is not obtained within 180
(��""1 , rzr--//e", days after it bat been accepted as complete.
Print name: '� (..4) r . l Date: I • Fee methodology set by Tri -County Building Industry Service Board
NBulldi n M g\ Permils\EC- Permdt4pp doe 01/19/07 171' (11 /02 /CObttwEB) /0 9y
77's4,
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