Permit CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00089
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/16/2012
Parcel: 2S112CB12800
Jurisdiction: Tigard
Site address: 15000 SW KENTON DR
Project: CALDWELL Subdivision: ASHFORD OAKS NO.3 Lot: 137
Project Description: Furnace and A/C replacement. A/C unit must meet minimum 5 ft. rear and side yard setbacks.
Contractor: CLIMATE CONTROL INC Owner: CALDWELL, MICHELE A & BRENT A
16500 SW 72ND AVE 15000 SW KENTON DR
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 453 -4822 PHONE:
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Air Conditioning 02/16/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 02/16/2012 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/16/2012 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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: l 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.
Feb 16 2012 8:41AM CLIMATE CONTROL INC 5039687224 p.2
City Tigard 0 nau er x� � rc""" Ne.: �/ c= iJ-
I3125 SW Hall Blvd., Tigard, OR 97223 e ,, ,;a Plan Review
Phone: 503.639.4171 Fax: 503.598,8960 - a n Dam/By: Other Permit.
A
1 I :, I: I> "\, Inspection Line: 503.639.4175 ,. \l.
y Q Dale Rendy/Sy: ]mil: ®See Page 2 for
Internet: www.tigard-or.gov
Notified/Method: Supplemental Infor
kie mation
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r4;. = ':'.*V _ * 'r i =a.f, frOFt tiCt:'. t -` - s.;;r�' t`:; :..y-, ei i i . 14W72,` i r ? r a 6 a tX -
❑ New construction A►ddition/alteratitantrepl cem Mechanic al permit fees' are based on the value of the work
�!° l a c e performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: \. r- mechanical materials, equipment, labor, overhead, and profit.
"ri n w 4r .;n':.:,-s: . ,. �t ;.,;*n,..,, y r M" : �..��.. .9 :2,� �`S,'.'u'# . V" ;i�j :
Value: S
,�. xirk. -:,i ,,, v ti 1±i t f3�F I t v 7. r' ,
1 and 2-family dwelling 1 -_ .� ..._ ..__; t.. c _..._ .. 4 . ..
y g ❑ Commercial/industrial ❑ Ac cessory building
❑ Multi-family special information use checklist.
ly ❑ Master builder 0 Other:
_ Description f Qty. I Fa. 1 Total
,.,
.,s,. g i;t :'.:.. Heatingtkooling
Job site address: Air conditioning
5CCX:t 5w Ken may Dr (Mans site plan showing placement) I 46.75 %IS
Cityrstate/ZIP: -nt�ltT 4, or qv . ZZ( Furnace 100,000 BTU (ducts/vents) I 46.75 y6•'7S
l Furnace 100,000+ BTU (dsculvents) 54.91
Suite/bldg. /apt. no.: I Project name: L1 , elWejI Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fael -type, not electric),
in -wall, in-duct, suspended, etc, 46.75
Subdivision
Lot Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: - Other fuel appliances
Gas � e: v ,, ,. _:.;: 1. ( 2332
iL:e��� � a.L`�'$'� �5�yYr��::.:�.::t ! I A ! .�i� � F 1 1 -.. tea... �'a..7�.«a4 -: �... r , Water "eater 23
R G- RJrtoAe Ate- Flue 33.39
i� Flue vent for water heater or gas
fireplace 23,32
Leg lighter (Bas) 23.32
Wood/ !let stove , 33.39
Wood fireplace/insert 23.32
. ' �. Y- ,- .14 . . .r,:,, , 3 +` +mow r l„t, „ z,, , r 3 .,1k,.._,,,,,:, 5 � Cbimae�lliner/iluelvml 23.32
11 __ � /� ,, W a` Other:
Name: jree IA\C�C.1, (t s wart } 23.32
Environmental exhaust and ventilation
Address: t50 S J il~�'I D r Range hood/other kitchen aluipment 33.39
City/State/ZIP: -neoctro O"C CI-' 22 9 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) 16 sir 'z'' L ! ' Fax ( ) toilet compartments, utility rooms) 23.32
CF 3A V °' r 1' :i O . .__ 7 P-+ ( A 7 n P1 Atticklewlspace fans 2332
Business name: 16.1.1 MATE L o n T7oL Inc.- Fuel 2332
Contact name: RQ 4 1..1.74.r 1..1.74.r r t .S $14.15 51414. F pi .15 for first four; 54.03 for each additional
Address: 1 (C�- � c w 72y o A r Gas titr etc.
rJ - r'V Gas Lea
City /State/ZIP: `H aria r 9 - 72-23 Wall/suspendedhmitheatur
Phone: (c ,) £453-118 2 � Fax::4 5b3)q(os ?2 251 Water beater
E -mail: rO € G I t O..- -e. C I� P■'��t R`� -lace
O 1 r1 G C D tv-� Rime
k > 4 •,r? t.rr.,z .!`' r; 4 _ 1 Mi , . `" i Barbecue
Business name: C �„1 YV'1 F' O ir) 1. Inc Clothes dryer (gas)
Other: •
Address: 1(10500 clot-) 7..,(111 /t " `; y. �yy"�
V6
(c,�4y�`xe, t Q r l l 2 Vr . I n 3�S . .d 1
r-r.:fr tOr�' Sir ...1..�w.�:.a�€- ':cac :d.�,a...
City /State/ZIP: port or- 93 *s 0
G 1 •Z Z y S ubtotal
Phone: (spa) ti L j' .? Fax: (03) Cr lD V - .. 1 z2Y Minimum permit fee (590.00)
/ ot G Plan review (25%. of permit fee) CCB lie.: t0 State surcharge l2°% of fee) It. 2Z
r€ ( permit fee
1 44,441: TOTAL PERMIT FEE dt
Authorized signature: 7 permi application e>pires if a permit M act obtained w�illifr�SO
days after it has been accepted as complete.
Print name: y � `,[ ��s Date: a f j( 1 t ' - I ' Fee methodology net by Tri- County Building Industry Service Board
I , auildmg'emutsWEC•PermitAppMx 10/01/09 4 40- 461 7T(it /t2 /COMMWEB)
P6 61--)KQ
Feb 16 2012 8:41AM CLIMATE CONTROL INC 5039687224 p. 3
<, 16500 SW 72nd Avenue ;;::;: '`
HEATING & AIR CONDITIONING Fax: 503 -968 -7224
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