Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00101
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/23/2012
Parcel: 2S109AA00700
Jurisdiction: Tigard
Site address: 14255 SW 125TH AVE
Project: DALE Subdivision: STANHURST Lot: 4
Project Description: Heat pump and fan coil replacement.
Contractor: CLIMATE CONTROL INC Owner: DALE, CONNIE RAE TRUSTEE
16500 SW 72ND AVE BY DONALD W MILLER
TIGARD, OR 97224 14255 SW 125TH AVE
TIGARD, OR 97224
PHONE: 503 - 453 -4822 PHONE:
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/23/2012 $46.75
Type of Use: SF Heat Pump 02/23/2012 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/23/2012 $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.
Feb 22 2012 4: 05PM CLIMATE CONTROL INC 5 0 3 9 6 8 7 2 2 4 p . 2
City of Tigard
Received i -----.-- ------■■■
weer th/77 / a 17,- P-mh.: MO c_,2c) i 4 --on w I
II/ 13125 SW Hall Blvd., Tigard, OR \ i .,*\.,
<T
C Plan Review
• II Phone: 503.639.4171 Fax: 5 . 8
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1 , , k I . 1 ) Inspection Line: 503.639.41
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t Vt, Sapptercentat laforwation
FMNIENINNONegirirT,MH - -' .;`.'.1::• 7° 7 7 . . e - t - F - 7.2 1 , - -- ; . 1 ' ::?? -_. '...4:.r.,
0 New construction 3gAddition/aheral4Pacarient Mechanical permit fees* are based oa the vake of the work
.4.,),. performed. Indicate the value (rounded to the Dewed dollar) dal)
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
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Er1 - and 2-family dwelling D Coonnercial/industrial 0 Accessory building
For special Wormation use checklist
0 Multi-family 0 Master builder 0 Other:
Desaiption .
1 Qty. I Ea. 1 Total
EINIRS-'411,7,1: lic r a t'-- AZ 3' X -6 : - . i f1 73 ,71 . 1 . 1WZFZ. 1 .. 1 7 1gr aa ' iql.ir.35.;;;9'.;.1 ' Hentiallfccolink . .
Air conditioning
Job site address: i q2,53 4 641„.. 1 / Aree oordres site oho showing elaceraro 46.75
City/State/ZIP: 7 elf9A--. ?7 Vs , Furnace 100,000 BTU (thictrAests) , / 46.75 44.71c
Furnace 100,000+ BTU (ductriveits) 54.91
Suite/bldg./apt no.: name: Ploft a4°."1--- Heat pump i 61.06
Cross street/directions to job site: Duct WWI 23.32
Hydronk hot water roateth 23.32
Residential boiler (radiator or
hydrook) 23.32
Unit heaters (liiel-type, not dectric),
in-wall, induct. suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: ,
Other. 23.32
Tax map/parcel no.:
Other td amallances
water Mawr 23.32
iv If. '`c la 'Y,...'.;` ',.. . ',.. 4 .... 4 .J...,:,_ ^, ,_ , '._ 'z
Gas fireplace 33.39
Flue vent for water lama 07 gas
fireplace 23.32
Lag titater (gas) 23.32
Wood/pellet stove 3339
.., .
Wood fireplace/insert 23.32
...,7 :". -i7"r'.- -, , --- : - S.7;;;,Fi7 . ;';' . .,r'; -.., 741' 7 - -r- .;.:, i,--- .r . .1 -- ,::•A, Chimney/finer/flue/vent 4 23.32
,....1'...: .--,---=, , ., :_: ...: ,,,,..L. .'2. , i:.: pe
23.32 _
Name: D A) • EZ - iy Al ii Pt. Entreamental exhaust and ventilation
Range hood/other lumber
Address: /V2 S"r" ll4) /25' ''' ,4./.46- entliPcond 33.39
City/Statt/Z1P: 774,,T 6 11.- 972z- Clothes drya ahem" 33.39
Slagle-duct exhaust (bathrooms,
Phone: ( ) .250 ,_
9 Fax: ( ) toad camera:ems, utility rooms) 23.32
,,.-., - .,, r, --..; ,-; -- :,_,_, - 7-7 -, --1-^"T''.1; ',:-;,;-......•,:le;;" ,,,,--- ::yrj ., :4; .-z ----- . --, ;4Z77- 7 n;:■9
Anrit
ic/celvm..- fees 23.32
0- ... $....„'i ''', '..e!'‘, -.":. rt, t ' ;I ■ v : - _,...::... ) ,,L s - 7:';■;,..:..7...k,..,•:':,1:...r...: -_,.±. , ,...2 , \ :,...2, , -;:..1
, Other.
Business name: t Litt/lA Tr Ao nrraL. inc. 23.32 Fuel piping
Contact name: Ro 4 4464frts 514.15 for first four; 54.03 for each additional
Funmee, eta.
Address: i(0500 SW - p." ° Au"
Gas heat pump
City/State/ZIP: p Hand. 0 r 9 WalYsuspended/unit belga
Phone: (ba) '1S3 qg ZZ- I FR : ( 9 ) "7 Zvi waif:theater
Fireplace
E-mail: r•
::3 € c 1 i 0_4-e.. c.c..-A-r Inc , C 0 ft." Range
Barbecue
Business name: 6 vv.! 4.Th-- Con4foL int . Clothes dryer (gas)
Other:
Address: i tit,500 c1.4-3 7 Av6
City/State/ZIP: ?on-- 1 a "Id or ci ZVI Subtotal
Phone: (51313) 22-2- F ax : ( PS) 110V-7e2 Minimum omit fee (5 MOO) ...-
Plan review (25% of pamit fee)
cc:a lk.: Co 7.4 ci Lo
State surcharge (12% of permit fee) i a.f 5/
TOTAL PERMIT FEE /24. 7 r"
A
Authorized signature: 4444; This permit application spire if a penal! is sat obtained widths 110
4.
days after Ii has been accepted Es conspbte.
[Print name: A-do y i 4,w f- i s i Dale: 1/zzi,//2_, 1 . Fee met/sodality tel by In-County Building Industry Senice Board
i IltaddioecootsWEC-PermitApp doc 10/01:09 0461 77 (luovcomma) 170.0.0.2:710
Feb 22 2012 4:05PM CLIMATE CONTROL INC 5039687224 p,3
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