Permit CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit# MEC2012 -00473 •
T IGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued 09/17/2012
Parcel 1S134CB01100
Jurisdiction Tigard
Site address 12335 SW SUMMER ST
Project Griffin Subdivision SUMMER HILLS PARK Lot 9
Project Descnption Replace electric furnace with gas furnace New gas line for furnace and log lighter Gas line for future water
heater, range, dryer, barbecue and fireplace
Contractor CLIMATE CONTROL INC Owner GRIFFIN, KATHLEEN J
16500 SW 72ND AVE 12335 SW SUMMER ST
TIGARD, OR 97224 TIGARD, OR 97223
PHONE 503 - 453 -4822 PHONE 503 - 484 -4526
FAX 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 09/17/2012 $46 75
Type of Use SF FlueNent For Any of Above 09/17/2012 $23 32
Class of Work ALT Type of Const Log Lighter (Gas) 09/17/2012 $23 32
Occupancy Grp Fuel Piping 09/17/2012 $26 24
Stones 12% State Surcharge - Mechanical 09/17/2012 $14 36
Fuel
Fuel Types Natural Gas
Gas Pressure
Total $133 99
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 quests. • • OUNC by calling 503 232 1987 or 1 800 332 2344
Issued = 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
1
Sep 14 2012 7: 48RM CLIMB CN C 5039687224 p. 2
City o! Ti and E i v i d
, ...,
• 13125 SW Hall Blvd , Tigard, OR 97223 $ E P 17 2012 >�wBy / 7 /A P Me-Ob 7`
III
d Phone 503 639 41 71 Fax. 503 598 1960 Plan Review
1 I c . ', I: i.) blspecbon 1 503 639 4175 y��� Date/ Other Pa=
www ttgard- oi.gov Ci i Y Of ( te Niobte R MCQtod l 67 See Prig 21or
ar �•I ` -r -, n<- yam..,, � nit4!? i ryi,P � _ _ Sopptemeatatl�lorma
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.6.. - .tis ..-; -- 4 : : '' emu' , ti;�:a .,„'S- _ '.q a 11 I :. ,,,
El New construction ;Additicm/aheratian /replacement Mechanical permit fees* are based on the value of the work
Demolition ❑Other performed Indicate the value (rounded to the nearest dollar) of all
Txty r.;, : w t ,, , �,�+� r jp� ( mechanical materials, equipment, labor, overhead, and profit
.,: `/5:5 } iA�; r: Ailt l >_»i 4 .r � �Sb .MXP r. �f� Imo Valeta' s T
- 1' and 2 y r ;--. XX-1 L 1 1 IT I I 7 • � I I: 7 m-`
- family dwelling ❑ Commacial/mdustrial ❑ Accessory building �:�= =r �l• -: ' Vii::` �[�i i � 2 i:_:
❑ Multi-family Master builder 0 Other:
For tperral Information use checklist
lti- family
V" :%. , 4271�. -TZ-* 7 e. 1 { I'1�3 al f. i.T 7;` . rR^`r - .r ,� Description "tic I �[V I Total -
,A �a �y >- t t.v ?!:' ±x� :yi;J #' Hestlnit/000iln
Job site address' /2 3 35 5s Slily, .1,77 sr Air c° � '°'�
(re4ma me edam showing Amman 46.75
City /State/ZlP• 77 64, 072 97Z-2-3 Furnace 100,000 BTU (dacwvent.1 1 46 75 1 {(, •7
Suite/bldg./apt no. Project name 6� 'n Furnace 100,000+ BTU (docts/vertla) 54.91
Hat pump 61 06
Cross street/directions to job site:
Duct twrk 23.32
Hydroids hot water system 23.32
Residential bolo (radiator or
h ydro c) 23.32
Unit beam (fuel -type, not electric),
in -wall, induct, suspended, etc 46.75
Subdivision I no . Mom= for any of above 1 23.32 P.2- 32
Tax map/parcel no.. • d 23 32
",r •xRr., ,� .,... z ..... •, Other fuel appliance'
:itr: } :t :r T iI;'. a• I i e . 11 or',.� = =Ff_...�r -.. '�' W
.+'�'� � :.•�Y�,�t�L'r�3�_lt�� -.�...'ri ;` ;C� = ,�t'C:,:Y�•`i� atchater 23.32
14Y-44 /& IG Fe//l V 4:. • G✓nkL c ,4.s ,(//24/ �i , Flue • fireplace vent 33 39
I f �^ � / , �+ Flue vmr for water Into or gas
rt/eld c745 (,g , �leil�/ - 7 ( ! Td,`,_ fireplace 23 32
CIS Lioe , jZ //r./t KJa lei / (e t4� ♦ ,' / Wo lighter (gas) 2332 �• 3
Wood/pellet atcwe
,t1/ � 9 d / 33.39
, t 1 / 4 / ��/ ( ,./}CE /W�ootirmd f�e�grlaedmsas 23 32
1 '1V� 'Z*,: R.I :` e `` . ..� ' • - , -4:irs x r ...-. ,. ; f:l. :;7 • .. 7--;.7.- - `- e flue/v ®S
k,: w r t s �� � r `e ! ' i .h:, I -f'' ....; . "; , 1 : , ; •`" e a.A k: . - / 23.32
Name. � .(� 6 f rtiF/r� _ ' . . - ._ Other 2332
Environmental exhaust and veatUadon
Address: / 2 335 5. j) SJJ/Yl M-� s1- Range hood /other kitchen
oluipmean
Crty/State/ZIP: 774 40_49 Dr 9 2,3 es dryer adieus 33.39
� Smgleo-duct exhaust (bathrooms, 33,39
PPhone: ( ) y/T / - e,.-2 e, Fax ( )
`r= """� -} _ toilet cwnpanmans, utility rooms) 23.32
.. .:.�.:.a Lw'.;ti: . �.P _?.i':.C.' `e�(v;c. A111C/Crawl.Sp,aOe fans name: /� / � '� - =- ' "• '�� l 23.32
CLIMATE' t o n rim inc-
Other 23.32 ,
Business io
Contact mile. Fact piping
D 4 414f r IS $14.15 for fiat four; $4.03 for each additional
Address: 16500 5w -- 72./t° AVE Flame, etc. i I [ 6/5
Gas beat pump
City /states. poi rianci r 9722-3 W
aWsaPmded/tmit heater
Phone. (9: ) ys3 - 98Z2- I Fax • . (9 - 7 2 2 Water heater I , rtc %.
n^ta4e. c an�•roL Itoc , c z_•
E- mail. ro G a . corn � i Fireplace miler
i tr` ; ''h.,_ nk711 : M3 , •-°:t.∎ ,_7°S_e' S'IM tar,:':;;:t;:e��'`•' t1M41f, 3. '1' Bid ec I 1 -1-o3
Business name: e_L.l h/1 �,• i E eon 4 L. Ire , Cloths dryer (gas) 1 t•I , 03
0 Other`
Address: 110500 _
Sry -7�. Ave- a5 :
I � r �} ; •15�. F f'V f Y . IId''i li7•� .: J:
r.T 11.. .�r3' •lC ^ t�_ c i;f
City/State/2IP' ?orr1a n d or cil -zzl -1
subtotal 11q.6,3
Phone (5 q5 Ili( 2.a._ I Fax: (OS) 910 Y - - z z/ Minimum permit fee ($90 00)
calk: G 7.4 q Plan review (2595 of permit fee)
State surcharge (1296 of permit fee) !1/. 34
1R �� / TOTAL PERMIT FEE /33 IS 9 p, /
A uthonzed signature. • � ,� „ I _ This permit ap�pl►ratim expires era permit is not obtained width, ISO
.�Y
wa�s�C days after It has been accepted err complete vUU �•�
Pint name A .A �
Ct ice► riS I Date g p/ / Z I • Fee methodology i
gy set by Tn- Coty Bmldmg Industry Service Board
I IBlaldmpWe nartdEC - Perm app dot IDAI/09 404617T (I I /02COMN/EB)
1 a 11471)