Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00096
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/13/2013
Parcel: 2S 103DA05300
Jurisdiction: Tigard
Site address: 10695 SW COOK LN
Project: Hughs Subdivision: FANTASY HILL Lot: 6
Project Description: Add (1) NC and replace (1) furnace
Contractor: CLIMATE CONTROL INC Owner: HUGHS, SUE
16500 SW 72ND AVE 10695 SW COOK LN
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 453 -4822 PHONE: 503 - 639 -3501
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Air Conditioning 02/13/2013 $46175
Type of Use: SF Furnaces < 100K BTU 02/13/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/13/2013 $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: J/ I n - Permittee Signature: Oki glPPL /041
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 13 2013 8:52AM CLIMATE CONTROL INC 5039687224 p.2
City of Tigard RECEIVED R�e.,ea -- - -�- ��
. • 13125 SW Hall Blvd., Tigard, OR 9724__ ma y: ail 3 `� vea,oi l� .�t(F� a vl 3 ■
- sooq (
• B Phone: 503.639.4171 Fax: 503.598
1 2013 D otbePertain:
>' t : r f, inspection Line 503.639.4175 _ Page 2 for hitenet: www-tigard- or.gov CITY OFTIGARD Date h le- , Svpp
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❑ New construction NAddition/aheration/neplacernent 1�eebanical permit fees* 7- ' ^ -Y" '
are based on value of the work
P
❑ Demolition 0 Other:
tsfarmed Indicate the value (rounded to the nearest dollar) edit!) . > i `ni! . t 1 � , q o mechanical ataaaiah, e9uipmem, labor, ovciwd, and profit. _
:; ..? a1.i '.'i , "'�.' :, ` ¢:zE r a r _fNa -- , Wt - y i TMI p,..4 " ,: V q' Value: S
Er] - and 2- family dwelling ❑ Commercial/industrial 0 Accessory building = � =' �- '�'x '� �/� ` { ` ''� :IL: � 1 . .
L 0 � Muul ` tii -fan Multi-family . � ❑ Master builder ❑ pa For :pedal lgja fixation UM checklist. ) _a.
- . "Z."TB a;tvu� r- �i ��i 1`•l i 4Y'f~iiYb yt ti'- �=-i- �y }:rn =r `.- on I Qy• I 1 Total
lob site address: 1x'95 540 /� _ Z/j Air toe nmg
�G� ,[ �
(requires dee Alan showing PLczmmt) I 46.75 1 (6.7.1
C ity/StatelZIP: 776 A-4 ?77Z 3 Furnace 100,000 BTU (duets/ems) / 46.75 9&
Suite/bldg/apt. no.: I Project name: / h s � to 100,000+ BTU (ems/vrom) 54.91
pump 61.06
Cross street/directions to job site:
Ductk 23.32
HYdrenic ha water system 23.32
Residential boiler (radiator or
>) 23.32
Unit hostess (fuel -type, not electric),
hl -wag, m -duet suspended, etc. 46.75
Subdivision:
Flue/vent o
Lot no.;
any of above 23.32
Tax map/pan el no.: Other 23.32
r- _ F T Other lad appliances
' rk u•.3 A. ' ` f ra e t l , r) r � 'I' 7, °_e i �,..,. ;7; .., ; ate : ,` Water halter 23
. _��;:>:'`� .32
Q Gas fowl= e..E .4l - arvitlo06 - f4-0I L 33.39
/
Flue veer for water berate or gas
fireplace 2332
Log lighter (gas) 23.32
Wood/pellet stove 33.39
„� _ w rte - _ T. Wood t1 hes/been 23.32
' p i1'tS? 1' h 1 . , '•r'a 'lS � ,� a ♦ , ,ti.,-:... t`, 1 r ..•_
}r�, ; , �-, -r., �,
.3. . Ch6rmey/lineNlluvt 23.32
t�tn
a .�_. . t.-.r .� mac.. � r �is sc¢�%:� �'n�.:c. t['•:�:7'r � :? r.1T �� p � +, S�i i { � j r s ... jo'A' �. �.��y ,
Name: r : _ ... Other:
rSU5 64 23.32
Environmental exhaust and ventilation
Address: /e6 945." , CO PZ 67 Range bond /other kitchen
City /StateJZJP: 776,4t.„--6 ,fir 9 7ZZ3 t 3339
Clothes dryer exhaust
7 Singl (bathrooms, 33.39
Phone ( 5b3) 4,3 9- 35? / Fax ( ) toile
_ _ wil rooms 23.32
.'�` - � L /� $ l ,\ `7. •F ,f3�>`'�. s, � �. �= �...;•' .' �,r, ,F rr_:-" t . a; i Atlsc/crawlspacefans 23.32
Business name: at i mAre- Lon rnoL, inc.- Other 23.32
Contact Mme: +�o f IS Fad piping
q
Address: l (050(3 51A.) " rO JE IS for first four; S4 /3 for tech additional
City/state /ZP: Hand ` Gas heat pump
9'7223 Walltsumentlechmit heater
Phone: ( 9 - 4IBZZ J Fax:: (Sa3)968 - 7229 Water heater
E- mail: (` G t t5 e` Fireplace
L: 5 ",�:;rt : �; n f , `�T�'y�i / L -.' � �� v :�- •f� S 'z+ e r..�,_ Range
r JS7 :raa :...�f '.. - , u7S Fiit' i :" Barbecue
Business name: / CL1 aTE- c, n-vL M nC , Clothes dryer (Pas)
Address: ! l0 S 110 Other:
t ✓0 / 44 - ) �� Q v 6 ' ♦ ` y ):' ri *e :71M. . X z._::. "5 1y �r j ii
City/State/ZIP: 'rl - t o.,i t� 0 z z L. nor..: , _;r�n�uaBLL��....:a � i ��'�...� : s , ° =ri�i 3
Phone: (, a3) 112 c Subtotal q 3
�l5-3- V Fax: (03 ) ',La _ 7 Z' Minimum permit fee (590.00)
CCB tier -: G 7,4 9 4/ Plan review (2395 otpermit fa)
State surcharge (12 E rc) O , 7
Authorized signature: / TOTAL E mit is n FEE /S/ 7Z
/ 71h permit application noires 1/ a permit is eat obtained within 110
Prim name: Q (, days situ It has been steepled at eotnpkte.
�I t {r7s I Date: 1 / 3 1 . Fee raettodoloey se by Tr}C.ommty Building Industry Service Board
I:{BusempWvm u NEC- rerrn;snyy,en novK" pD 5 - l a t r
410-461 7T c1 tAycone WEB)