Permit ti , ! �= CITY OF TIGARD MECHANICAL PERMIT
:r r COMMUNITY DEVELOPMENT Permit #: MEC2009-00674
TIGAD
R' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/22/2009
Parcel: 2S111CD06100
Jurisdiction: Tigard
Site address: 9835 SW KIMBERLY DR
Subdivision: KERWOOD ESTATES Lot: 26
Project: Moore
Project Description: Replace fan coil and heat pump. Unit must meet minimum 3' rear and side yard setbacks.
Owner: FEES
MOORE, BRIAN J & DONNA L Description Date Amount
9835 SW KIMBERLY DRIVE
TIGARD, OR 97224 Heat Pump 12/22/2009 $61.06
Other, Heating /Cooling 12/22/2009 $23.32
PHONE: 503 - 620 -6972 12% State Surcharge - Mechanical 12/22/2009 $10.80
Minimum Fee Adjustment - Mechanical 12/22/2009 35.62
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 $100.80
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.
,/t 1)21
Issued By: .e Permittee Signature: ii i- � / fie /✓
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.
• Dec 18 2009 2:53PM CLIMATE CONTROL INC 5039687224 p.2
Mechanical Pe i is �° DECEIVEr , . - e uS - w ,. ° •
. u L t r y YI.,ri
' j '' ; City of Tl and Received
III 4 . ' DateBBy:/J1 t 4 /%9 J Pernut No.;i1 &C � 7y
13125 SW Hall d rTt f e ji 23 ,, n Plan Review / "Jl
Phone: 503.639.414 -1 `' F9ic 5 t - . • 1960 DEC 1 8 Date/By: Other Permit:
T l u'r\ i. Cs inspection Line: 503.639.4175 Date Ready/By: lwis: hnernet: wwr ® See Page 2 for
®�ei�IGARD X + �
_ 1 ING DIVISION CITY OF TIGARI Notified/Method: `/ l �aPaem.�tai
, n m ! � t i '. '` ��z9 rtts� a t : z r ;. y '. ..t- `}�'n, ;'= pi' ,�� ` t F, - .� sit7„, .
i i (P4. " 11-Wi.a • .�•r,��••_ _fit .: :/
Mechanical permit fees* arc based on the value of the work
171 New construction XAddition/alteration/replacement
❑ Other mac performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition r cal materials, equipment, labor, overhead, a nd profit.
4: , . cq 1: ,, " ; " € fir+ MIME, s Value $
x. ¢ : ba 4' .s -,..t et �h t. 24 taw r rf"'+ 1 i t t �i G T t n :n a ,J a .a t}. , z t
�1 -and 2-family dwelling Commercial/ industrial ° = -•:� "- .- - -'r,• . 1 .�.r�' ,..'.-` `e' .
Y & ❑ ❑ Accessory building
For special information use check list.
❑ Multi family ❑ Master builder ❑ Other:
Description i QTY. fa. 1 Total
v �9`;:;ia! .,.. tract �:� �, ..- _ �; . ��.a�.:� � �4 � , „� ;r [.n,z �[? . �� u� Hulling/cooling Job site address: 99'_5 el_ �r�1 L r Air conditioning
(requires site plan showing placement) 46.75
City / State/ZIP: - 1 - l 6 Prei) C i f ( 2 1 1 1 . - V 1 Furnace 100,000 BTU (ducts/vents) 46.75
Suitelbldg.'apt. no.: I Project name: MO b� Furnace 100,000+ BTU (ducts /vents) 54.91
Heat pump 1 61.06 (pt 0(0
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 (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot tto : Flue/vent for any of above 23.32
Tax map /parcel no.: Other: P 0011 k 23.32 23-
Other fuel appliances
v f vA i - '�4i, F 7.T .; f,. F Y 9 M1
6;i"`,ni�{s r„� ,,ti p '7 r f i ;:k...,',.';',-. y. Za C im k 3"
4 .r..a .hi- . .`� <F .. zsttit.- ? ` ,.sr :t,..�_ :,,It...Wr P... f,, + , Water heater 2332
? - 9 4 E Fan CUN1 4
Gas fireplace 33.39
��CC Y IrJ(/� Flue vent for water heater or gas
f .lace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood ftreplacelmsert 23.32
r, k 7 44 f$ a ;, 'nsf , ,, m r Chtnmey/liaer /flue/vent
�.fa: K - a t!,,, f ::. ' i k ,,< t , t : r y-. T 8 1 ( ,�:. 23.32
:: - C-"' _ mi..,.- rtro..F.�i.f r:: .33! _..s.. ♦nt.t;c` a: �, _4._ :'� i xv.�..._ other 2332
Name:
1, o r 1-.r~ f 1.e_.. M oo Ce. Environmental exhaust and ventilation
Address: 9 8 3 S- 5'1,.-J K( An 6 eri 7 D i Range hood/other kitchen f
t =rui. ,aril 33.39
City / State/ZIP: 7 6A coif 9-1 -2--2-4 Clothes dryer exhaust 1 33.39
Phone ( ) Cp Lf�"1 '2.- Fax ( ) Seigle -duct exhaust (bathrooms,
X4 1-+ `" ` , xre � � c,7��r- '`F C ? ""fug r ' ,.�-' 'a' " ••�€ y d,�•s � ■s � � toilet compartments, utility rooms) 23:32
a r -._ :., _ r + ,,,t.tns,?�4tn a, `{ ..,_" ,� 7 r t c[as r�{ ro ,.. :. Attic /crawlspacefats 23.32
. s.,: -, ,._,_ _ . .nut .os , r.� t� ,t �..� .tea • ilr... . +z4".. €.1 1 i.11 �!3Yrt - ..- t 4.1i 1'1 �• -i.w. ,.'
Business name: (..LJ MA T E G} 0 n mot 1 inc--
F el 23.32
Fuel piping
Contact name: Ro 4 r 13 $14.15 for first four; $4.03 for each additional
Address: t c5 r rp Furnace, etc.
^� J � Gas heat pump
City / State/ZIP: 4 ( t or c -7 vZ3 Wall/sus
- pended /unit heater
_ Phone: (93) j53 Lib z2,_ Fax: :(b3)gto8 -7 2Z(' Water heater
E - mail rO eLitn, ..�e.Con4 , r - oLInc. cOty3 Range
.lace
re.i t"� 3`U rr' t: t " rs tip v,>i.4�r , t� - ,x a m .
a Range
, � 5" t"nx *g L ,f� .; .. ,� ry � t ,) s ` a c i m t % Barbecue
+
.ra�a w_�.ab-.zraa� 3,�������.•��a�� „?ii:.:
Business name: C,LI ( V 1 L T E .o In 4VL ( Y ? . Clothes dryer (gas)
Other:
Address: _
I ( o S QO S - 7� n" a v 6 _ � � r 1� � d r .h;
City /State/ZIP: por7 10. n G or Gf •Z2'-/ _ Subtotal $Y.3 8
hone: ( V3) (ash q$ Z .. Fax: (�3) c 't LA - 7 Z Zy Minimum permit fee (590.00) 913 .
Dian review (25% of permit fee)
CCB he.: 7.49 � State surcharge (12% of permit fee) /0. $ )
TOTAL PERMIT FEE / , a. S Q
Authorized signature: 4/44
This permit appliradon expires if a permit h not obtained within MO
days after it has been accepted as complete.
Print name: A70ti r,S Date: 121) eD ! o 5 • Fee methodology set by County Building Industry Service Board
1:1 Ruitdiug ■Peratits PermitApD. doc 1Mtli09 440.44617T(1 I /02,Co 4'WEB) Q LL
Dec 18 2009 2:53PM CLIMATE CONTROL INC 5039687224 p. 3
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L! 16500 SW 72nd Avenue Portland, OR 97224
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Phone: 503 -453 -4822 Toll Free: 866 -453 -4822
H E A T I H G & A I R C O N D I T I O N I N G Fax: 503- 968 -7224
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SYSTEM DESIGN - INSTALLATION SERVICE MAINTENANCE
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