Permit 71 v CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00617
Date Issued: 11/19/2009
TA G A. ' Et. D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S114BD02900
Jurisdiction: Tigard
Site address: 9600 SW RIVERWOOD LN
Subdivision: COPPER CREEK NO. 3 Lot: 69
Project: Counts
Project Description: Replace furnace.
Owner: FEES
COUNTS, CHRIS D & Description Date Amount
HOGBERG- COUNTS, LINDA, 9600 SW
RIVERWOOD LN Furnaces < 100K BTU 11/19/2009 $46.75
12% State Surcharge - Mechanical 11/19/2009 $10.80
PHONE: 503 - 639 -5039 Minimum Fee Adjustment - Mechanical 11/19/2009 $43.25
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 ! !cation Cent Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or ect questions to OUN! .' ;.Ilin. 503.246.6699 or 1.800.332.2344.
Is ued By: / O t /b .: _,L _ Permittee S W`_ i /1i �i�(f/i 2��
Call 503.639.4175 by 7:00 a.m. for an inspection that busi • s 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.
Nou 18 2009 11:27F1M CLIMATE CONTROL INC 5039687224 p.
' 'Mechanical Permit Applicatio ��` ( _
It� ealvea 3 n () \ x ° ti :A•,',''''• t °i
l ' C of Tigard p �/ � `�
_
a Datel it . $ ` � e 1 � A y Permit No.: �/ � 7. / 7
13125 SW Ball Blvd., Tigard,OR 97223 NOV 1 2009 r t errs[
Ilk -� a Phone: 503.639.4171 Fax 503.591.1960 Plan Review
DatetBy: Other Permit:
PI (,;'A P 1 -) Inspection Line: 503.639.4175 Date Brad B kris:
Internet: www.tigard or.gov CITY OF TIGARD y y ®Sec Page 2 for
Notified/Method: Supplemental Information
IP { '. -�4� T �.R�.••Y°L � •���r�. k�+•' Fes`
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❑ New construction T; Addition /alterationJreplacement Mechanical permit fees* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, - •ui • rent labor, overhead, and . .fit.
f � 1 r , i i$a S f 1, ,! 1 d fa..szm.'Y 17* .' A ,,,," z- �,., -- -, a ; .5 Value: 5
- r � f 1 . - . , ,.o a ,r -•- .vr1`' .- S a'•. _-- n:c rF, -D r i
r]:1 fr' ,. A ♦ r �. ; « u f , FA •" . 5 � ya ;-
Er, - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ^ lira, s -- a � s'a-^ °- ' fl a``* r r.' �xc ,-r`z
❑ Multi - family ❑ Master builder ❑ Other:
For special information use checklist.
� Description Qty. Ea. Total
�% _~ . s S t h d "1,i ;s t/ t� 'et' `''� r- s ° 'it `h '-r'E`` Hearin: oobn
1 � 6i �`. �. ��zr- r� : � a . '�t.. 4 - �' Y-it a:ri e ' -_
Job site address: t ?fir �7G J P/ up 66 d ;Dr Air conditioning
J re• site ,Ian showin: •lacemeru 46.75
City/State/ZIP: 776/97 Or 97-22u F1imace 100,000 BTU (ducts/vents) / 46.75 y.-2
Suitelbldg. /apt. no.: project name: �oU S 7 Furnace 100,000+ BTU (ducts/vents) 54.91
_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 (fuel -type, not electric),
in-wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax ma no Other fuel appliances
�tjt#•�" { 1'Kela 3, tiri '.0 r i., r t zLt'# ; rt . a '.i 5 9 t : Wfz : +
nn:3K L;..y.. f'.t,� _1Lt aria &!3._.s...c -.: •ie .'Aix- ° _tra�,a.f = e #41.1.�,r ' g.' 4 - t Y .kit i ? 4 S.5 y Water beets 23.32
/e6P E /0',--4/04 C L- Gas V II foe 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
..,ppsL� a Chimney/lines/Me/vein /liner /flne/vent
ells' R, ,5.tr; � r { Sr`7 J 'L a-= r { 3 t fi� A ",M �iw`^fa •t*' h 1 . ' ' -a 5z y 1_
A'7. ii r'.(.::.w ..A i,.iNi �tx .. :'1. :7.e..+ :.a:
1w ...i J, #�tL i.' L ' t.. .",;z1.'ic�t 41', cL 4 <" < sr j 'ill eY 23.32
Name: c_hioi,s /706-- /j
Other: 23.32
(;n / // A' Environmental exhaust and ventilation
Address: 960 ,/W ,, J �� Range hood /other kitchen
U 1 Sit) i"t' Gf/GCIr?. equipment 33.39
City/State/ZIP: 6.47-2 9 Clothes dryer exhaust 33.39
Phone:.( ) CF3�6 5 Few ( ) toilet exhaust(bathrooms,
hone
P _ toilet compartments, utility rooms) 23.32
` ' T it i µ y 1"ri #, rM s * i T. 1i` ie:•* a 3 Attic /crawlspace fans 1 2332
Business name: L ! .LZ MATS A L p n ne.OL Inc- Fu lr 23.32
Contact name: R o '4 � r ( Fuel piping
S 514.15 for first four; 54.03 for each additional
Address: l (0500 .S W - f. o /s v E Gas he t o
City/State /ZIP: r rl Cnd c / �r- t 9 TV i 2 �3 i Gas heat pump
Wall/suspended/unit heater
Phone: (5b3) y53 - yBZz Fax:: (5a3)eibg_ zZe./ Water heater
C'Q e C 1 ` n
Fireplace
Y J<marl t
�- _ ''10..� t^_ O r1T f 0 �- 1 >1 G con Rang
Wi ariY...L •fs�«'aid: A . ?r � N).
..�3i.. `rc aaN*a.�' rr - <>xI<ts��:„ ° �F�',� i '�M Barbecue
Business name: CLl i+1/l al-r- 6 O n -L me e . Clothes dryer (gas)
Address: I _ S
]0 _ other:
t, tt .as_ x'A„e3 af6 r o,--s�t t' .is..cci ';i'
Ci ty/StatclZJ': •( or ZZ�1 Subtotal
V 4 •7r
Phone: (, f s !/ . Minimum 9
( ) I ZZ ax: (,P3) i4 - z Z permit fee (590.00) 0 . op
Plan review (25% of permit fee)
CCBlic.: (0 74 9 1, to S tr State surcharge (12% of permit fee) is -849
•
TOTAL PERMIT FEE /op, g
Authorized signature: .# .� - This permit application expires Ha permit is not obtained within 180
days after k has been accepted as complete.
j Print name: ,J t/ �r f,S Date: le i8 1, I • Fee methodo!opv set by Tri- County Building Industry Service Board
r :�eww 1Permiu vteC- rcrcai doc 10 / / /�yy
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