Permit •
, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00595
` - I 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/09/2009
TIGARD, Parcel: 2S110BD03200
Jurisdiction: Tigard
Site address: 14916 SW 116TH PL
Subdivision: HELM HEIGHTS Lot: 9
Project: Hopkins
Project Description: Replace furnace and heat pump. Must maintain a 3' rear and side yard setback
Owner: FEES
HOPKINS, GENE H Description Date Amount
14916 SW 116TH PL
Furnaces >= 100K BTU 11/09/2009 $54.91
TIGARD, OR 97224
Heat Pump 11/09/2009 $61.06
PHONE: 503 - 684 -6202 12% State Surcharge - Mechanical 11/09/2009 $13.92
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 $129.89
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.
Issued By: AiLtAhLt Permittee Signature: 0-1,L, V o tLe„ 7tiL�
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.
.Nov , 06 2009 11:16RM CLIMRT,� C O ROL INC 5039687224 p.2
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Mechanical Permit Application 1 ' , ; 1 , � t. 1, 6 ° I or ? c �r rlc r8' ��1 , . ° ,>
" F 4 W 6 2009 Received M nn 'N ,
City of Tigard NO V 0 Permit No. G f� `'- V v54
u ° H Rlvd.,1'igard, OR Da Re
R Plan Re view
Phone: 13125 503 .639 .4171 Fax: 503.596.1 60
9 A�T DateBy: Other Permit:
CITY OF TIG
I z A Inspection Line: 503.639 4175 r�ilJ / Date Ready/By: h:rs: r ® See Page 2 for
': •,L, 1 Internet: www.tigard- or.gov BUILDING DIVISIONhotified/Method: Supplemental Information
:�& s ,t �r1¢ e ° t "'' r#s.s F a �'� °m i re' vt=r
- .v, ', ,-ter w.... L: ' :,Aisx .. s � � 3 j_?i; r): i�th ? =l - ..4":�..,...wr ] User.. s a..-ct...
10 New construction Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
ID Demolition ❑ Other:
;' . , diC .ascsi` g _a 1 � W � '' Vaht
mechanical materials, equipment, : S labor, overhead, and profit.
bor o ead a d ro
Ell- and 2- family dwelling El m
ComerciaPindusnial ❑ Accessory building 11 ' '
❑ Master builder ❑ Other: For special information use checklist.
❑ Multi family
t nu i �s _�- r � �t Description Qty. I Ea. Total
w i b� ' f _ 4 � c � 1' � rjs a st lr r ;r t ry1� t,1 E ti s T at n r +
Y 3 A mi . _t- . ..,:.
// Heating/cooling
I_ -
Job site address: 1 qq1 w SGJ II lip r Air conditioning 1491-0.--.. (requires s ite plan howing placement) 46.75
City/State/ZIP: o f ( 2 . 2 1 Furnace 100,000 BTU (ducts/vends) 46.75
Furnace 100,000 ven
BTU (ducts/ts) i 54.91 f `}� 9/
Suite/bldg. /apt. no.: Project name: m �
Heat pump / 61.06 � (p
Cross street/directions to job site: Duct work 23.32
Hydrtmic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
-- Unit heaters (fuel -type, not electric),
in -waft in -duct, suspended, etc. 46.75
Subdivision: Floe/vent for any of above 23.32
Lot no.:
' Other: 1 23.32 r
Tax map /parcel no Other fuel appliances
1- ��u, r.. �( r •7 }re ^rrz-7 , 1 2 y r ry s 23.32
, +-x' u y4h '°s " t �' � a n ti i s i e s I o d , t .y. - cLzik: -4: .. - Water heater
�, !: �2� `SC.� -a. s .tt�,'ss.t c� ;bT. -7 ; ��i�s.. tSz ..ti.,r.:!+., � .'�tt: '' _ w:i:ss;t..A.u+'0: .t s.sro�....4-x
Gas fireplace 33.39
�9 a. j / ,/ ' ., i Flue vent for water beater or gas
fireplace 23.32
Lo lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplacelmsen 23.32
• <" 3 r e 2332
-1 s i ;�� � & :: : :.;K4,"�9 „, r tCr EM -Ai ncoli. 14-: � ..fr: . -s,7cs -3 .Lr ,,Irv..c: Chimney/liner/flue/vent /liner /flueJvent 23
Name: �" �� 2332
P tr-�/1' T Environmental exhaust and ventilation
Address: /y9 /[� , 5j /14 f �t /)t Range hood /other kitchen
T r equipment 33.39
City/Stale/ZIP: 77 6 07d 0r 97 27-Y Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone ( 2 3 ) (es G 20 Z Fax ( ) toilet compartments, utility rooms) 23.32
Y",' rrs g at, - . . 474 7 }: - ' a . . iR!` iz,, F . tiligi n-!-, girr ,r.t'1, .t' s y " Attic/crawlspace fans
Kr ra .c,,, ,..f...ie -... - . ' dv.�.. u..f.,..-csr" ti p, r A§A ,,sz i r r' 3,? : pa 23.32
Business name: 6.L.1 MAI MAIM" 4%O n J..raL 1 17L
Other: 23.32
Fuel piping
Contact name: RO u r - i s
$14.15 for first four; $4,03 for each_ additional
Address: 112,5 (.00_5_ 1 t7 A t/ 6.- fie, etc.
Gas heat pump
City/State,2IP: ` d (- 9-7 �3 Walsuspended/unitheater
Phone: (5jj3) cis- 3 - 48 22_ Fax:: (So3)q(oS- -- 7ZZy Water heater
E -mail: c G 1 t 1 Range
n'-1 t?.'� � .. C O r1'S-Y'
. �, y Range
'.'
' u` N I T � 5
' 'N a 37 ' i -.�'�` ■ M Barbecue
G
Business name: e_L( yvl q, " r& -- CO I L i h e . Clothes dryer (gas)
_ Other:
Address: I 0 500 �jGl ) 7 �/ + ya wa z- .F- ,* o c. .. ," •
'D r1r' :.:E - .mow _ ... .. "' �id 5 € n
City /State/ZIP: o _ t a n d o z f Subtotal
Phone: ( G7.Z p erm i t fee (590.00) /Lc. 9�
sa3) �rs3-- ii az- F ax: ( �3) '11,1 -7ZZy Minimum
Plan review (25% of permit fee)
CCB 1ic.: q State surcharge (12% of permit fee) I / 3.9 Z
TOTAL PERMIT FEE 1 /1 ?. $ 9
Authorized signature: This permit application expire If a permit is not obtained within 160
days aver it has been accepted as complete.
Print name: ,kb /4 fps Date: 0/ Q • Fee methodology set by Tri -County ltuild oa ing Industry Service Brd
1: 1i3 ui1diug1Permits \MEC- PernmApy.doc 10/01/09 /022,'COM/vEB)
Qb .°i50/7.
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