Permit '' � ,t!I CITY OF TIGARD MECHANICAL PERMIT
` ' COMMUNITY DEVELOPMENT Permit #: MEC2009 00566
I Date Issued: 10/23/2009
TIGAFtD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S133AD15700
Jurisdiction: Tigard
Site address: 11227 SW SUMMER LAKE DR
Subdivision: Lot: 0
Project: Regency Property Management
Project Description: Replace furnace.
Owner: FEES
FRICK FAMILY TRUST Description Date Amount
PO BOX 56482
SHERMAN OAKS, CA 91413 Furnaces < 100K BTU 10/23/2009 $46.75
12% State Surcharge - Mechanical 10/23/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/23/2009 $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 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: 7 Permittee Signature: / v' /52-10/0Z./ ei9 -77G1"//
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.
•Oct 23 2009 8:03AM CLIMATE CONTROL INC 5039687224 p.2
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Mechanical Permit Applicati • � N �,t z .,,, ,• t I C ►� It c t , h .. *i . ti l • AOV 1 1 „) +' l's , i
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CEIVED _
�$1 "' ' Received
` City of Tigard Permit t.0
Date/By: / v� 3 �� �/ 0 • 4
a 131 SW Hall Blvd., Tigard. OR 97223
Plan Review
'fj G Phone: 503.639.4171 Fax: 503.598.1960 C T 3 2009 Dam By: Other Penna. i G.• R D inspection Line: 503.639 Date Ready 6y; is: RI See Page 2 for
smadNosaisact Internet: www.tigard- or.gov
CITY OF TIGARD Notified MethodSupplemental Snppleental Information
• „!.Y � t'A: - r: d1Z'T° *' :'..G J @a,7[F i e J q Tsr., • s� '. Y Y �+�T -2 .yam
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❑ 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
t fi r. • 1 ra - r�� 'r b : - 4 -0
7'.'`; I� � , �.. , � . e�;� g� g�qa� r(r ! ,.'�"o+�.�,� � � ' Value $
'F4 l'r *' � 11 g tiCk �l ' p�'JiF a t 7 '` ` {Jn.�' a ki £ � ,t��! t {
ErI and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building °'a* „ ' ^tL +•rn.. `
For special information use checklist.
❑ Multi- family 0 Master builder
❑ Other: - Description I Qty. i Ea. I Total
t s s i It - •t .yr � . Heallngfceoling
='a .�'� �- , -. � a c sr.:�t�- ?3�c�S. -- E ?J,t�a .3,g•,: -.,�wr a
Air conditioning t
Job site address: 7/227 54,0 SUlrI„,,, 6 ,e0- „o
(inquires site plan showing placement) i 46.75
City /State/ZIP: 7 c t2 r4 9 7Z z 3 Furnace 100,000 BTU (doctsrve nts) / 46.75 y( �S'
Suite/bldg. :apt. no.: V I Project name: / E ey mace 100,000+ BTU (ductsrvesa) 54.91
Heat pump 61.06
Cross streetldirections to job site: Duct work i 23.32
�Hydtonic hot water system 23.32
Residential boiler (radiator or 1
hydronie) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: Lot no.:
Flue/veal for any of above 23.32
Other: 23.32
Taz map /parcel no.: Other fuel appliances
Ore 1. . "-aa f: 1"." iy:w. 417 dr ..41 F . vet F. , . v S ' 14 �
io` , r „, o'` a 1t,t el ,ta itF`"lr ar : ' i tz,z , Water heater 23.32
, . .e, u. 3?m.cr.tw:3Sasa,.1. L,,.J- .3:... rr.-ht �` .as.....t. �a"� t �£ -"�.t t
1 Gas fireplace 33.39
i M-A/ t! _ Flue vent for water heater or gas
fireplace 23.32
- Loglighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
� �c�� C �- rxZilt ,,, 7 i- - ,;,.,. s FA1 it p e on.,,, y..s r� s•. Chimney/luter /0ue/vent 23.32
�4.re. _ Other: 23.32
Name: /L!•y ,fa,eyrri , xN4 ge77/6/T Environmental exhaust and veatilation
�a t^� Range hood/other kitchen
Address:
7 0 5W /I Z / k �� - r J equipment 33.39
City/State/ZIP: 7 iv-a , GY 972 z 3 Clothes dryer exhaust 33.39
6 � Single-duct exhaust (bathrooms,
Phone: ( ) s10.- 773 Fax: ( ) ONO - /5 /eb toilet compartments, utility rooms) 23.32
�yl�;,ti '7 r ++i - n vt -"er^ _ :, rre > r . - a y , i 4 'F ryc W aE vim' Te. Attic trawlspace fans 23.32
7 !` t grs t ✓°' i ',, -f m F r n, a e 9 a lt 3
..r ,,,Zsa; oho's:,. t: -.,1Pt h._,.wa ...r ,o,v $21 alt..--- --
Other: 23.32
Business name: 6.Li M A 1 L O n rrot' (ITT L
Fuel piping
Contact name: R 11 (.44 -r r lS $14.I S for first four; $4.03 for each additional
Address: • AIlk w rto 4 1 Furnace, etc.
` Gas heat pump
City /State /ZIP:
�f I 0 ( 9 -72.23 Wall/suspended/unit heater
Phone: (5 0,3) 9553 - y a Z Z Fax:: ( Si>3) 94 - 7 Z V/ Water beater
Firep
Range E -mail: �^p e G 1 t
M a►-'� e C C r1A`rp L Inc Co r►'"1 Range ge
x-• t•- .. tea a, . ., '.''. . t I ; r. + ! W. : 3 �` d" i
Aon. : . ,,, a k ,r.' . . .t s`tle3 `c . ri," ,
i - N�•. '74• L,kszo,lit,.rk e-
Barbecue
m
Business name: Luigi! a-'rr 6o � � Clothes dryer (gas) i
Other:
Address: i 500 w n �_ A V 6"-- a e �. e .. �. x , a ; # d"
Cit /State/ZIP: p orr -t an 0(- Cn2:2 - Subtotal ti4•71'
Phone: (5-03) USA L/Z2 Fax: (g)3) °l (�� - i Minimum permit fee ($90.00) 90.
J Plan review (25% of permit fee)
CCB tic.: 7...A, of t..0 _ State surcharge (12% of permit fee) /0. eo /
TOTAL PERMIT FEE ( /00. U 1/
Authorized signature: This permit application expires if a permit Is not obtained within I8D
days after it has been accepted as complete.
Prim name: A10 u /1 JS I Date: / e Fee methodology sel by Tri- County Building Industry Service Board
: �H
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