Permit CITY OF TIGARD MECHANICAL PERMIT
I .' • COMMUNITY DEVELOPMENT Permit #: MEC2009 -00215
T I C ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/20/2009
Parcel: 2S112BC04800
Jurisdiction: Tigard
Site address:,_ 14840 SW 83RD AVE 7
Subdivision: LA MANCHA ESTATES Lot: 1
Project: Norman
Project Description: Replace furnace and a /c.
Owner: FEES
NORMAN, COLIN D & LINDA A Description Date Amount
14840 SW 83RD AVE Air Conditioning or Heat Pump 05/20/2009 $14.00
TIGARD, OR 97224 Furnaces < 100K BTU 05/20/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 05/20/2009 $8.70
Minimum Fee Adjustment - Mechanical 05/20/2009 $44.50
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 $81.20
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
Issued By: Perm ittee Signature: ( 'A/ , 5z77O/v/
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.
M May , 12 2009 7:00AM CLIMATE CONTROL INC 5039687224 p.2
Mechanical Permit App FOR OFFICE ILSE OM.)
City of Tigard t: F Receivd Date/B V s 1 - ` � , Permit No.: O .
M 88Q . a
13125 SW Hall Blvd., Tigard, R �' ` �l
Phone: 503.639.4171 Fax: 503.5 0 Flu Review other Permit. Ins Inspection Line' 503.639.4175 Q 12 2009 r
T1G nkt) p Date Rea /H
Internet: www.tigard-or.gov o S S P ent l for
CITY OF TIGARD
Notified/Method: Snpptemee eatallnformation •
TypidtatiaucuivISIOil COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction ' Addition /alteration /replacement
❑ Demolition ❑Other; performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit. _
CATEGORY OF CONSTRUCTION Value: $
1- and 2 -famil dwellin RESIDENTIAL EQUIPMENT / SYSTEMS FEES•
y g ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family 0 Master builder For special information use checklist.
❑ Other: Description
l Qty. : Ea. + Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
lob site address: fii/ y0 83rD 7 41/ -- Air conditioning or heat pump
(requires site plan showing placement) / 14.00 y
77 �
City /State/ZIP: t7y ? 72-2-Y Furnace 100,000 BTU (ducts / veats) / 14.00 / y
Suite/bldgJapt. no.: Project name: l a r m .r. A Furnace 100,000+ BTU (ducWvenu) 17.90
/'�"" Gas heat pump 14,00
Cross streetldirections to job she: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: I.ot no.: Flue/vent for any of above 6.80
Other: 10.00 _
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/*Agee �tirti � 1 4// Gas fireplace 10.00
Flue vent for water healer or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 1000
•
Wood fireplace/irrsert 10.00
a PROPERTY OWNER 1 ❑ TENANT Chimney/liner/flue/vent ^ 10.00
Name: / �,/
Other: 10.00
��r /� Zen` I- /liarn9 ■VA Environmental exhaust and ventilation
Address: / /e ye) 5w ts3 ( fl v �� Range hood/other kitchen
TJ /T equipment _ 10.00
City /State /ZIP: 776, ,Q er .972 z y Clothes dryer exhaust
10.00
/- Single -duct exhaust (bathrooms,
( ) C>7gy- 9,2-9 5 Fes: ( ) toilet compartments, utility rooms) 6.80
fig APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: LI rn re �O 0 -,04_ f j) 6_, Other 10.00
/ '
Contact name: Rod -e l S Fuel piping
(I �r S5.40 for Brat four; $1.00 for each additional
Address: J (S 00 s .7 2-h O 11 - Furnace, etc.
71 /lvG Gas heat pump
City/State/ZIP: �O
tfi , ,1 d t3'� 9 2-7-4 Wall /suspended/unit
Phone: (s ) y s -y t 27 Fax: : ( ) 9 i, -�2 Waver heater
E -mail: COI e (' 1 1 ern or 4-e. CO rl -4 '119 5 l t f)C - C m Range
CONTRACTOR Barbecue
Business name: m E Co 1 i n , Clothes dryer (gas)
Address: 116SOIO Sk} °,72 i1 ' _ V a- _Other:
MECHANICAL PERMIT FEES*
Caty /State /ZIP: PO r r - ion al or 4 '2Z ` j Subtotal ZQ.
Phone: 611 ) ./ 3 Li k ZZ I Fax: (5) Ciao ...-11-2-41 . Minimum permit fee ($72.50) - 7,7 .sv
CCB lic.: (40 Plan review (25% of permit fee)
r )--1 ki State surcharge (12% of permit fee) 03 .7e3
14a4/1/122 TOTAL PERMIT FEE SA 2D
Authorized signature: This permit application expires if a permit h not obtained within 180
days after it has been accepted as complete.
Print name: k6/ (—MY-(73 Date: ,57/2/41 f r' ' Fee methodology set by Tri-County Building Industry Service Board
I. 16 uildinglPermits \MEC- PvmhApp,doc 01)19/07 440.4617T(11 /02/CGM/WE13)
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CIA, 1.2 2009 7: 00FIM
CLIMATE CONTROL INC
5039687224 p.3
C LIMATE CONTROL 16500 SW 72nd Avenue Portland, OR 97224 •
HEATING & AIR CONDITIONING Phone: 503-453-4822 Toll Free: 866-453-4822
Fax: 503-968-7224
,
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SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE
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