Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00111
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/16/2011
Parcel: 1 S134BD10200
Jurisdiction: Tigard
Site address: 10824 SW 118TH CT
Project: ROBINSON Subdivision: PENN LAWN ESTATES NO. 2 Lot: 30
Project Description: Furnace and A/C replacement. A/C unit must meet minimum 3 ft. rear and side yard setbacks.
Contractor: CLIMATE CONTROL INC Owner: ROBINSON, STEVEN S & MARY E
16500 SW 72ND AVE 10824 SW 118TH COURT
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 453 -4822 PHONE:
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Air Conditioning 03/16/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 03/16/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/16/2011 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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 -0090. You may obtain a copy of the rules
or direct questions to • C by calling 503.232.1987 or 1.800.332.2344.
Issued By: C.7 Permittee Signature:
Call 503. • •.4175 by 7:00 a.m. for the next available inspection date.
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.
Mar 16 2011 7:30F1M CLIMATE CONTROL INC 5039687224 p.2
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City of Tigard 4 ,, Received � R
: 71 • 13125 SW Hall Blvd., Tigard, OR 9722 � P a n Rev iew
Phone: 503.639.4171 Fa �� P erre i t H o.: .-
Q 1 2011 Dat Review
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t t t; 1 +. D Inspection line: 503.639.4175
Date/By; Other Permit:
Internet www.lig or.gov Date Ready/By: 7wn: See Page 2 for
Notified/Method 7 Supplemental Information
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Mechanical permit fees* are based on the value of the work
❑ New construction XAdditionialteration /replacement
performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑Other
Y ';':5'.1' materials, equipment, la
trn tip ''`,� - r-i e M.. t s e4 ., 1 s 1 mechanical alue: s labor, overhead and profit_
Fri_ and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building t ry � ° 3u � "; ^ t * k �! in
❑ Multi - family ❑ Master builder ❑ Other: For special information we checklist.
Fy �:.ax Description on
:,7,<r� a t e i ;i i-„r v ''i`i<E t .y. L Qty. Ea. i Total
amt ��"�c } _. C r ? " HeadnRlcoohng
Job site address: ae2f/ 5'k) Ng ei-
J Air conditioning /
City/State/ZIP: �
y� (requires site plan showing placement) t 46.75 L-16 `
64 - cv' 97 223 Furnace 100,000 BTU (ducts/vents) I 46.75 cf (o • JS"
Suite/bldg./apt. no.: I Project name; Ro �l ✓7 v Furnace 100,000+ BTU (ducts/vents) 54.9]
Cross street/directions to job site: Hat pump 61.06
Duct work _ 23.32 32
- Hydmnic hot water system 23.32
Residential boiler (radiator or
hydtonic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: Flue /vent fur any of above 2375z - e s 3
I Lot no.:
Tax map /parcel no.: 23.32
, _ Other fuel appliances
f �.
:: �"• '- >` t z ; ' )��' } ? Water heater _ 23.32
L/ C fur Ai _ a.-- - Gash fireplace 33.39
Flue vent for water heater or gas
fuaplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
.._ . .._ 1 .. a r i N 1- Wood fireplace/insert 23.32
r h Chimney /linrx /flueart Ana R� K 5 Other: 23.32
Name:
r r 1( �t g lo i n So n Environmental exhaust and ventilation
Address: JO e 2 -L1 e ,)1� ii S Cam" Range ltood /other kitchen
J
equipment 3339
h oY Z z3
Phone: (�3) ] ( . clothes adryer exhaust
33.39
CitylState2lP:
(!J Fax ( ) Single-duct exhaust (bathrooms,
? ,15 ` c� � Y s ° � v� _ toilet compartments, utility moms) 23.32
.
. .rrt ,y_ � 1 lEJ r ; 5 r; e 5t`27. Attie /erawispacefans 23.32
Business name: aUM4> CO n rreDL 1 f L Other. 23.32
Contact nartx:f7 4 t r L is , Fuel piping
't f4 - S14.15 for first four; $4.03 for each additional
Address: , (o`Jco 5w �,o Ave-
Furnace, etc.
City/State /ZIP: ` `. / TV Gas heal pump
9 , 2 Wail/suspended/unit heater �
Water heater
Phone: (r y5'3 98az. I Fax::( 5133 )9(4913- u _ -7 -
E-mail: �+� 7 Fir iacc
e t Mta..Jr -a. co.. -%4CpL Inc Cnrvn Range
L�z*':s?>.z ..i �-.t �.�'.�.. ��•i.'..fa1 Barbecue
Business name: �L,l rV1
Co In ot__ me , Clothe er s
Address: f SOO S (� Other:
City/State /ZIP: ?er l 0.!n d "u L Z 7' , I c: -; S ' r t e ` - t
Phone:(�j'3} or ef 1,2.2-Li Subtotal r C s
`75 y$ZZ_ I Fax: (O 1 6O 6 —� .i[l� (5�, --
v
3) � Z z y Minimum permit fee (590.00)
CCB tic.: 2-_I Plan review (25 of permit fee)
State surcharge (12% % of permit fee) ; �jL
r
Authorized signature: /jam/
TOTAL PERMIT FEE / , 1if, `)2. ?
This permit app)ication expires if a permit is not obta ned within 180
Print name: days after Ii has been accepted as mmpkte-
J r r/S 1 bate: s// t 1 / ( ' Fee methodology set by Tri -County Building industry Service Board
I•lau➢d'ag•Terauts doe 10,01709
440.461 7T (I 1 /02(COMJWE13)
Mar 16 2011 7:30AM CLIMATE CONTROL INC 5039687224 p. 3
CLIMATE CONTROL 16500 SW 72nd Avenue Portland, OR 97224
I� A T I( G AIR CONDITIONING Phone: 503 - 453 -4822 Toll Free: 866- 453 -4822
Fax: 503- 968 -7224
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