Permit CITY OF TIGARD MECHANICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00127
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/29/2011
Parcel: 25111 CC10400
Jurisdiction: Tigard
Site address: 15820 SW GREENS WAY
Project: CHEWNING Subdivision: SUMMERFIELD NO. 2 Lot: 131
Project Description: Furnace replacement.
Contractor: CLIMATE CONTROL INC Owner: CHEWNING, C MARIE
16500 SW 72ND AVE 15820 SW GREENS WAY
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 453 -4822 PHONE:
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/29/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/29/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/29/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to • NC by calling 503.232.1987 or 1.800.332. .
Issued By: � Permittee Signature:
Call 503.639.4175 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 28 2011 7:25AM CLIMATE CONTROL INC 5039687224 p.
'. a.....•aal..411 .1 Cl Marl h t1JlJ LiUll
uoR (IF 1 ONIA
City of Tigard Received
II x t 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: �� ��,
Phone 503.639.4171 Fax: 503.598.1960 Plan Review 4 ins ection Line: 503.639.4175 Date/By, Other Permit
A
I IC I1
Internet www ugard -or.gov Date Ready/By: S See Pa 2 for
Notified/Method pp m entalIn for
0:',,,,,,,11-, .(mar- _` Su k Information
ir0 :i :�ixs •gt• ,. n .nX n .'k _x r if y k5 wP AN "a `: .`'" ., _.
9 � a �x ! v . , .a A,. 1 d Mechanical peer,-- fees" are based on t alueto - -r 1 t
ED New construction IgAddidonia]teration /replacement
the work
❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
t< �av r 3 s +t t. r ' " e O,:-th � k ,v - mechanical materials, equipment, labor, overhead, and profit.
)r r ;..4.: f l eta ®t a' , ,r van -e_a
1 and 2- family dwelling 0 Commercial/industrial � . f „ t �� c3 ,6 ,w a t: n , k
0 buil . s al.. ;i , ,,,,, ,,_ - .4. ,rh s
For special information use checklist.
❑ Multi- family ❑ Master builder
❑ Other:
Description
� ' :. t ` ' ZiMg! . f %' P Hews �_ Qty. Fa. I Total
� �' Hewing/cooling
Job site address: 15 8 Zv `� 6 reens (&)04-ki Air conditioning
City /State /ZIP: (tt4uires sire plan slowing placement) 46.75
4 A-r_b O (. q -7 vv./ Furnace 100,000 BTU (ducts vents) k 46.75 LQ (p. -t,r
Suite/bldg./apt. no.: Project name: e' le w3 fVl NQ Furnace 100,000+ BTU (ducarvenis) _ 54.91
-'
Cross streevdirections to job site 1 Heat pump 61.06
Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydmrnic) 23.32
- Ugh heaters (fuel-type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no : Flne/vent for any of above 23.32 23.37 -
Tax map/parcel no.: I
Other: 23.32
Other fad a
1 _ a i ppliancea
K ..u�, . ^ .. � €i ': °.�Li�.t ( a ._, r i a ,2. .. .F` - Gas fireplace
2332
Pe PLAC . FU ae6- „�... , ., .. Gmm fireplace 33.39
Flue vent for water heater or gas
fireplace
23.32
Log lighter (gas) 23,32
_ Wood/pallet stove 33.39
Wood fireplace/insert 23.32
�i ,,,....-4.-_---c,-".!",:!? t Chirnney/Unerlflue/vent 23.32
Name: Mir t G`n(� N 1 NFj Other: - 2332
Environmental exhaust and ventilation
Address: 1 fJ , 2_ 6 ( -.�, -, vat Range hood /other kitchen
City/State/ZIP: ^ b A_-n o a he'� 33.39
ri* s.� q - ] "ZZ Clothes dryer exhaust 33.39
Phone: ( ) 4 , Il d 2 Fax ( ) Single -duct exhaust (bathrooms,
y g compartments, utility rooms) 23.32
3 �"'4 .. 7 o \F ;_i' vs l f< 5 . 7 ,„\ 4 ; . . „ T � i 1 d. e ; `°°' i tf ir2 ��
sf � , .7;lt ... ... . q• i 3 G .,. 1 r? . .-. ; . Attic /crawlspace fans
2332
Business name: �U M4 T� to n 170L. I nL Other
23.32
Contact male: 4 Fuel piping
1 r l S $14.15 for first four; $4.03 for each additional
Address: l t75eX) 5(A--) "_� 0 AV f t Furnace, etc.
City/State/ZIP: f-�r eland r Gas heat pump
(sa3) ys R � Z�.3 wawa -, . , ed/t►n;t heart �
Phone: 3 - Li 8 Z Z � Fax:: ($ o3) c (0e- - 7 7.2-0 Water heater
E -mail c-c, € t� 1 t 1 P _
€ MO.. -tom c p> L� r Inc ,.�� - co
:. . - � i. AtI c V" r 7 W W
'I'j i 3 c ti � :41. .' . °�K . T` r ) ,, r� Range
�� ;. "� Barboeue
Business name: EL( arF Co n�L j � Clothes
L (as)
S Gl
(0 SOD - 7 - ._ n o A V t
Other:
� ��
City/state /z1P: ?Orr l a to Cj or Z ' '' ., .gip 1 S • to t al . ' .
�/ G n .z y Sub to t a l
Phone: (5-03) (as'� 7 (/i-2_ Fax: _TO•
( e - z zy Minimum permit fee ($90.00) - op
CCB lie.: 7„,.A O( � Plan review (25 % of permit fee)
/2 State surcharge (12 %of permit fee) l :O
Authonzed signature: /�J 1Z�b TOTAL PERMIT FEE CO. ± D
`"' % Tb -s permit appl ication expires if a permit b not obtained within tau
Print name: y ✓ �� ( f � �� t F 1 days after It has beta accepted as eorepiete.
7 Tf 1 Date: 3/ ( ` 1 f I • Fee methodology set by Tn County Building Industry Service Board
1 :\Buldmp∎Pernsn: tMEC- PamnApp.doc 10101 N9 i I
440.46177 (1 I /02/COM/WEB)
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