Permit CITY OF TIGARD MECHANICAL PERMIT
111 11 * '° COMMUNITY DEVELOPME Permit #: MEC2011 -00156
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2011
Parcel: 2S103DC04700
Jurisdiction: Tigard
Site address: 13855 SW 114TH AVE
Project: VATERNICK Subdivision: VIEWMOUNT Lot: 35
Project Description: Replacing furnace and adding heat pump. Heat pump must meet minimum 3 ft. rear and side yard setbacks.
Contractor: CLIMATE CONTROL INC Owner: VATERNICK FAMILY TRUST
16500 SW 72ND AVE 13855 SW 114TH AVE
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 453 -4822 PHONE: 503 -639 -9661
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/13/2011 $46.75
Type of Use: SF Heat Pump 04/13/2011 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/13/2011 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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 OUNC by calling 503.232.1987 or 1.800.332.2344. •
Issued By: Permittee Signature:
Call 51 .• • .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.
Apr 12 2011 7:58AM CLIMATE CONTROL INC 5039687224 p,2
RECEIVED — ------- .,-- . —...,
IN City O� Tigard Received o I
i • 73] 25 SW Hall Blvd., Tigard, OR 97223 , Dile/Br! '1 //i Permit No -: M ), I f)
Phone: 503.639.4) 71 Fax: 5O3.598AFA 1 Plan Review S-6, i I, .., t L
: :) inspection Line: 503.639.4175 2 � � Date/By. Usher Permit:
Intentet: w ane: aid- or.gov Dace Ready/By lu:is: See Page 2 fw
CITY OF TIGARD Notified/Method: - Supplemental
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:34 vu 1 �?rT(. c t f CRki, ,t Y F
�:' � AMR . �...a,: I�� i�^u � Zq I a i r'o1 O4't t a i Ta` v`s3 �; "` =.
❑ New construction Addition /alteration/replacement permit fees* are based on the value of the work
Mechanical
Demolition ❑ Other: Performed. Indicate the value (rounded to the nearest dollar) of all
t'Z.42:-..i.:',?..esir it mechanical materials, equipment, Labor, overhead and
:.,`.>rU t>, . -.�;,P e' r r- - 4 ,. ttt i ' t+" '. - .`^ g. . i profit.
g 1- and 2-family dwelling El Commercial /industrial ❑ Accessory building s "r ° s ' " �''
�l ) f._.... S- d r.f r
❑ Multi- family ❑ Master builder 0 Other: For special information acre checklist.
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Description 247A.3t s i . q�-'s " 7 � i"zn� ..��?'.�., 1,1 w o t."?. ?' ±4- 1,`: L i s H I Qty. i Ea. I Total
� :� eatiseR/eootirap
Job site address: /555-3— 561 Pi/ �y�- Air conditioning
C � °� — (inquires site phn showing placement) 46.75
City/State/ZIP: 77(37}7 DY 97 z 2. 3 - Furnace 100,000 BTU (d ta/ven s) I 46.75 4 _
97 -
V •7Lrt AJr a Furnace 100,000+137'U (duets/vents) 54.91 pip!
Suite/bldg./apt. no,: f Project name:
Heat 6106
Cross street/directions to job site: Duct wed(
2332
Hydranie hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Subdivision: Lot Flue/vent for any of above 23.32 •3
Tax map/parcel no.: Other 23.3
Other the! appliances
...,,3 5 �i ea cir� P - )
. � . _ Water healer
/2 �_�� " '� 2332
C -Alt° _ it - A//¢ - t'4 - - 4'p / ,4 iL Gas (replace 33.39
/ ' v ' " Flue vises for water heats or fireplace 23,32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplacelinsert 2332
1 / 0 i' ri Y S Chum /Im /
.�. �._ . -_ . ,,,-. ' .... y _ ,,
._ ,_ 4 -;--, , / eY er flueJvent 23.32
.
Name; 66-7,4-6.— �" �i Otte
L - f o L. rte- 14 /!,- eLd e 23.32
Environmental exhaust and ventilation
Address: ��� C- .5 //VAC ✓ � Rangehood/other kitchen 1
equipment 33.39
City /State/ZIP: 7?4 _ / rte" (7'722_ Z ° � Clothes
/ dryer exhaust 33.39
941, / Fax:( ) single duct exhaust (bathrooms,
Phone: (03) 63 9—
toilet compartments, utility rooms) 23.32
OT: a �ti o y ' 4 Attic /crawlspace f
- - ...� 9.: .� . _ 4 Qkb , ;- °� .:.,.�� 2332
Business name: 61-1 MA r- ton rrdL. I !l L Other: _ 23.32
Contact name: R s Ln I Q's Fad piping
514.15 for first four; 54,03 for each additional
lP S SW -fro 6" Furnace, etc. .
Address: r �T �'1
City/State/ZIP: r �'-1 and Gas heat pump
Pine: ( 9,3) ys3 `' q � F»:: ( so3)9eoe 22 y Water ed/unit heater
Water heater ■�
E F'. ct
� ,,���ppyy�� 0 � C^ t �a� M 0.-� �. C O r1-�' �f"O L I t1 G s t O n _
' . .- �t:;;4 . 'a's �".,.. r _9 , +rt,,,' « �t.�.�.,f�f.' � ,M F a ; :7 s , 3Y ,
f i 1'. Ban
I -) ..�u.,r�...t ..:f - r.�:k =, Barb ecue
Business name: Lb M a.-7-E-- Ca n-1�aL r r7 , Clothes dryer (gas)
Address; r✓ toSoo CIA nfl _ Other
A V G ��s -1Tpl .q.� ��tW .'Z'�f t�oi'�t Cry �1 nF ! • �,dr4�
city /StateiZIP: ?art or C ,zzY � " �� . �,
Subtotal IM 3
Phone: (�3) q — Li 1L J Fax (OS) e� 1 ' z zy Minimum permit fee ($90.00)' I U � �I
CCB tic.: 7,._t el J Plan review (23'56 of permit fee)
State surcharge (12% of penult fee) - 7y /al, t4H
Authorized signature: /�/ � ��� � fie 1 TOTAL PERMIT FEE f v. y - S
" / Tbls permit application expires if a permit is not tshsatssed within taA ,
I Print name: days after it has been scripted as complete.
' fee methodology se
� �( 14/'r s I Date: L,�f � �� I gy by Id-County Building Industry Service Board
1 :\Buildemg, Permits 'MEC•Prn App,doc 1 0/01/09
44 0 -461 77 0 1/02,COM•wEB)
Rpr 12 2011 7:58AM CLIMATE CONTROL INC 5039687224 p.3
^` CLIMATE CONTROL 16500 SW 72nd Avenue Portland, OR 97224
H F /lY I G & AIR C 4 N D I T l O N I N G Phone: 503- 453 -4822 Toll Free: 866- 453 -4822
Fax: 503 - 968 -7224
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