Permit . , CITY OF TIGARD MECHANICAL PERMIT
I ''-- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00275
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/16/2011
Parcel: 2S110AD90044
Jurisdiction: Tigard
Site address: 14926 SW 109TH AVE
Project: EARLE Subdivision: :ANTERBURY WOODS CONDOMINIUM Lot: 44
Project Description: Ductless heat pump with (2) air handlers.
Contractor: CLIMATE CONTROL INC Owner: EARLE, JOANNE L
16500 SW 72ND AVE 14926 SW 109TH AVE
TIGARD, OR 97224 PORTLAND, OR 97224
PHONE: 503 - 453 -4822 PHONE: 503 - 639 -3907
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Heat Pump 06/16/2011 $61.06
Type of Use: MF Other, Heating /Cooling 06/16/2011 $46.64
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/16/2011 $12.92
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.62
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.
, 41 111111111b
Issued By: �� Permittee Signature: er
*Z .... 7_ ,... 2 1
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.
Jun 15 2011 10:16AM CLIMATE CONTROL INC 5039687224 p.2
li City of Tigard "V al
Received -�` _�� �� -
• 1 3125 SW gall Blvd., Tigard, OR 97223 . Datelay: e �5 I Permit No.:
Phone: 5 03.639,4171 Fax: 503.598.1960 Plan Review iv. " /� •
7' i c: n r, n Inspection Line: 503.639.4175 �p� Dat Re a Other Permit
Internet: www,tigard- or.gov
Y 0ti1 DateRadyBy;
1 Notifi cad ethod: Puri`' 1 S See Page 3 for
1+t 3 �� - • 7-176, I SaPPlenentallnfortauction
s 1 s
r .a
>: .o_� v NN " -; : Mechanical rzG ia e,
❑ New construction ` .��r •._a!ti� � tr;.i r �c t t
�Addidon/ alteration /rep permit fees+ are based on the value of the work 0 Demolition ❑ Other: �,�
77:,..- ` , ` l Performed. Indicate the value ll
t � V e ue (rotmded to the hen nearest dollar)
� r ; n : ,, f t t ^ y ` y � mechanical materials, equipment, labor, overhead, and profit.
of
k # • ,. ;Ay at`ai - Pro
...,, : .`. ' ti,.` 0K.,,4-444)'`;.
l
' rr Value: S
Tel. and 2- family dwelling ❑ Commercial/industrial
I a ` 12 , 2 ',^ P L T � V r' T �4'
® Multi-family ❑Accessory building - �� =�- �y
lY ❑Master builder [] Other: For special information use checklist.
Description [ Qty.
? i r (y . t `. °`5 15V, � � �`n r'N Ea. Total
Job site address: -_ *t '' � ' °, �. Heating/cooling .
Z OA • V� (/ y } Air conditioning
City /State/ZIP:
(regains site plan showing placement) 46.75
" • 22-y Furaace 100,000 B71) (ducts/vents) 46.75
Suite/bldg./apt. no.: Project name: — • _ Furnace 100,000+ BTU (eucwvetds) 54.9)
Cross street/directions to job site:
Heat pump ` 23.32 40, j,�
Duct work 23.32
Hydmnic hot water system 23.32
Residential boiler (radiator or
hydronic)
23.32
Unit haters (fuel -type, net electric),
in-wall, induct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above
23.32
Tax map/parcel no.: Oth .41 a- //11/1/0/0- fJ 1, i l,�,� Z 2332 q6 '44 '>` r Other fnel a liances
S N":k 1 .,� C. wr } e, 1 a ° �) '' ; gip, 1 ., . PP
��yy ^��^ ,a ��..,= i �..�.� _ ��. �.; Y ��, .,.ti._ .�: ._�.a � ,t�s� Water heater 23.32
1 TfJtJ t'.tti) I UGr less- 1 r Gras fireplace 33.39
Flue vent for water heater or gas
f 4 / ..,1 N b /a�3 fireplace 23,32
Lag lighter (gas) 23.32
Wood/pellet stove 33.39
;2 , Wood fateplace/instrt
i w a :"'•.,,7, a t '. vxa rm 1 r 23.32
"""" " 1 '::.`- -, . a+ - 1 ., i e l 7, ` k l' Chimney/liner /tlurhtaot 23.32
a Other: '
23.32
Environmental exhaust and ventilation
Address: S OT ) � . Range hood/other kitchen
b
C
City/State/ZIP: 77 0 lot 3339
�'Z. thes es d dryer eathatist 33.39
Phone: ( r 3 90 7 Fax ( )
Single -duct exhaust (bathrooms,
"• r : ) ��
( e rr " r --. a
toilet 23.32
p _ i �, +� . € {.. t'� .,, . � d Q +�• �', � .1M:� �r �t { {
�, ,t Y y F let Cempartml7ltS, utility rooms) .� :•_ • 3 J •:x. S, sa$ _.�..., :�` y..' K t` a o`aT •i rs,�'<" di:1 % Atticicrawispacefana
i,�.., ;,, 2332
a I i Other: 23.32
Contact name: Fuel piping
a its
514,15 for first four; 54.03 for each additional
Address: (0 ►1. w n p , Furnace, etc.
Gas heat pump
City/State/ZIP: rrro , nd
r C • -1223 Wall/sus • - ded/unit heater
Phonel :('St)3) 1 / 5 3 -1 48Z7- Fax: :(Sp'3)e��GB- ?.Z.Zy Water heater
t'a @ L I t M 0-4- 11111 Inc . con--1 gliii 7,€; ... g: 6 Ra' h . '; Tr ° u ra y al �`algi - , vy.� az� tit .
,�..� ri $ r t 1K;z ��ac Barbecue �_■
Business name: (•„ ( YVI 4-71 Cl othes
C. n4 roc (.a5 )
Address: S ♦ Q (et,...) n _ ' Other:
City/State/ZIP: • - A V 6 ---
('a -; "7'W` ,.,.d t •. _,
�( - ta n Or .Z ZLI .�. Subtotal /ej 76
.
Phone: (5-03) / f V Subtot
"f5 i Fax :(�3) ��0 �zz Minimum permit
CCB tic.: b 24 9 Lo Plan review (25% of permit fee)
Jr
State surcharge (12% of permit fee) / . "'7.-
Authorized signature: TOTAL PERMIT FEE %7D. /p 2_
_ This permit application expires if a permit is not obtained within 180
0 o after t has steepled as complete, l a®,� Fe e methodology ologlog y set et by y Tn -Co Service Building Industry Service ljoard
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