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Permit 1. CITY OF TIGARD MECHANICAL PERMIT 117 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00470 Date Issued: 09/04/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111 D603200 Jurisdiction: Tigard Site address: 15345 SW ALDERBROOK DR Subdivision: SUMMERFIELD NO.8 Lot: 418 Project: McPherson Project Description: New gas line to range, dryer, BBQ and griddle. Owner: FEES MCPHERSON, BETH Description Date Amount 15345 SW ALDERBROOK DR Fuel Piping 09/04/2009 $5.40 TIGARD, OR 97224 12% State Surcharge - Mechanical 09/04/2009 $8.70 PHONE: 503 - 692 -5848 Minimum Fee Adjustment - Mechanical 09/04/2009 $67.10 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: Natural Gas 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 or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: Dm7 ,9 /'/ ( j /O4 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. '9ep 02 2009 2:42PM CLIMATE CONTROL INC 5039687224 - p.2 Mechanical Permit Applicatio 1. ¢1:l 101 I :Sh- ONLY City of Tigard ECE�VE� Date •ed Date/B Permit No �y 9 • 1312 SW Hall Blvd., Tigar OR 97223 y �� ' /�C ©/ - 0o M 0 Phone: 503.639.4171 Fax: 503.595.1960 S E P 0.2- I' t PDaanteryvi: eW Other Permit .TIGARD InspecdonLine: 503,639.4175 .I' Date Internet: www.tigard- or.gov By i 118 E3 See Page Z for CITY OF TIGARD Notified/Method: T6...* Supplemental Inlormaii cm TYPE OF mal ;INN DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees" are based on value of the work ❑ New construction XAddition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑Other: mechanical materials, equipment, labor, overhead, and profit. ,CATEGORY OF CONSTRUCTION Value: $ Al- and 2- family dwelling ❑ Comercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /S FEES m For special information use checklist ❑ Multi- family 0 Master builder ❑ Other: Description Qty. Ea, Total JOB SITE INFORMATION AND LOCATION Rea -Air Job site address: t S 34 ��1 _ .�� r Air conditioning or heat pump CJf (requires site plan showing placement) 14.00 _ City /State /ZIP: fl 64ra or p.- Z Furnace 100,000 BTU (ducts /vents) 14.00 Suite/bldg./apt. no.: Project name: ! I , Furnace 100,000+ BTU (ducts/vents) 17.90 e(n Gas heat pump 14.00 Cross street/directions to job site: Duct work LOAD 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: Lot no.: Flue /vent for any of above 6,80 Other: 10.00 Tax map/parcel no.: • Other fuel appliances DESCRIPTION OF WORK • • Water heater 1000 P... .0 � LC i 7-4 e4t6 h iti E � n^ Flue v e t for 10.04 �' Flue vent for water heater or gas C I AQ le , . fireplace 10.00 Log lighter (gas) 10.00 _ — - Wood /pellet stove 10.00 Wood fireplace /insert 10.00 PROPERTY OWNER ' • I ❑ TEN Chimney /liner /flue /vent 10.00 J , '-3 Mc.. p� erg?) a Other: 10.00 Name: I j Environmental exhaust and ventilation Address: 1 63 Cis-- s i,t) A , I ! _- / b ` Range hood/other kitchen r tl -CLG�t lam( L equipment . City /State/ZIP: Ti (4rG 7 .22 �/ _ Clo thes dryer exhaust or 10.00 Phone: ( ) Gil 2, ��l ? Fax: ( ) I toilet corn exhaust (bathrooms, �° �l [� compartments, utility rooms ) 6.80 J� APPLICANT . ❑ CONTACT PERSON Attickrawlspace fans 14.00 Business name: /1 l 1 tvf a-Y- e � L I n Other: 10.00 ` r �T Fuel piping Contact name ROL/ cri S 1 55.40 for first four; SL00 for each additional Address: ) tc. S 00 .5 �n Q � Furnace, etc, City /State /7_1P: PO -' -.(a rl Id 97 2:14 Gas heat pump nde 1 Wall /suspendedhrttitheater Phone: (SZ3 ) "1 S -Li 22 , Fax: : ( ) 96 l .; l �►'1 Ran ' —'JZZ' I _Water heater E -mail: tell €, L 1 Ifn a 4 Cv r, } 1()C - C _F _Water C.c.; Range I ,S': y 0 CONTRACTOR Barbecue 1 Business name: 6.4_4 ATE (I n f . I 1i) Clothes d rye r ( g as) I e i/ ` Tt'UC `` vie Address: 1llJ S0L no ^a , Other: DuTaoa� 6 ri cid Le 0 t S -7'Z rT u L • MECHANICAL PERMIT FEES* • City/State /ZIP: f)(,) r r-ro ti Di ar "! e - 7 22 / Subtotal 5-, c fb Phone: (t5.'63 ) 1 S3 If Z. 1 Fax: ( ) ��y - Minimum permit fee ($72.50) -2).-S-6 (,, CCB lic `� � � ! (25% of ermit fe ?•--1 1 q ( ✓ Plan review e p ) State surcharge (12% of permit fee) S 7() 1-1604,,,.:,2 TOTAL PERMIT FEE $t • / Authorized signature: 00\1 This permit application expires if a permit is not obtained within 150 / days after it has been accepted as complete. ✓ ✓✓ Print name: yr - i J I Date: Cy Z i 61 • Fee methodology set by Tri•Couunty Building Industry Service Board 1,\Building\P erm3 ts\ EC- PermitApp,aoc 01 /19/07 440 -4617T 01 /02/CCM/WEB) pO CM 2S 4 m n1g ,ayt,,,a 1 St) tt. ,QL -V r u J..05ya� d e pj raci A�w ss t = ,QL �ss� , C.,c -2.4 CS °T_S' n L ,4yW , ) = 1 0L 135'7 1 , 17 1c -- u } — 1 Q)41,� O _ Wl yam . 1 abr PL - a - h t a-, b h�t ` ,QL o4►LU ©czz'voZ r.t. IQ N N W 1 co m 39 {�-)vE } in t-v °S J.Sc, y,hi£ a 1::1,471.4 t- u ,^. z 8 vorr -�rnti a l,I t 1 k.otialt 1 :____________ r. . I z I _1/44°c r aSn W U 0 + I1lif ' r -mss c . III J ,, N fa N 1 ' f 1 N � ,�y o Rig QCQ 1 " 14 o i } -' N i I { t, N - i1b CL. ! V W X y,fl y q t1 w RI _IP