Permit 0
CITY OF TIGARD MECHANICAL PERMIT
14 I - - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00469
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/04/2009
TIGARD Parcel: 25111 DB11000
Jurisdiction: Tigard
Site address: 15345 SW OAKTREE LN
Subdivision: Lot: 0
Project: Gleason
Project Description: Replace A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
GLEASON, ROLAND Description Date Amount
15345 SW OAKTREE LN Air Conditioning or Heat Pump 09/04/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 09/04/2009 $8.70
PHONE: 503 -317 -9945 Minimum Fee Adjustment - Mechanical 09/04/2009 $58.50
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:
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:
‘01 Permittee Signature: /91 ., e %'C
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.
,_` Sep 02 2009 3:44PM CLIMATE CONTROL INC 5039687224 p.2
Mechanical Permit ADalicatio ECETvED l l l(:l� FOR () I!' F: (P:1.1
City of Tigard Received ,
a DateBy: . _,, A Permit No. EC200 0 ....".0
13125 SW Hall Blvd., Tigard, OR 97223
I • Phone: 503.639.4171 Fax: 503.598.1960 S E P 002..2009 D yew
Other Permit
t_ tc,A --- 12.0 Inspection Line: 503.639.4175 r,. • .
Internet: www.tigard- or.gov
44,1 Date Ready/By: Sr ® Page 2 for
CITY OF TIG II Notified/Method: Sepptemesul information
BuiLDING nry ISION
• TYPE OF WORK . COMMERCIAL, FEE* SCHEDULE - USE CHECKLIST
El New construction Addition /alterationJreplacetnent Mechanical penult fees* are based on the value ate work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: • _ mechanical materials, equipment, labor, overhead, aid profit.
. . CATEGORY OF CONSTRUCTION Value: $
.�l- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building • RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
0 Multi-family ❑ Master builder ❑ Other: For specicl o(Jo►niction use checklist
Description . 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Beating/tiding
Job site address ' 5 5 H 5- 5w 6 A KTR 4 Air conditioning or heal pump
J Orgies site plan showing placement) f 14.00 1 t1
City/State /ZIP: f b 4D c c 7 ZZY Furnace 100,00013W (ducts/vents) 14.00
Suite/bldg. /apt. no.: 1 Project name: C Leriso� Furnace 100,000+ BTU (duets/vents) 179
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydro nit hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit beaters (fuel -type, not electric),
in -wall, i•duct, suspended, etc. 14.00
Subdivision: 1 Flue/vent for any of above 6.80
l Lot no.:
• Tax map/parcel no.: Other: 10.00 •
Other fuel appliances
DESCRIPTION OF WORK , Water heater 10.00
pl e c -- It L Gas fireplace 10.00
�i Flue vent for water heater or gas
,fireplace 10.00
• •
•
Log lighter (gas) 10.00
Wood/pellet stove : 10.00
Wood fueplace/ioseri 10.00 _
. PROPERTY OWNER ' I ❑ TENANT Chimney/liner/flue/vent 10.00
Name: ��, O. 10.00
( `e a s `�-' Environmental exhaust and ventilation
Address: ( _ 3 L S s w k free Range hood/o6er kitchen
J equipment 10.00
�t �)
City/State/ZIP: T? L C 7 Z'Zy . aothes dryer exhaust 10.00
Phone: ( ) . 317^ etc? t
Fax: ( )
Single
-duct exhaust (bathrooms, toilet ecompartments, utility rooms) . 6.80
St APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: (I 4 m gpi L'O ei 4,.- / n , Other: - 10.00
_Fuel piping •
Contact name: R 40=ir rl S _ . $3.40 for first roar; $1.00 for each additional
-
Address: S p0 5 7 � O d.. n--
Furnace, e tc
t rl vc _Gas heat pump
City/State/ZIP: Pa ( -H a ^ a c:; ,e- 9- - 1 2 -. 14
/ • Wap /suspendedhmit heater
Phone: (513 ) L 1 S"3 --(St 22 I Fax:: (3) 96 6 2 2 6, Water heater
E-mail: 9
mail: e 1, root 4 co n -1-yo YP 1 1 ()C co Range e
• CONTRACTOR Barbecue
. Business name: at ATE- eo 4,7,4 j 7� i n G Clothes dryer (gas)
Aaaress: 6500 S`v ^O Other:
�� 4 �! MECHANICAL PERMIT FEES' .
City /State/ZIP: Pv r ria n d pr .' 7 - 22-1 • Subtotal f
QV Phone: (503) 1.4 s3 N k ?A, I Fax: ( 533 ) c158 - 7 Zzy Minimum pemtu fee ($72.50) -72, sv
CCB tic.: �� Plan review (25% of permit fee)
&..,)
� State surcharge (12% of permit fee) g • 70
TOTAL PERMIT FEE (• 2.4)
Authorized signature: 01.1 t !_ WV"'' This wing septic-mien aspires ifs permit is not obtained wirbio 180
Print name: days after it has beets accepted as complete-
�� (4 4y r/3 I Date: G} • Fee methodology se- by Tri•Coanry Building Industry Service Board
!� .� I F n8
mild;e�r•R„ita\MEC- Permiupp.dor 01 /19/67 461 (( iv - axrcomAtrs) Qbg ciLi5z7
• Sep 02 2009 3:44PM CLIMATE CONTROL INC 5039687224 p.3
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