Permit IN CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00277
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/29/2012
Parcel: 2S 111 CC 18900
Jurisdiction: Tigard
Site address: 10365 SW GREENLEAF TER
Project: Goodrich Subdivision: SUMMERFIELD NO.5 Lot: 248
Project Description: Replace furnace and A/C Must meet the minimum 5' side yard and approved rear yard setback
Contractor: CLIMATE CONTROL INC Owner: GOODRICH, GLADYS I
16500 SW 72ND AVE 10365 SW GREENLEAF TER
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 453 - 4822 PHONE:
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Air Conditioning 05/29/2012 $46.75
Type of Use: SFA Furnaces < 100K BTU 05/29/2012 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/29/2012 $11.22
Occupancy Grp: .
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION' Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. w 11n
_____IWia
Issued By: Perm ittee Signature: D N, PO /4 //1 ii/
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 1 �/ l !
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
May 25 2012 8: 50AM CLIMATE CONTROL INC 5039687224 p.2 5:4:r r
City of Tigard !r' Received - _._ --_
■ 13125 SW Hall Blvd., Tigard, OR 97223 5 Date/By:
Permit �T �' f) ^
ill
e 5
2012 Plan Review �� ''� �'� a`'' la_Dva 7 7
Phone: 503.639.4171 Fax: 503 598.196h✓I/-11 Other Perrnir.
/ 1 1 c r, Ili , Inspection Lane; 503.639.4175 Date/
�, Internet: www.tigard- or,gov CITY Date Ready /By: la is: S See Pape 2 for
YI� u ,. , , yM, :�..t; -•. ,. .,.. _ , I II �� �- !� F Notified/Method:
YI IGAR'�' 11(p Supplemental latorm
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r :. ,a-s e.. 1, - it ",. ;$ ,:. ".1� .�'.a. r •ti ^
:Ar f :: - V' ql'�q Get: +�
L j ❑ New construction _:..� R ... , r a- .._ y
�Addition/aheration /rep lacement Mechanical permit fees* are based on the value of the work
` ❑ Demolition Other: performed. Indicate the value (rounded to the nearest dollar) of all
1 = t = sr , :sair, s . , ::. `t ', a ' . �� ,,„,,, mechanical materials, equipment, labor, overhead, and profit.
-
' '`� �6':"'3�'= a't�i "� a1WW, 14�"��`t K""'',�Lr`�'�.. . $
v ^'1 tin'+,[ -7;= • �s, o ,, Z.
etV ' �1 - and 2-family dwelling Y °� •
Y g ❑ Commercial/industrial ❑ Accessory building
' 1 i = Va
i° ' �:r!- C►e �� , x`
s
I!�' [] Multi -family ❑Master builder ❑Other: For special information use checklist
/` 1 ' c r e
Description Qtr. a [ Total
S t t � i k rP 5r � � ,..ice 'f; :, Heating/ma site address: / 0 3 ( 5 - 5 r" t &k Th L Air conditioning f u Afti,
City /State/2IP; �' l (requires site pan showing placement) 1 46.75 1 �p ��
1 1 b Or Prosser• 100,000 BTU (ducts/vents) j 46.75 1.1 ( 7 r
Suite/bldg. /apt, no.: f Project name: d e-(CIN Furnace 100,000+ BTU (ducts/vents) 54.9]
Cross street/directions to job site: Heat pump 61.06
Duct work 23.32
Hydrosic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fueliype, not electric),
in-wall, in-duct, suspended, etc. 46.75
Subdivision:
J Lot no.: Flue/vatt for any of above 23.32
Tax map/parcel no.: Other: 23.32
tr
5'. yfr t K:, 7 S i i c ra cf l a Other fuel appliances
I A� , , � �y zz.:s J. k ` r!�.77 ,? ; .v. t <. : 77 i .5 4 � •r Water heater 23.32
pt-° ere RAIL/A-00/ 4 6, 33.39
A'
Flue vent for water heater or gas
fueplac6 23.32
Log lighter (yeas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
c,-+?` ' -3 .^w fr• "r" fry l,'��t. �r'2 ,��
t 1 mss. {'`� .,.,s� < 1 . ; .r 1. t� 4 .... � s ....., " -d,. z i_,.�& .w-1, . ..o-.
` 1 / ChimneYliner/fluehent 23.32
Name: '1101 c3 _ C i 1 � 23.32
} Eavinnunental exhaust and ventilation
Address: l C3 J (p 5 5110 L- �I ( u / 7 - Range hood/other kitchen
City /State/2>p: J"] , s p- , t equ 33.39
t `��" Q 1 / Clothes dryer exhaust
Phone: 3339
( ) ( j Single-duct exhaust (bathrooms,
8 1( U Fax ( ) ity moms)
.,,. , toilet
gg r ,;� is 3 +i f.a�'" k C 'gr '�,� , t" i? 6 1_ �,,,.. dents, utility rooms) 23.32
....; .rcn t' 4 :4 A .r '1..,,... �-:�t z ' 1�' t:cl.Y�Q_. tlic/cr9wlspace fans
� � �. - y;: A 23.32
V
Business name: e � MAJ- A L o n rroL Me-
Other: 23.32
Contact name: R 4 1,T 1 r-13 Fuel piping piping Address: 1 ! _ �� 514.15 for first four; $4.03 for each additional
l0 5(A) ) '7'^- ° AV - FUrnaca ac.
Ciry /State/ZIP: j� r i Gas heat pump
1 r � 9-1223 Wall/suspended/unit heater
Phone: ( 50 ) 1 153 - ' 8 Z.- I Fax:: ( 53) C!( -7 Z. V / Wales beater
E-mail ro G (t Mme �� cc, -'4 7 Fireplace
1,., •'i - I roLInC C R an
c-r �„ Range
a9t. -: ;#V- r ss �- 4 tk: • 1C� 1 ° • t T .r ° •-:t 2�w H ' s ;;;1_ Barbecue
Business name: C/..J ]v1 rE
or c
6 (11_ Piz . Clothes dryer (gas)
Address: 110500 S t n p r Other,
Address:
City/State/ZIP: �D I a n r. -. 7 . .. Q v &-- 4 ' At t, P r i ' % i = , : 4
n,Zz ° . a,:J
(�3) Subtotal q 3 s
Phone j,� s-� Z. J Fax: o td ^ -
4 Z (3 � z 2 y Minimum permit fee (590.00)
CCB lic.: (0 7_1 el Plan review (23% of permit fee)
State surcharge (12°J of permit fee) 1 l • z 2.
Authorized signature: / ,/ 1��d TOTAL PE
mit It t FEE f3 2_
" �u/v�b Thi per app lication expires if a permit Is not obtained within IRO
Print name: 0 days after ii has been accepted as osmalete.
r + l j Date: C• • Fee methodology Set by Tri.County Building Industry Service Board
1'.' Bandit gtPrxwits,MEC- PersvtApp. I0Po1/09
440 -4617T (11 /07 /COM'WEB)
May 25 2012 8:50RM CLIMRTE CONTROL INC 5039687224 p.3
C.:',' CLIMATE CONTROL 16500 SW 72nd Avenue Portland, OR 97224
I Mil: 503 -453 -4822 Toll Free: 866 -453 -4822
HEATING AIR CONDITIONING a 1! V ,, t 503- 968 -7224
MAY 2 5 2012
CITY ' OF TIGARD
BUILDING DIVISION
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SYSTEM DESIGN INSTALLATION SERVICE MAINTENANCE
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