Permit f 4
CITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00160
T i G A R. o 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/15/2009
Parcel: 1 S134ACO2610
Jurisdiction: Tigard
Site address: 11315 SW WILLOW WOOD CT
Subdivision: Lot: 0
Project: Meith
Project Description: Replace furnace and install fan coil.
Owner: FEES
MIETH, RICHARD C & BETTY M Description Date Amount
11315 SW WILLOW WOOD CT Air Conditioning or Heat Pump 04/15/2009 $14.00
TIGARD, OR 97223 Other, Heating /Cooling 04/15 /2009 $10.00
PHONE: 12% State Surcharge - Mechanical 04 /15/2009 $8.70
Minimum Fee Adjustment - Mechanical 04/15/2009 $48.50
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
Issued By: Una! V \ 9 \ J illl Permittee Signature: Q Q i v3* 5Avp
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.
r Rpr:itlO 2009 11:43RM CLI T L � . k . INC 5039007224 p.2
Mechanical Permit Apalicatio f l' OR O► 1.1(: I _L
It. 1.1
City of Tigard Received
i 'e 13125 SW Hall Blvd., Tigard, OR 97223 APR 10 2009 Dare/Br: • 4 • t. I _ ��� Mfg
f
C . Phone: 503.639.4171 Fax: 503.598.1960 Nan Re`1e" Other Permit
-, i , , II, ; ,, Inspection Line: 503.639.4175 CITY OF TIGARD Date Other dyBy ® See Page 2 for
Internet: www.tigardor.gov BUILDING DIVISIO' I N°°s°diMeth °d: EN Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction �'Addition/alteratioNreplacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
Al and 2- family dwelling ❑ CommerciaLrrndustrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi - family ❑ Master builder ❑ Other For special in;rornmuon use checklist
Description I Qty. Ea I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1/3 �� 54) a), �It Ala, c/ Air conditioning or heat pump
(27 (requires sate plan showing placement) / 14.00 /7
City/StateJ?IP: 776 a< 97 � �3 Furnace 100,000 BTU(ducts/veau) 14.00
Suitelbldg. /apt no.: Project name: Furnace 100,000+ BTU (duets/vents) 17.90
�/P Gas heat pump 14.00
Cross street/directions to job site: Ductwork 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 1400
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
Tax map/parcel no.:
Other: f'¢rt/LGiCr _ / 10.00 /U
Other fuel appliances
DESCRIPTION OF WORK Water heater 1000
/�'' � ��� Gas fireplace 10.00
���/// / Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 1000
,.
Wood fireplace /msert 10.00
PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
Other. 10.00
Name: 2) k ' /g/ / Environmental exhaust and ventilation
Address: //3/5 ��, • � S /10 eyed d C7- Range hood/other kitchen
equipment 10.00
City/State/ZIP: 276 4,40 e912 7 z.23 Clothes dryer exhaust 10.00
Phone: ( ) 3e� Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
Act
APPLICANT ' ❑ CONTACT PERSON Attir/crawlspace fans 10.00
Other Business name: (! 1.4 7 ri- Lio I �{roL / L F 10.00
Fuel piping
Contact name. Roll / - S $5.40 for Brat four, $1.00 for each additional
Address: ) (0 S 00 s .7 2 ° -v Furnace, etc
City/State/LIP: Gas heat pump
Pa a t el o r- 9 7 2.Zy Wall/suspended/unit beater
Phone: ( 913) Li J ' 3 ..i D G 2 7 [ Fax:: (3) C� t Ci z 1 . Water heater
E -mail: 0) € C i w Co n 5 I nC f1 tilit CoRange
CONTRACTOR Barbecue
Business name: r' f / 0 ^X- 00 r, -C.- i t7 L Clothes dryer (gas)
Address: heSOO 5 ! w r 33-- —7,221° V
� /�"a` Outer:
MECIgANICAL PERMIT FEES*
City/State/ZIP: Po( Hall at Or g - ? 72 -v Subtotal V y
Phone: (t 3) 1.4 s3 ' H g ZL Fax: ( 563 ) z Minimum permit fee (572.50)
CCB lice:'1 I Kiti� -?Z (25% 7� SC
Plan review
/_ permit fee}
State surcharge (12% of permit fee) I s. 7O
TOTAL PERMIT FEE s/..2
Authorized signature: 01 Thu permit application expires if a permit is not obtained rvebin 180
days after it has been accepted as complete
Print name: k 44-re I Date: 0 I • Fee methodology set by in- County Bwlduig industry Service Board
t Murianovenro C- Permwpo.doo wnwm ptroveoattit>3n►
4'.9Pr r:10 2009 11 : 4 3RM CL I MRTE CONTROL INC 5039687224 p • 3
CUMATE 16500 SW 72nd Avenue Portland, OR 97224
HEATING AIR CONDITIONING " phone: 503- 453 -4822 Toll Free: 866-453-4822
Fax: 503- 968 -7224
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SYSTEM DESIGN INSTALLATION SERVICE
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