Permit q CITY OF TIGARD MECHANICAL PERMIT
1,114 • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00634
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/05/2012
Parcel: 2S104BB01400
Jurisdiction: Tigard
Site address: 14335 SW WINDSONG CT
Project: Kelly Subdivision: CASTLE HILL Lot: 53
Project Description: (1) furnace replacement
Contractor: CLIMATE CONTROL INC Owner: KELLY, BARBARA S TRUST
16500 SW 72ND AVE 14335 SW WINDSONG CT
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 453 -4822 PHONE: 503 - 521 -0206
FAX: 503 - 968 -7224
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/05/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/05/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/05/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
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.
Issued By: ;DMA/ 11 ` S . L ` Permittee Signature: �I /4PPLI C A i !- 1 O&_,L
SLL
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.
Dec 05 2012 9:37AM CLIMATE CONTROL INC 5039687224 p.2
City of �.. .ai..a.a .m ea
Tigard RECEIVED R eceived
• 13125 SW Hall Blvd., Tigard, OR 97223 Dated (�s' I Z S1 Permit No.: G (� .
Plan �(E �v oo63�F
Phone: 3.639.4171 Fax: 503.598.1960 DEC 0 5 2012 Dat
Review
line: 75
503.639.41 Date/B eSthvPerrait
1I,. :1 1) ti
brieroet: Line: g 03 639.4 3 Dale Rady/By: hob: ® See Page 2 for
<,' CITY OF TIG a p n Nadledimethad: 'i � j Supplemental latormagoa
+r , "ri_',�:' z +` . ;� a ' • i' -f,' •. 7;�. - O K 1 �� 1L O J ', ; + t<:A.y': �:. �.. n.r ..� -.:; -
i: ,:.r; : let -2;. a, ..; . 1 ,, E I, .' d. ,. 5 I iF di g..TU:I c:,a
❑ New construction Addition/aherstion/replacement Mechanical permit fees' are based on the value of the woods
pall:
❑ Demolition ❑ Other:
m med. indicate the value (rounded to the nearest donor) of a11
t;ts;r.emolitnT- �;' wary �. : echanical
::: a ` . , , (.. .: .ry.,,. -/��� �j materials, materials, e4uipmequipment, labor, overhead, and profit.
:3Z FR.7`,�':t' • .- �. +'ti: r'7r.Ff+i'i.S'O r... ,.urn -' x M,Ititirer; Value: S
-- .1:1`x; iv :7:
al/indu ��
�l - and 2-family dwelling ❑ Comma rci stria] ❑ Accessory bui]dgtg i r M <_; . f �'_; '_r r= *Lt�r�: , 57..ir a :4.1
builder ❑ Other: }�,. , � For special injonwatior, use clrectlirr.
❑ Multi- family ❑ Master b
Kip t, ' I � . it:' s� . ( R Qtr. I Fa f row
Job site address: /V336 S' A i )7 A: 41 G':t- An conditioning T- ,
City/State/ZIP: (resumes site On allowing etaeemeat) 46.73
�6 l q7 Z Z 3 Furnace 100,000 BTU (ducte/v i 46.75 14 (r'
Suite/bldg. /apt. no.: Project name: /` / e1 /y Furnace 100,000+ BTU (ducts�vems) 54.91
Cross street/directions to job site: Hat
Dag work w 61.06
23.32
HYdronic hot water system 23.32
Residential boiler (radiator or
b) 23.32
Unit heaters (fuel-type, not electric),
in-wall, in -duct, suspended, etc. 46.75
Subdivision:
I Lot no.: Hutt fur any of above 23.32
Tax map/parcel no.: Other: 23.32
a -�' a� =� Other fuel appliances
� s � �1; � a .. �.F..i'ti �� _�i�s'.W� Water beater 23
I .3
6-77 li¢ 2332
C4� f�i�ft/.�rC� Gas fireplace 33.39
Flue vent for water heater or gas
emplace 2332
Log lighter (gas) 23.32
w�-� .? i Wood/pe9dstove 33.39
RAT:41+Y� i; '.
Wood fireplaceinsen 23.32
¢ �Gt - a . -" F i. ;)7,: let " ' i ` , 07.737,-,7):::::.. ti Chimneyninerifiuelvan 2332
Name: &11Y:.,647-#7 / y �•
en 2332
Environmental cabanas and ventilation
Address: /V33 g 51.1„J 14.)M else e-7.? Range hood /other kitchen
• � eQ 3339
City/State2IP: 7 /6�d , Y' 7'7 3 Clothes dryer exhaust
33.39
Phone: ( 5'93 ) Cat � p f/ Fax: ( ) Single-duct exhaust (bathrooms,
r toilet
;?2F c ;;; /f # �TI `,7. c.,� .;�; ; < � 7,: oawhpacmts,ult7ityropp>ls) 23.32
d, .3 (,�. .:a, �� !`� _ � -' , 1 � _i`,:Ir_,J �.+ Anic%aaw>spacefans 2332
Business name: 60 MA IL GO n rrri., Inc-
Other: 23.32
Coulee name: RD e 1_n f. IS Fad Opine
15 for
Address: I I_SoQ Sur - 72t° Ave- Pupae; first four; 54 03 for each additional
City/State/ZIP: i) r rlarld r 9-7 z2 3 Wall/ Gashes*
pump
+
I
penile
Phone: (Sa3) W S3 - IJ Wall/ beater
7BZz Fax: :( CO3 )9( - 72z y Wata beater
E-mail; CAD G t o.. #e Fireplace
CCn'�r0 C o en
•Y, +qua ..3;ri;7: �� �� i . � . ,, • r
=i c5:a '+`�' : �'�r. # �.. �'`�f „b c c � +�'� ti ti'-�•�- r�nm,�.. Range
�n 'r •lr.. !=� F, T1 3 Ar e . 1- S A z' n•y
rt-1.:LaL � ' �+.�va.YO
Business name: e l yo Q.TE eb ri 1 /Y)G Clothes dryer (gas)
Address: f (p SOD S Gt.� ' 7� fl D At t" o' er
City /St SIP: �OrT-�0./1 or C( ZZc� : : 2,- ;:.l
7 JJ ,
Subtotal _ Snbto
Phone: (5-03) qS3 Yic ZZ ( Fax: ( lbli - -jzzy Minimum permit fee (590.00) qp. 6
CCB tic.: Co 7...t q Plan review (25% of permit fee)
- State surcharge (12% of permit fee) Ale , Oa
Authorized signature: •/f ���dWVie TOTAL PERMIT FEE /a0.0? - / This permit application expires If permit Is not obtained Wilde tea
I Print name: D ti ,� [[�� `��� � days anew ee n has been sic
7 / Tf s�� as eompdete.
42 5 � . 1 ' Fee methodo tel by Tri- County Builam 1
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