Permit •
CITY OF TIGARD MECHANICAL PERMIT
v
°:: COMMUNITY DEVELOPMENT Permit#: MEC2013-00469
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2013
Parcel: 2S104CC07700
Jurisdiction: Tigard
Site address: 13604 SW ASCENSION DR
Project: Sandford Subdivision: HILLSHIRE WOODS Lot: 96
Project Description: Install new fan coil and heat pump with new duct work. Placement of heat pump must comply with manufacturer's
clearance requirements.
Contractor: CLIMATE CONTROL INC Owner: SANDFORD, JUSTIN S&TRACY A
16500 SW 72ND AVE 13604 SW ASCENSION DR
TIGARD, OR 97224 TIGARD,OR 97223
PHONE: 503-453-4822 PHONE: 503-341-1858
FAX: 503-968-7224
FEES
Specifics: Description Date Amount
Heat Pump 08/14/2013 $61.06 -
Type of Use: SF Duct Work 08/14/2013 $23.32
Class of Work: ALT Type of Const: Other,Heating/Cooling 08/14/2013 $23.32
Occupancy Grp: 12%State Surcharge-Mechanical 08/14/2013 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.62
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: 11 ``_ J Permittee Signature:
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.
Rug 12 2013 8: 08RM CLIMATE CONTROL INC 5039687224 p. 2
Mechanical Permit Applies • t I:,ut of I:,,.1. 1 til: I,vl.'
City of Tigard rv�
Date/By: 0 ��`r P Na: p(6C
�/j-OU 1/6� ! 131SW Hall Blvd.,Tigard,OR
Phone: 503.718.2439 Fax: 503.598.1960 Plan Renew Other Permit:Dateffir 1 1;_; ••,;i, Inspection Line: 503.639.4175 AUG 1 2 2013 pate Ready/By: rude: RI See page 2 for
Internet: www.tigard-°r.gov
Nodded/Method: Supplemental Information
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Mechanical permit fees'are based on the value of the work
❑New construction Addition/alteration/replacement
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment labor,overhead,aidproft
��. L:lr,, .r`Y p.• ,,.:;rA• ,,( , •-r -tr;dal.:,t.r,- rz•nrs.,,..v.... Value:S
C./:� ! :' S r':'•...'6 i:x,* )l .r r .. 'N,,°.'�,.t r•-1,>'4,7,i' :6r 41..V'.', ; fi Pam" '':E•
- fin. !��•7?r" w1''���,'iN'I^ �4'+..4.! '�' 1��.�, '2Se�..Yf�'�;i7,�: .Y•�wic:.!�`.�`'1<,;
gl-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For ipeedalinformation we checklist
❑Multi-family ❑Master builder ❑Other: Description j Qty. I Ea 1 Total
�'x%. r*��` ,�:.-'J�a< Wli.';1�1¢,:� ,����-.T•.-'!!a'a�:^.V�.r'•`!4;es:,)i+;�•�.F'-r.'�.'. ;�YS.(a Yi EICatIngfMOling:
.; '>•.,..; ?.a;, :_.:;;, Air conditioning 46.75
Job site address: 1 3 LDOl.i A S 51 Uv1 (J r Furnace 100.000 BTU(ducb/venta) 46.75
City/Stale/ZIP: 63 14Y`ci t Q,,ZZ3 Furnace 100,000+BTU(dueb/vents) • 54.91
Suite/bldg./apt.no.: Project name: -per Han I 61.06 (01-Oie pump
Duct work 1 23.32 2 3.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other (-0`, 1 23.32 :13 32
Other fuel appliances:
Tax reap/parcel no.: Water heater 23.32
DLScRIPY'ION Ol ;WORK . Gas fireplaixAnsert 3339
6 1 Flue vent for water heater or gas
kJe.,r- -a �v. � , (AV1 & C .4- fireplace 23.32
( f
ea r w e !/IC.I-4-) FrArce a A-t/L Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/inert 23.32
Chinmey/linedflueh'ent 23.32
PEtOWN A�$1 :. Other: 23.32•
Name: ` Q ck n ., l Ean a hood/other exhaust and ventiladoa:
vtt V�'�tt,�to c7 {-t�� Range hood/other kitchen
Address: 1 )1D O -i ,� (� k II OVI 0 Y � 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: U AY or t'l^7.--2,-3 Single-duct exhaust(bathrooms,
I �rJ� �l 1 toilet compartments,utility rooms) 23.32
Phone:( )
s Fax:( )
Atiidcrawlspace fans 23.32
�^:;y".y$:-;C .r ='y'�;^•aq?ts"yr.!41 k`.::',.;:::1-.. '.,l�-..., y ,}r, r� ,,
11,0.; ' 41-:` rt.7 il;.T.. :•::rr,;',. +1 ^ 't3 Other: 3.32
Business name: Cb'n(1 f}A-e. COr Fuel piping;:
\ C' 511.15 for first Saar;$4.03 for each additional
Contact name: Rorl& .(-r(S Furnace,ote
Address: ) (. ' b0 S w -7/N A rev Gas beat pump
City/State/ZIP: 11 p� Walllntspendedhmit heater
POrLr-\ck n d tom. 1 t 22-Lf water heater
Phone:(933 ) L i r 7.3 `^LA%2Z Fax::(9)3) °14,a ..•-(2'Ly Fireplace
&mail: co la G�tm0. cal Barbecue
-4.•I:;fi':FZ :•` •7i4 ! 0,•N~ ri-`5+2C•4.b':i,^'"�'a. i'.a34 `�'fr°�N:�;M7 : Clothes dryer(gas)
�j'4Me Aes �9LCa1 . � .::::.,
Business name:
Address: Other:', l Mss `S�'''3 4 ∎' `'' '
41)
Y Ss �..sr J;j:
Subtotal 01•1.0
City/State/ZIP:
Minimum permit fee($90.00)
Phone:( ) I Fax:( ) Plan review(25%of permit fee)
Co State surcharge(12%of permit fee) f -9 2.
CCB lie.: t 1 19 TOTAL PERMIT FEE I 20 t Ip Z. ��/
This permit appHeation e:pl res ifs permit h not obtained within ISO
qtr
Authorized signature: days after it has been accepted as complete. V
• Fee methodology set by Tri-County Building Industry Service Board
Print name: (M -.c-ye}yrri I Date: S))2i/3 I
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