Permit (7) MECHANICAL PERMIT
4 CITY OF TIGARD
` o COMMUNITY DEVELOPMENT Permit #: MEC2010 -00354
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/30/2010
Parcel: 2S110DD14000
Jurisdiction:
Site address: 10650 SW SUMMERFIELD DR
Subdivision: SUMMERFIELD NO. 1 Lot: 0
Project: Summerfield Club House
Project Description: Replace (2) existing roof top units.
Owner: FEES
SUMMERFIELD CIVIC ASSN Description Date Amount
10650 SW SUMMERFIELD DR
TIGARD, OR 97224 Permit Fee 07/30/2010 $423.91
Plan Review 07/30/2010 $105.98
PHONE: 503 - 620 -0131 12% State Surcharge - Mechanical 07/30/2010 $50.87
Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 97281
PHONE: 503 - 624 -2704
FAX: 503 - 598 -0270
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -2 Occupancy Load:
Stories: 2
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $580.76
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
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 que - • UNC by calling 503.246.6699 or 1.800.332.2344.
Issue. By: / i fr 1.4 Permittee Signaturift
CaII 503.639.4175 by 7:00 a.m. for an inspection that busin. s 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.
Jul 1610 03:54p Columbia Heating /Cooling 503 - 598 -0270 p.2
9
Mechanical Permit Applica> idi \ l ;; c I ()u t )1 � R 1 1:S )N l 1'
�� ` - , n om
r City of Tigard g , ' ,.. ,. ? Y ,. / d .: Petit Nod fg /0 00 3 S
` - a 13!25 SW Hall Blvd., Tigard, OR 97223 1
Date/By: j ( / llhi
11 Phone: 503.639.4171 Fast: 503.596,196 16 6 2010 Plan j � I �
U L Other Permit:
I 1 ti'1R l): Inspection Line: 503.639.4175 pare Readpay: i a t?1 See Page 2 for
Internet: www.tigard- or.gov
CITY OF TGARD �� NotiTied/Method: S u mental information
O.f 6t:ARD fl pt
Cil NI nil, c ril igtt - w
• TYPE OF WORK - ' ! COMMERCIAVFEE * SCHEDULE - USECHECKLIST
•
1:1 New construction air-Addition/alteration/replacement
Mechanical permit fxs* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION. Value: $
1- and 2-family dwelling RESIDENFIALEQUA'MENT� /
11:1 y g "3'Commcrcial/industrial ❑ Accessory building
Multi - family For special informal :•on use cnecklisi.
❑ ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: / ��'no'P,�� Air conditioning 1 •'ti
Air conditioning
plan showing placement) ,...."1 46.75 •
City/State/ZIP: -pear Furnace 100,000 BTU (ductslvents) 46.75
/ Furnace 100,000+ BTU (dtxtsivents) 54.9]
Suite/bldgJapt. no.: Project ram � f [C/ Gill Heat pump 61,06
Cross st: eet,'directions to job site: C L u. 6 ck...s Duct work 23.32 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. 23.32
Tux map /parcel no.: Other fuel appliances 1
. DESCRIPTION OF WORK • • C Water heater 23.32
I
Chary) �[ J Gas fireplace 33.39
Flue vent for water heater or gas •
fireplace 23.32
Lo_g lighter (gas) 23.32
Wood/pellet stove 33.39
Wood ftreplaceJinsen 23.32
Chimney/liner/flue/vent 23.32
PROPERTY O ER . I ❑. TENANT _ Other 23.32 I
Name: l\ V . . fj J j f i d . f' ''4 - Environmental exhaust and ventilation
C vv t f r Range hood:other kitchen
Address:
,i li",11�_. . /1 _iL ., gi _.. equipment 33.39
Cily!StateiZ( ° it f i ` M Clothes dryer exhaust 33.39
"f Single -duct exhaust (bathrooms,
Phon Sa ) ( , " �Dia I Fax: ( ) ' toilet compartments, utility rooms) 23.32
❑ APPLICANT . F . ❑ CONTACT PERSON Atticicrawlspace fans 23.32
Business name Other: ( 23.32
Fuel piping
Contact name: m(1 r / no /2 eedor � 514.15 for first four; 54.03 for each additional
1 Furnace. etc.
Address:
Gas heat plump
City /State /ZIP: l Watt/suspended/unit
Phone: a3) (.J 4L,a -7 04. Fax: :563 ,s -aa70 Water heater
Fireplace
E-mail: Range
CONTRACTOR .. Barbecue
� _� • Clothes dryer (gas) •
name: nae: � - /CJ'�T /' f / }/.�■ Other. _
Address: o � 3 9.7 ` �! MECHANICAL PERK FEES*
City /StateJZIP: 7 o T7,8 f Subtotal 4 51/
h ` I Minimum permit fee ($90.00)
0 4°7(11°11e: 6 - 13 ) r0 Q-7 () Fax: (� �j Oa7 (D f' . 9Fj i
Plan review (25% of permit fee) Q
CCB tic.: `,6. %q State surcharge (12°/0 of permit fee) : .5 0. e7
/ 1 TOTAL PERMIT FEE 15g 0 .741 ,
Authorized sigrtatur / Q� This p ermit application expires if a permit is not obtained within 190 �� _ j j
v `✓✓✓tit days after it has been accepted as complete.
Print naltte_/ � r (�l l p _ 71 , - Fee methodology set by Tri- County Bidding Industry Service Board
1: :s`_MLC- PemilAD doe 10'01/D9 440.4617T (: l /Q2'COM'W B)