Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00637
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/30/2009
TIGARD' g Parcel: 2S103DCO2800
Jurisdiction: Tigard
Site address: 11290 SW VIEWMOUNT CT
Subdivision: Lot: 0
Project: Hight
Project Description: Replace gas furnace
Owner: FEES
HIGHT, WILLIAM H JR & DOREEN Description Date Amount
11290 SW VIEWMOUNT CT Furnaces < 100K BTU 11/30/2009 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 11/30/2009 $10.80
PHONE: 503- 670 -8492 Minimum Fee Adjustment - Mechanical 11/30/2009 $43.25
Contractor:
COKUMBIA HEATING & COOLING
PO BOX 230397
TIGARD, OR 97281
PHONE: 503 - 624 -2704
FAX: 503 - 598 -0270
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: L , / " Permittee Signature: i nk_ ZW
Ah 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.
Mechanical Permit Application -�2`W ' ,: Z,ft-t :a : � t ,i' ,.t.
P p ;. 1 .P , ,. ¢ T FYN t' I C (�L -S 1 07'81: r: r ' : 1r ,,:411 'a,
1 `" Ci of Ti and Received
t 3' g Daie!B Permit Nn. Met 4v7Y9 - 07)1,037 13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review
it!--- 124 503.639.4171 Fax: 503.598.1960 Other Perm
Date/By:
}T [G RD Inspection Linc: 503.639.41 75 Dale ReadylBy: Jr vis' ® Sec Page 2 for v
. , !t4'S6'iiiiiiiii Internet: www.tigard- or.gov Notified/Method: Supplemental Information
I — TYPE OF WORK I I COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
El New construction r I Mechanical permit foes' arc based en the value of the work
. ❑ ldtiition, altcration/replacement I performed. Indicate the value (rounded to the nearest dollar) of all f
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
CATEGORY OF CONSTRUCTION . - - value: S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
❑ 1- and 2- Family dwelling ❑ Commercial/industrial ❑ Accessory building For special infor'ma.'icn use checklisr.
❑ . ❑ . ❑ Other: Description 1 Qty. La. Total
JOB SITE INFORMATION AND LOCATION 1 • Heating/cool iag
///���'
///]]] / /7; l ' Air conditioning
.ln.1n1) // 7 f silo address: S �/ / t„S U N �- of /1 d .(re site plan showing placement; 46.75 -
C. itv,is[ate / %IP: ` � ' Furnace 100.000 BTU (duets/vet-1[k) 46.
Furnace 100,000 RTII (ducts/vent:0 54,91
Suitc'bldg.'apt. no.: I Project name: Heat pump 61.06
Cross streeUdircetions to job site: I Duct work 23.32
Elydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23,32
Unit heaters (fuel -type, not electric),
in -wall. in -duct, suspended. ete. _ 46.75
i
Flue/vent for any of above I 23.32
Subdivision: Lot no.: —
Other, 1 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
1_ _I - .4 LI Flue vent for water heater or gas i
f 23.32 ;
Leg lighter (g 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23 -32
PROPERTY OWNER 0 TENANT Chimnevlinerlfludvenf 23.32
CCC Other 23.32
Name, A/14- Environmental exhaust and ventilation
Addressff I Range hood/other kitchen
equipment 33.39
City: /State/ZIP: Clothes dryer exhaust 33.39
Single -duet exhaust (bathrooms,
Phone: ( ) 42'2 e ii r,C., Fax: ( ) toilet compartments, utility rooms) 23.32
0 APPLICANT ❑ CONTACT PERSON Attie /crawlspace fans 23.32 •
Other: 1 23.32
Business name:
Fuel piping
Contact name: / �Q Y /...e r. $14. f5 for first four: $4-03 for each additional
.Address:
/ / ' Y)� Furnace, etc. I
Gas heat pump I !
Cit' ✓Stato'Z1P: Wall.suspended:unit heater 1
r `� f cc ,rte �, Water heate
(Mono: (513) (p4L'Q70.`t l Fax:: } 3 55:5 -b 70 W att he I
1::,-mail: Range T_
CONTRACTOR . Barbecue i 1 ,
Clothes ever (gas) ` 1
Easiness name: aj u ling/ t3 rst r r r `_��� / S- /f y. �/ • { ` )6-- ( Other: 1 .
-
Address x 0 2 , 3 a 9 .7 • MECHANICAL PERMIT FEES*
City /State/ZIP: iiG /� 0 g f Subtotal
` ' ° _ 7 n 77.... I 9 � ` c o Minimum permit fee ($90.0)
Phone: 6).3 1 (1 FaX Plan review (25% of permit fee)
•
CCB tic.: r 7/) Q State surcharge (12% of permit fee) 1
I TOTAL PERMIT FEE i i CD _
This permit application expires if a permit is not ohtained within 185
Authorized signatur': / / f dsy+ after it hay been accepted as complete •
y �/�'t Date: / ` Fee rneihodoicgy set by Tri- County Builiity lu/ iL y Sri vice -lone I
Print lame: // /�'tiM ( �J �7 ti' J • ( }�/� l _.- r , j 1 .
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