Permit iipA
®Y OF TIGARD D MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00026
TIGARp 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 1/10/2007
PARCEL: 2S 110DC -00500
SITE ADDRESS: 11445 SW SUMMERFIELD DR ZONING: C -G
SUBDIVISION: WILLOW BROOK FARM LOT: 017 JURISDICTION: TIG
Project Description: Replace furnace. Project Value: $2,000
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS, CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PRESTIGE PROPERTIES Description Date Amount
11445 SWSUMMERFIELD DR
TIGARD, OR 97224 [MECH] Permit Fee 1/10/2007 $72.50
[TAX] 8% State Surchar€ 1/10/2007 $5.80
Total $78.30
Phone: 503- 639 -4255
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU NC by
calling 503.246.6699 or 1.800.332.2344.
/
Is- ed By: L �, /JA/ z Permittee Signa , %/ /'11 J/A , —
Call 503.6394175 by 7:00 a.m. for inspections t at busine 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.
COMMERCIAL . FEE *..SCHEDIIL.E.: -. USE CHECI{LJST
Mechanical permit fees'' are based on
performed. Indicate the value (rounded
mechanical materials e, , men 1 .> •,
Valve: $
' . RES1DF.NTiAL EQIIIPhMENT
the value of the
to the nearest
overhead and
%/ I
work
dollar) of all
•rofit
FEES*
/
For special information use checklist.
Description Qty. Ea. Total
Head I. cooll • :
Air conditioning or heat pump
( • uires site • Ian sbowm • tacement
.108 SITE INFORMATION AND LOCATION
14.00
(�
City/StatefZIP:
Furnace 100,000 BTU duets/vents
-111
14.00
Furnace 100 000+ BTU iducls/ventsl
Y
17.90
Gas heat .um
DESCRIPTION OF WORK
14.00
Duct work
14.00
❑ TENANT ..
H dronic hot water stem
!
14.00
/� [� c
Phone: 3) �37 . /r 5
`/1 `�'`
Rcsidentist boiler (radiator or
h dronic
0 APPLICANT
14.00
Business name:
Unit heaters (fuel -typc, not electric).
in -wall in -du s • • nd • etc.
Address:
10.00
—
Flue/vent for of above
E -mail:
10.00
Business name: (7 4 / zip 6 ¢ Ji,Q,4kir 69Q/`4Z
Other.
City /State/ZIP:
d/Q
10.00
2 97 ar>/
1 Fax :6 59g 7Q
Other fuel a • 'Nantes
Water heater
10.00
'
Gas f • lace
10.00
Flue vent for water heater or gas
fire • lace
10.00
• : li: ter ; .
10.00
Woodl•• tletstove
10.00
Wood • lace/insert
10.00
Chimn A iner/flue/vent
10.00
Other:
10.00
Environmental exhaust and ventilation
Range hood/other kitchen
e•ui•ment
10.00
Clothes • er exhaust
`0.00
Single-duct exhaust (bathrooms,
toilet -•• • •artmeets util rooms •
6.80
Attic/crawl • ace fans
1 0.00
Other
10.00
Fuel .1.
S5.40 for first four- 51.00 for each additional
Furnace, etc.
Gas heat . um .
_
--
Wallis - •ended/unitheater
Water heater
_
--
F — _ • lace
_
--
Barbecue
Clothes • r:
Other.
MECHANICAL PERMIT FEES;
Subtotal
Minimum permit fee ($72.50)
. D
Plan review (25% of permit fee)
State surcharge (8% of permit fee)
g. g
TOTAL PERMIT FEE
IBC " •.
ration/replacement
• New construction • ARAM]
• Demolition Q Otfiec
CATEGORY OF CONSTRUCTION
• I- and 2- family dwelling ommercia1/industrial ■ Accessory building
Q Multi - family r El Master builder • Other:
.108 SITE INFORMATION AND LOCATION
Job site address: /f4/ Sox ) �I f4 r-71 �% /lJ
* 1 '
(�
City/StatefZIP:
Suite/bldgJapt. no.:
Project name:
Cross street/directions to job site:
Subdivision:
1 Lot no.:
Tax map/parcel no.: 0 0K5 // 7) e —Qc:LS
DESCRIPTION OF WORK
f
..
R OPERTY OWNER
❑ TENANT ..
Name: " ) l-5 •f_so /9-e . 7
Address:
City/State/ZIP:
/� [� c
Phone: 3) �37 . /r 5
`/1 `�'`
Fax: ( )
0 APPLICANT
lit CONTACT PERSON
Business name:
Contact name: '] v 4 /6
/ 7 / t7
Address:
City /State/ZIP:
Phone > G�q 7'109
F ax:: 43 599 O _vf3
E -mail:
CONTRACTOR
Business name: (7 4 / zip 6 ¢ Ji,Q,4kir 69Q/`4Z
Address: h day ,, a 391
City /State/ZIP:
d/Q
, y 70�fjfJ/�
Phone:` Lo7K r7'T
2 97 ar>/
1 Fax :6 59g 7Q
CCBIie.: 74359
IVi b 'i ical Permit Ap
City of Tigard
(3125 SW Hall Blvd_, Tigard, OR 9
Phone: 503.639.4171 Fax: 503.59811960
Inspection Line: 503,639.4175
Internet www.ci.tigard.or.us
Authorized signature:
,
Print name:
i:\Building\PermicskMEC.PermitAcp.elne 12103
Z
OLIO 869
/ 0-7 A ✓ Permit No.: t/f
Received ,
Other Permit:
Plan Review
D
Date Ready/13y:
Notified/Method:
tubs ` Id See Page 2 for
Supplemental Information
vb7
440-4617T (11 /02/C0MW103)
This permit application expires if a permit is no obtained within 180
dsys after it bas been accepted as complete.
• Fee methodology set by Tri -Comity Building Industry Service Board
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