Permit r `
C CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00164
f- Date Issued: 04/14/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112BB11100
Jurisdiction: Tigard
Site address: 14258 SW FANNO CREEK LP
Subdivision: Lot: 0
Project: Hookie
Project Description: Replace existing gas furnace.
Owner: FEES
HOOKIE, ANN & JIM Description Date Amount
14258 SW FANNO CREEK LOOP Furnaces < 100K BTU 04/14/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 04/14/2010 $10.80
PHONE: 503 - 684 -1852 Minimum Fee Adjustment - Mechanical 04/14/2010 $43.25
Contractor:
COLUMBIA HEATING & COOLING INC
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: Natural Gas
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.
i
Issued By: 0 ' jI �� Permittee Signature: j r / i . 7 �G j e (9-7-70 /\/
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.
Apr 12 10 10:32a Columbia Heating /Cooling 503 - 598 -0270 p.2
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Mechanical Permit Anplicatio 5 or . , .. ',b . . va.; ... nl1 i.il. ., .
City o Tigard Datc /Bed PertttitNo.:1R-C(j)I ..--6
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ipil 'IWA A ; A PR 1 2 2 010 Deceive:
v 13125 SW ! Blvd. T OR 97223 per, Review
1 11 Phone: 503.639.4171 Fax: SO3.59B.196 Da Other Perim:
. ,, .., p C ITY OF TIGARD
e Inspection Line: 503.639.4175 Date Ready/11y: f H See Page 2 for
T ] G i � It D Supplemental Informat
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TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
0 New construction ® Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanic_al materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- fancily dwelling ❑ Commercial. /industrial ❑ Accessory building For speciel information use checklist.
0 Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: 14258 SW FANNO CREEK LOOP (regains site plan showing placement) 46.75
, City /State /ZIP: TIGARD OR 97224 Furnace 100,000 BTU (duets/vents) 1 46.75
Furnace 100,000+ BTU (duets/vents) 54.91
Suiteihldg.iapt. no.: Project name: ROOKIE Heat pump 61.06
Cross street/directions to job site: Duct work 2332
Hvdronic hot water system 23.32
Residential boiler (radiator or
h dronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct suspended, etc. 46.75
Flue/watt for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel al lances
l
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace
REPLACE EXISTING GAS FURNACE Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32 ,
Wood/pellet stove 33.39
Wood fire •lacelinsert _ 23.32
, Chimnev/liner /tlueivent 23.32
tEl PROPERTY OWNER ❑ TENANT Other: 23.32
Name: ANN AND JIM BOOKIE Environmental exhaust and ventilation _
Range hnodlother kitchen
Address: 14258 SW FANNO CREEK LOOP equipment 33.39.
City /State /ZIP: TIGARD OR 97224 Clothes drver exhaust 33.39 _
Single -duet exhaust (bathrooms,
Phone: (503)684 -1852 I Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attickrawispace fans 23.32
Other: 23.32
Business name: COLUMBIA ILF.ATING AND COOLING Fuel .i .in. _
Contact name: MARLENA S14.15 for first four, $4.03 for each additional
Furnace. etc.
Address: PO BOX 230397 Gas heat pump
City / StateiZlP: TIGARD OR 97281 WalUsuspendcd/unit heater
Fax: (503) 598 -0270 Water heater
Phone: (503) 624 2704 ( Fire place
E -mail: COLUMBHCrTELEPORT.COM Ramie
CONTRACTOR Barbecue
Clothes dryer (gas)
-
Business name: COLUMBIA HEATING AND COOLING F Other:
Address: PO BOX 230397 MECHANICAL PERMIT FEES*
Sahrota l
City/State /ZIP: TIGARD OR 97281 -.— Minimum permit fee (S90.00) . 4, crt)
'hone: (503) 624 -2704 Fax: (503) 598 -0270 Plan review (25% of permit fee)
-
/ CCR lie.: 76359 ✓ / State surcharge (12% of permit fee) /0 , jr0
TOTAL PERMIT FEE /Q p , a
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: MARLENA MEEDOM Date: 04 -12 -2010 • Fee methodology set by Tri-County Building Industry Sen Board
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